The mechanisms of differential glucocorticoid and mineralocorticoid action in the brain and peripheral tissues

Mineralocorticoids and glucocorticoids are key categories of adrenocorticosteroid hormones that mediate distinct physiological responses. While the primary role of aldosterone, the major mineralocorticoid, is in regulating sodium homeostasis, the major role of the glucocorticoids is mediating the catabolic response to stress. Over the past two decades, these adrenocorticosteroid hormones have been the subject of considerable attention due to the paradox that despite exerting greatly different physiological effects, they act through very closely related receptors and a common DNA response element. This review will examine the research focused on the mechanisms of selective adrenocorticosteroid action. In general, it has been demonstrated that differential adrenocorticosteroid action is mediated at pre-receptor, receptor, and post-receptor levels, depending on the target tissue and physiological environment. The marked neuroendocrine pathophysiologies resulting from perturbations in this complex system make it imperative that further research into mechanisms of coordination of the three levels of adrenocorticosteroid control be conducted.