1998 Fiscal Year Final Research Report Summary
APPLIED STUDY OF SCREENING SYSTEM FOR ADRENOCORTICAL HYPERTENSION
| Project/Area Number |
09557128
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| Research Category |
Grant-in-Aid for Scientific Research (B)
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| Allocation Type | Single-year Grants |
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| Section | 展開研究 |
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| Research Field |
Urology
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| Research Institution | HOKKAIDO UNIVERSITY |
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Principal Investigator |
CHIBA Hitoshi Medical Hospital, Hokkaido Univ., Lecturer, 医学部・附属病院, 講師 (70197622)
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| Co-Investigator(Kenkyū-buntansha) |
MATSUMORI Shigeru Kyowa Medex Co., Ltd., Chief Scientist, 研究所, 主任研究員
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| Project Period (FY) |
1997 – 1998
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| Keywords | hypertension / adrenal / 18-hydroxycortisol / immunoassay / aldosteronism / screening / chemiluminescence |
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| Research Abstract |
We established a monoclonal antibody-based chemiluminescent immunoassay for 18-hydroxycortisol, using chemically synthesized 18-hydroxycortisol and its acridinium ester-conjugate, in order to detect patients with primary aldosteronism (adenoma) and hereditary glucocorticoid-remediable aldosteronism. This system enabled measuring 0.1 to 10 ng steroid per tube, or 2 to 200nglml in serum) in 15 minutes. We also developed a filter paper-based immunoassay and also a gel matrix-based immunoassay for convenient bed-side measurement. Serum 18-hydroxycortisol levels in patients with primary aldosteronism were 10.6 * 3.5 ng/ml, and were lowered below 2 ng/ml after adrenalectomy. Urinary 18-hydroxycortisol in patients with hypertension (n=261) were screened for 18-hydroxycortisol by measuring the steroid in spot urine samples, and two with the highest 18-hydroxycortisol levels were diagnosed as primary aldosteronism (0.8%). Glucocorticoid-remediable hyperaldosteronism was not found in this study, suggesting its low frequency in Japan. However, a high urinary 18-hydroxycortisol was demonstrated in an established family with glucocorticoid-remediable hyperaldosteronism. We conclude that our chemiluminescent immunoassay for 18-hydroxycortisol is useful for screening adrenocortical hypertension.
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