Dr Jun Yang, MBBS FRACP PhD, Research Scientist, Cardiovascular Endocrinology

Dr Jun Yang is a Research Scientist within the Cardiovascular Endocrinology Group at Hudson Institute, a Consultant Endocrinologist at Monash Health and a Senior Postdoctoral Fellow in the School of Clinical Sciences at Monash University.

She undertook PhD studies with Dr Morag Young, Dr Colin Clyne and Professor Peter Fuller at Prince Henry’s Institute of Medical Research, now Hudson Institute, from 2008-2013. Her PhD thesis, entitled ‘Mineralocorticoid receptors (MR): mechanisms of ligand- and tissue-specific activation’, identified and characterised novel coregulators of the MR using a novel phage display technique in addition to cell culture work and gene expression assays. This work identified four novel coregulators that interacted with the MR in a context-specific manner, and was published in the journal, Molecular Endocrinology.

Since completing her PhD, Dr Yang has continued to work on coregulator discovery. In particular, as the Cardiovascular Endocrinology group has shown that MR in macrophages is a key determinant of the macrophage proinflammatory state, she is working to identify macrophage-specific MR coregulators with the ultimate aim of developing a tissue-selective MR modulator that can alter the macrophage proinflammatory state without affecting epithelial MR activity. This would offer protection from cardiac fibrosis and failure without causing hyperkalemia.

In addition to laboratory-based research, Dr Yang established the Endocrine Hypertension Service at Monash Health with Prof Fuller. She developed the guidelines for the management of primary aldosteronism (PA), coordinated inter-disciplinary research between the Departments of Interventional Radiology, Pathology, Cardiology, Respiratory Medicine, and Endocrinology, and collaborated with research groups in Perth, China, Italy, the Netherlands and the USA. A range of projects have stemmed from these collaborations, including investigation of

  • Techniques to improve the success and accuracy of adrenal vein sampling
  • Confirmatory tests that can accurately diagnose PA as well as predict the subtype of PA
  • 24-hour blood pressure parameters that can better characterise PA
  • The relationship between obstructive sleep apnoea and PA;
  • The prevalence of PA in patients newly diagnosed with hypertension
  • Transcriptomic profiling of patient samples to identify biomarkers of PA.

In December 2018, Dr Yang also formed the Primary Aldosteronism Centre of Excellence (PACE). PACE is built on existing collaborations and led by internationally respected clinician-scientists in PA-related research in Australia, including Prof Peter Fuller from Hudson Institute of Medical Research/Monash Health, Prof Michael Stowasser and Dr Martin Wolley from Queensland University, who have published extensively in the field and set the standards for PA management in Australia. PACE also has the support of world leaders in cardiovascular endocrinology, resistant hypertension research and cardiovascular epidemiology, Dr Morag Young (Hudson Institute), Prof Markus Schlaich (University of Western Australia), Prof Trevor Mori (University of Western Australia) and Prof Christopher Reid (Curtin University); prominent primary care health services researcher, Prof Grant Russell (Monash University); and a senior biostatistician, Dr StellaMay Gwini (Monash University/Barwon Health). This inter-disciplinary and trans-national collaboration will allow the team to optimise capacity in the field of PA research and address knowledge gaps using a systematic and evidence-based approach. Discovery science will be woven into the fabric of clinical practice where mechanisms from preclinical models and molecular pathology will be translated into improved patient care.

By developing a clinical service with an embedded research component that is supported by a capable team of committed academics, clinicians and scientists, Dr Yang strives to enhance the culture of ‘bedside to bench, and vice versa’ translational medicine, and allow the integration of cutting edge science into day-to-day healthcare.

Endocrine Hypertension Service

The Hudson Institute/Monash Health Endocrine Hypertension Clinic offers a referral service for hypertensive patients with a suspected endocrine cause. It is led by Dr Jun Yang and offers rapid access to 24-hour ambulatory blood pressure monitoring (usually same day) and comprehensive evaluation for secondary causes of hypertension. There is no cost to the patient.

The clinic has the capacity to review patients frequently for medication adjustments and blood pressure monitoring during the diagnostic process. Diagnostic tests such as the saline suppression test and adrenal vein sampling can be promptly arranged for patients being investigated for primary aldosteronism.

The clinic actively engages the referring clinicians and patients in clinical research so as to better understand the prevalence, cause, diagnosis and treatment of primary aldosteronism.

Referral guidelines

Appropriate patients to be seen at the Endocrine Hypertension Clinic may include those with

  • Newly diagnosed hypertension and an abnormal aldosterone:renin ratio (ARR>70)
  • BP>150/100;
  • Refractory hypertension (BP>140/90 despite three antihypertensives, or controlled BP<140/90 on four or more antihypertensives)
  • Spontaneous or diuretic-induced hypokalemia
  • Adrenal incidentaloma
  • Sleep apnoea
  • A family history of early-onset hypertension or strokes at age<40 years
  • A first-degree relative with primary aldosteronism.

