Aldosterone - a bridge between cardiovascular and mood disorders?

摘要

Aldosterone is the main mineralocorticoid hormone involved in the control of blood volume. Its effects on water-electrolyte homeostasis have impact on the control of blood pressure and cardiovascular functions. It is well known that the comorbidity of cardiovascular and mental disorder is high, however, aldosterone has not been implicated in the psychopathology so far. Aldosterone is acting via mineralocorticoid receptors, which are thought to be fully occupied by glucocorticoids in the brain. We have recently provided new evidence on anxiogenic effects of chronic treatment with aldosterone in an animal model. Hyperaldosteronism was associated also with increased depression-like behaviour which was concomitant with gene expression changes in the hippocampus relevant to major depression. To challenge possible immediate therapeutic impact of these findings we evaluated the effects of a well established drug in the treatment of cardiovascular disorders, the aldosterone antagonist eplerenone. Indeed, both single and repeated treatment of rats with eplerenone decreased anxiety and induced neuroendocrine changes consistent with anxiolytic outcome. Moreover, we have demonstrated significant correlations between salivary aldosterone concentrations and trait anxiety in healthy humans, which were dependent on the gender and on the phase of the menstrual cycle in women. These finding may support a role for aldosterone in the development and course of depression or at least in some sub-types such as those linked to cardiovascular disease.