In conclusion, the analysis of apoptosis provides new aspects of normal adrenal zonation and allows the differentiation between normal and neoplastic adrenal cortex although the differentiation between malignant and benign neoplasms requires further markers. The human adrenocortical tumour cell line, NCI-H295, secretes steroids on the mineralocorticoid, glucocorticoid and adrenal androgen pathways. The NCI-H295R cell line therefore serves as a useful model for investigation of the differential regulation of the steroidogenic pathways in the human adrenal cortex. Nuclear fragmentation, morphologically confirmed at electron microscopy, showed a 4-fold increase after exposure to taxol. Taxol is an effective cytotoxic and antiproliferative agent in a human adrenocortical steroid-secreting carcinoma cell line.
Apoptosis induced by the drug is involved in neoplastic cell death.
Recent evidence suggests that insulin is mitogenic on the adrenal cortex and stimulates adrenocortical tumor formation. All 13 patients were insulin resistant. To further investigate the potential role of insulin we examined its effects on the NCI-h295 cell line. Insulin stimulates adrenal cancer cell lines in vitro. We propose that adrenal incidentalomas are a newly recognized manifestation of the metabolic syndrome comparable to insulin-mediated stimulation of the ovary in the polycystic ovary syndrome.