Location

The Endocrine Hypertension Clinic is located in the Department of Endocrinology, on Level 3, Block E, Monash Medical Centre.  One-hour parking is available on Wright Street, with entry via a walkway directly opposite 18 Wright Street.

Fax referrals to (03) 9594 3558
e: elise.forbes@hudson.org.au
t: (03) 8572 2515

Selected publications

  • Wu S, Yang J, Song Y, He W, Ying S, Yang S, Luo R, Hu J, Li Q (2019) Confirmatory Tests for the Diagnosis of Primary Aldosteronism: A Systematic Review and Meta-analysis. Clinical Endocrinology DOI: 10.1111/cen.13943

  • Fuller PJ, Yang J, Young MJ (2019) Mechanisms of mineralocorticoid receptor signaling. In: Vitamins and Hormones, Volume 109 Chapter 3; Litwack G (Editor), Academic Press, Elsevier

  • Jiang XL, Quan X, Zhou XL, Yang J, Hu AH, Zhang YQ (2019) Electrocardiographic criteria for the diagnosis of abnormal hypertensive cardiac phenotypes. The Journal of Clinical Hypertension DOI: 10.1111/jch.13486

  • Laurent I, Astere M, Zheng F, Chen X, Yang J, Cheng Q, Li Q (2018) Adrenal venous sampling with or without adrenocorticotropic hormone stimulation: A meta-analysis. The Journal of Clinical Endocrinology and Metabolism DOI: 10.1210/jc.2018-01324

  • Lim YY, Shen J, Fuller PJ, Yang J (2018) Current pattern of primary aldosteronism diagnosis – Delayed and complicated. Australian Journal of General Practice 47(10):712-718

  • Yang J, Funder JW (2018) Setting up a primary aldosteronism program: an Australian experience. Chinese Journal of Endocrinology and Metabolism 34(6):451-459

  • Yang J, Fuller PJ, Stowasser M (2018) Is it time to screen all patients with hypertension for primary aldosteronism? The Medical Journal of Australia 209(2):57-59

  • Hashimura H, Shen J, Fuller PJ, Chee NYN, Doery JCG, Chong W, Choy KW, Gwini S, Yang J (2018) Saline suppression test parameters may predict bilateral subtypes of primary aldosteronism. Clinical Endocrinology (Oxford) 89(3):308-313

  • Fuller PJ, Yang J, Young MJ (2017) 30 YEARS OF THE MINERALOCORTICOID RECEPTOR: Coregulators as mediators of mineralocorticoid receptor signalling diversity. Journal of Endocrinology 234(1):T23-T34 [Review]

  • Yang J, Shen J, Fuller PJ (2017) Diagnosing endocrine hypertension: a practical approach. Nephrology (Carlton) 22(9):663-677 [Review]

  • Yang J, Young MJ (2016) Mineralocorticoid receptor antagonists – pharmacodynamics and pharmacokinetic differences. Current Opinions in Pharmacology 27:78-85

  • Teng J, Hutchinson ME, Doery JC, Choy KW, Chong W, Fuller PJ, Yang J (2015) Role of adrenal vein sampling in primary aldosteronism: the Monash Health experience. Internal Medicine Journal 45(11):1141-1146

  • Yang J, Fuller PJ, Shibata H, Clyne CD, Young MJ (2015) Gemin4 functions as a coregulator of the mineralocorticoid receptor. Journal of Molecular Endocrinology 54(2):149-60

  • Fuller PJ, Yang J, Young MJ (2015) Corticosteroid receptors. In: Nuclear Receptors: From Structure to the Clinic, Chapter 2; McEwan IJ and Kumar R (Editors), Springer International Publishing, Switzerland

  • Yang J, Fuller PJ, Morgan J, Shibata H, McDonnell DP, Clyne CD, Young MJ (2014) Use of phage display to identify novel mineralocorticoid receptor-interacting proteins. Molecular Endocrinology 28(9):1571-1584

  • Yang J, Fuller PJ (2012) Interactions of the mineralocorticoid receptor – Within and without. Molecular and Cellular Endocrinology 350:196-205 [Review]

  • Fuller PJ, Yao YZ, Yang J, Young MJ (2011) Mechanisms of ligand specificity of the mineralocorticoid receptor. Journal of Endocrinology 213:15-24

  • Yang J, Safi R, Chang C, Fuller PJ, McDonnell DP, Clyne CD, Young MJ (2011) Identification of ligand-specific peptide antagonists of the mineralocorticoid receptor using phage display. Molecular Endocrinology 25(1):32-43

  • Yang J, Young MJ (2009) The mineralocorticoid receptor and its coregulators. Journal of Molecular Endocrinology 43(2):53-64 [Review]