11-BETA HYDROXYSTEROID DEHYDROGENASE TYPE-2 ENZYME IS EXPRESSED IN NORMOTENSIVE AND HYPERTENSIVE PATIENTS WITH RENAL-DISEASE

The enzyme 11 beta hydroxysteroid dehydrogenase type 2 (11 beta HSD2) converts glucocorticoids to their 11-keto metabolites, permitting bind ing of aldosterone to the non-selective mineralocorticoid receptor. Re cent studies have suggested that 11 beta HSD deficiency may be implica ted in essential hypertension and renal disease. Using an antibody aga inst a peptide deduced from the cDNA sequence, the renal expression of 11 beta HSD2 was examined in patients with advanced stages of renal d isease and associated hypertension, patients with primary hypertension resulting in renal damage, and patients with preserved or mildly dama ged renal architecture without concomitant hypertension. Despite varia ble degrees of tubulointerstitial damage, 11 beta HSD2 was expressed i n distal convoluted tubules and collecting ducts in all patient groups . Collapsed tubules retained strong immunoreactivity, but decreased st aining was apparent in dilated tubules. There was weak staining of the thick ascending limb of Henle. Variable glomerular expression of 11 b eta HSD2 was observed. Our results therefore suggest that absence of r enal 11 beta HSD2 is not a prominent feature of hypertensive nephroscl erosis, or primary renal disease associated with hypertension.