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CYP11B2 gene
Reviewed by Medicinsk Expert•Last updated: 2026-10-22•Gene

CYP11B2 gene

The CYP11B2 gene provides instructions for making the enzyme aldosterone synthase, which is critical for blood pressure regulation and fluid balance.

Normal Function

The CYP11B2 gene provides instructions for making an enzyme called aldosterone synthase (previously known as corticosterone methyloxidase). This enzyme is found in the adrenal glands, which are located on top of the kidneys. Aldosterone synthase is a member of the cytochrome P450 family of enzymes, which are involved in the formation and breakdown of various molecules within cells.

Aldosterone synthase helps produce a hormone called aldosterone. Aldosterone helps control blood pressure by maintaining proper salt and fluid levels in the body. The enzyme is involved in a series of three chemical reactions that produce aldosterone from precursor molecules: the conversion of 11-deoxycorticosterone to corticosterone, the conversion of corticosterone to 18-hydroxycorticosterone, and the conversion of 18-hydroxycorticosterone to aldosterone.

Health Conditions Related to Genetic Changes

Corticosterone methyloxidase deficiency

At least 30 CYP11B2 gene mutations that cause corticosterone methyloxidase deficiency (also known as aldosterone synthase deficiency) have been identified. These mutations lead to insufficient production of aldosterone, which impairs the kidneys' ability to reabsorb salt (sodium chloride) into the blood and release potassium in the urine. The resulting imbalance of ions leads to:

  • Nausea
  • Vomiting
  • Dehydration
  • Low blood pressure
  • Extreme tiredness (fatigue)
  • Muscle weakness

Familial hyperaldosteronism

A genetic change affecting the CYP11B2 gene causes familial hyperaldosteronism type I, a disorder that leads to high blood pressure (hypertension). This change fuses the section of the CYP11B2 gene containing instructions for making aldosterone synthase to a section of a nearby gene called CYP11B1.

The added part of the CYP11B1 gene contains a promoter region, which normally helps start the production of an enzyme called 11-beta-hydroxylase. In the fusion gene, the hormone adrenocorticotropic hormone (ACTH)—which normally triggers 11-beta-hydroxylase—abnormally triggers the production of aldosterone synthase. High levels of aldosterone synthase result in excessive aldosterone production, leading to hypertension.

Other disorders

Normal variations (polymorphisms) of the CYP11B2 gene have been associated with an increased risk of cardiovascular problems, including hypertension, stroke caused by a lack of blood flow to the brain (ischemic stroke), and a heart rhythm abnormality called atrial fibrillation in people with heart failure.

Frequently Asked Questions

Patients may present with persistent low blood pressure, fatigue, muscle weakness, vomiting, and low sodium with high potassium levels. In children, failure to thrive and dehydration are common. If these signs appear, especially with a family history of electrolyte disturbances, testing for CYP11B2 mutations is advised.
Treatment focuses on correcting electrolyte imbalances: sodium chloride supplementation to raise sodium levels and potassium‑binding agents or diuretics to lower potassium. In some cases, fludrocortisone (a synthetic mineralocorticoid) may be used to replace aldosterone activity. Blood pressure monitoring and electrolyte panels are repeated regularly.
The diagnosis involves measuring plasma aldosterone concentration and plasma renin activity; a low aldosterone-to-renin ratio suggests deficiency. Genetic sequencing of the CYP11B2 gene confirms pathogenic variants. Additional adrenal imaging may be performed to rule out other adrenal disorders.
Familial hyperaldosteronism type I is caused by a gene fusion that leads to excess aldosterone production, causing hypertension. Management includes mineralocorticoid receptor antagonists such as spironolactone or eplerenone, and in some cases surgical removal of the adrenal gland. Genetic testing for the CYP11B2–CYP11B1 fusion confirms the diagnosis.===
Source: MedlinePlus, National Library of Medicine

MedlinePlus brings together authoritative health information from the National Library of Medicine (NLM), the National Institutes of Health (NIH), and other government agencies and health-related organizations.

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