Chimeric gene formation in GRA results from an unequal crossover event. The 5' ACTH-responsive promoter region of the 11-beta-hydroxylase gene is fused to the 3' coding sequence of the aldosterone synthase gene. As a result, aldosterone synthesis is abnormally regulated by ACTH rather than by the renin-angiotensin system.
Reproduced from: Halperin F, Dluhy RG. Glucocorticoid-remediable aldosteronism. Endocrinol Metab Clin North Am 2011; 40:333. Illustration used with the permission of Elsevier Inc. All rights reserved.
