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This version published online on May 28, 2009
Endocrinology, doi:10.1210/en.2008-1498
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Submitted on October 24, 2008
Accepted on May 14, 2009

Low Renal Mineralocorticoid Receptor Expression at Birth Contributes to Partial Aldosterone Resistance in Neonates

Laetitia Martinerie, Say Viengchareun, Anne-Lise Delezoïde, Francis Jaubert, Martine Sinico, Sophie Prevot, Pascal Boileau, Geri Meduri, and Marc Lombès*

INSERM, U693, Le Kremlin-Bicêtre, F-94276, France; Univ Paris-Sud 11, Faculté de Médecine Paris-Sud, UMR-S693, Le Kremlin-Bicêtre, F-94276, France; Université Paris-Diderot et Assistance Publique-Hôpitaux de Paris, Hôpital Robert Debré, Service de Biologie du Développement, Paris F-75019, France; Assistance Publique-Hôpitaux de Paris, Hôpital Necker-Enfants Malades, Service d'AnatomoPathologie, Paris, F-75015, France; Centre Hospitalier Intercommunal de Créteil, Service d'AnatomoPathologie, Créteil, F-94010, France; Assistance Publique-Hôpitaux de Paris, Hôpital Antoine Béclère, Service d'AnatomoPathologie, Clamart, F-92141, France; Assistance Publique-Hôpitaux de Paris, Hôpital Antoine Béclère, Service de Pédiatrie et Réanimation Néonatales, Clamart, F-92141, France; Assistance Publique-Hôpitaux de Paris, Hôpital de Bicêtre, Service de Pharmacogénétique, Biochimie Moléculaire et Hormonologie, Le Kremlin Bicêtre, F-94275, France; Assistance Publique-Hôpitaux de Paris, Hôpital de Bicêtre, Service d'Endocrinologie et Maladies de la Reproduction, Le Kremlin Bicêtre, F-94275, France

* To whom correspondence should be addressed. E-mail: marc.lombes{at}u-psud.fr.

The human neonatal period is characterized by renal immaturity with impaired capacity to regulate water and sodium homeostasis, resembling partial aldosterone resistance. Since aldosterone effects are mediated by the mineralocorticoid receptor (MR), we postulated that this hormonal unresponsiveness could be related to low MR expression in the distal nephron. We measured aldosterone and renin levels in umbilical cord blood of healthy newborns. We used qPCR and immunohistochemistry to analyze the expression of MR and key players of the mineralocorticoid signaling pathway, during human and mouse renal development. High aldosterone and renin levels were found at birth. MR mRNA was detected in mouse kidney at day 16 postcoitum (E16), peaking at E18, but its expression was surprisingly very low at birth, rising progressively afterwards. Similar biphasic temporal expression was observed during human renal embryogenesis, with a transient expression between 15 and 24 weeks of gestation but an undetectable immunoreactive MR in late gestational and neonatal kidneys. This cyclic MR expression was tightly correlated with the evolution of the 11{beta}-hydroxysteroid dehydrogenase type 2 and the epithelial sodium channel {alpha}-subunit. In contrast, glucocorticoid and vasopressin receptors, and aquaporin 2 followed a progressive and sustained evolution during renal maturation. Our study provides first evidence for a low renal MR expression level at birth, despite high aldosterone levels, which could account for compromised postnatal sodium handling. Elucidation of regulatory mechanisms governing MR expression should lead to new strategies for the management of sodium waste in preterms and neonates.
Key words: mineralocorticoid receptor • aldosterone • renal development




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