4 We also learned that a local regulatory system modifies tissue levels of cortisol to improve aldosterone selectivity 5 and that steroid receptor signaling includes rapid nongenomic effects. Novel evidence has shown that aldosterone and the RAAS can also be locally synthesized by adipose tissue. Over the last decades, our conventional understanding of aldosterone biosynthesis and signaling has been dramatically challenged. 2 Two decades after, it was described that aldosterone acted through a specific steroid receptor that was named the mineralocorticoid receptor (MR). 1 Then followed the enzymatic activity of renin and the production of angiotensin (formerly hypertensin/angiotonin) in the 1940s and the isolation of aldosterone by the Taits (formerly electrocortin) in the 1950s. Romero, in Textbook of Nephro-Endocrinology (Second Edition), 2018 1 IntroductionĪdrenal hormones from the cortex, such as cortisol and aldosterone, are essential for human life and evolved with a complex regulatory system to play a crucial role in metabolism homeostasis, stress response, and blood pressure (BP) regulation.ĭespite their importance in human physiology for millions of years, the history of the renin–angiotensin–aldosterone system (RAAS) only starts by the end of the 19th century with the discovery of renin by analyzing the effect of renal extracts on arterial pressure.
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