Characterization of Pendrin in Urinary Extracellular Vesicles in a Rat Model of Aldosterone Excess and in Human Primary Aldosteronism


Pendrin is a Cl/HCO3 exchanger selectively present in the intercalated cells of the kidney. Although experimental studies have demonstrated that pendrin regulates blood pressure downstream of the renin-angiotensin-aldosterone system, its role in human hypertension remains unclear. Here, we analyzed the quantitative changes in pendrin in urinary extracellular vesicles (uEVs) isolated from a total of 30 patients with primary aldosteronism (PA) and from a rat model of aldosterone excess. Western blot analysis revealed that pendrin is present in dimeric and monomeric forms in uEVs in humans and rats. In a rodent model that received continuous infusion of aldosterone with or without concomitant administration of the selective mineralocorticoid receptor (MR) antagonist esaxerenone, pendrin levels in uEVs, as well as those of epithelial Na+ channel (ENaC) and Na-Cl-cotransporter (NCC), were highly correlated with renal abundance. In patients with PA, pendrin levels in uEVs were reduced by 49% from baseline by adrenalectomy or pharmacological MR blockade. Correlation analysis revealed that the magnitude of pendrin reduction after treatment significantly correlated with the baseline aldosterone-renin ratio (ARR). Finally, a cross-sectional analysis of patients with PA confirmed a significant correlation between the ARR and pendrin levels in uEVs. These data are consistent with experimental studies showing the role of pendrin in aldosterone excess and suggest that pendrin abundance is attenuated by therapeutic interventions in human PA. Our study also indicates that pendrin analysis in uEVs, along with other proteins, can be useful to understand the pathophysiology of hypertensive disorders.

Authors: Fumika Ochiai-Homma, Emiko Kuribayashi-Okuma, Yuya Tsurutani, Kenichi Ishizawa, Wataru Fujii, Kohei Odajima, Mika Kawagoe, Yoshihiro Tomomitsu, Masataka Murakawa, Shinichiro Asakawa, Daigoro Hirohama, Michito Nagura, Shigeyuki Arai, Osamu Yamazaki, Yoshifuru Tamura, Yoshihide Fujigaki, Tetsuo Nishikawa, Shigeru Shibata
Keywords: exosome, pendrin,
DOI Number: 10.1038/s41440-021-00710-5      Publication Year: 2021

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©2021 Primary Aldosteronism Foundation

The Primary Aldosteronism Foundation is a registered 501(c)(3) public charity. Donations are tax deductible in the US.