The role of endothelial cell products in the regulation of adrenocortical function: actions of endothelin, nitric oxide, adrenomedullin and PAMP.

There is evidence to suggest that the cells of the vascular endothelium secrete factors, including endothelin-1, nitric oxide, adrenomedullin and PAMP which have a role in regulating adrenal function. There is strong evidence from many studies that each of these factors is able to affect aldosterone secretion, with much less evidence relating to glucocorticoid secretion. The recent evidence suggests that both adrenomedullin and PAMP, like endothelin-1, stimulate aldosterone secretion. The controversies surrounding this issue are discussed. What emerges most strongly from the literature, however, is the evidence that, in addition to being secreted by the vascular endothelium of the adrenal, the peptides endothelin-1 and adrenomedullin are produced within the zona glomerulosa cells themselves, suggesting an autocrine as well as a paracrine role in the regulation of zona glomerulosa function and aldosterone secretion.