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Cortexolone antagonizes development of alcohol tolerance in mice.

Mice treated with cortexolone during a period of chronic ethanol feeding displayed significantly less tolerance to a challenge dose of ethanol than mice fed ethanol but not given cortexolone. This glucocorticoid receptor blocker did not alter the hypnotic effects of ethanol in animals not previously given ethanol and no differences were found in ethanol consumption or blood ethanol levels between ethanol-fed mice receiving daily injections of cortexolone and the vehicle-injected controls. It was concluded that cortexolone interferes with the development of tolerance to ethanol.

17-Hydroxycorticosteroids↗

Postnatal course of plasma levels of adrenocortical steroids in premature infants with and without NaCl supplementation.

To assess the adrenocortical response of premature infants to alterations in sodium balance, the postnatal course of plasma progesterone, 11-deoxycorticosterone, corticosteronoe, aldosterone, 17-hydroxyprogesterone, 11-deoxycortisol, cortisol and cortisone was compared in healthy premature infants kept on low (1-2 mEq/kg per day) or high (3-5 mEq/kg per day) sodium diet. The mean birthweight (1470 g, range: 1210-1670 g vs 1410 g, range: 1130-1750 g) and mean gestational age (30.5 weeks, range: 29-32 weeks vs 30.2 weeks, range: 28-32 weeks) in the low and high sodium groups, respectively, were similar. Simultaneous steroid hormone measurements were made weekly up to the 5th week of life using mechanized Sephadex LH-20 multicolumn chromatography and standardized radioimmunoassays. It was demonstrated that in response to renal salt wasting and negative sodium balance there was a significant rise in plasma aldosterone concentration. The plasma levels of other individual corticosteroids generally declined with advancing age, the initial fall, however, was followed by a transient and insignificant but simultaneous increase in 11-deoxycortisol, cortisol, cortisone and corticosterone in prematures on low a sodium diet. This effect could be prevented by giving NaCl supplement. The NaCl-suppressible increase in adrenocortical activity may be the result of the combined effect of stress or angiotensin 11-induced adrenocorticotropic hormone (ACTH) release and/or prolactin-mediated enhanced adrenal response to ACTH.

17-alpha-Hydroxyprogesterone↗

The effects of omeprazole on endocrine function in man.

We have assessed the effect of omeprazole on various endocrine functions in man. Eight healthy subjects took 60 mg omeprazole or placebo daily for 1 week in a double-blind, randomized, cross-over study. On Day 7 basal concentrations of follicle-stimulating hormone (FSH), luteinising hormone (LH), prolactin, testosterone, thyroid-stimulating hormone (TSH), and serum thyroxine (T4) and tri-iodothyronine (T3) were measured, followed by the gonadotrophin response to luteinising hormone releasing hormone (LHRH) and the prolactin and TSH responses to thyrotrophin releasing hormone (TRH). There were no differences in basal or stimulated values between omeprazole and placebo. In a second study, a further 8 subjects were similarly treated, and on Day 7 serial measurements of cortisol and 11-deoxycortisol were made before and for 2.5 h after intravenous adrenocorticotrophin (ACTH). There were no differences in basal values or pattern of response to ACTH for either hormone. Omeprazole in clinical practice is unlikely to cause any significant interference in endocrine function.

Adult↗

o,p'-DDD (mitotane) treatment for Cushing's syndrome: adrenal drug concentration and inhibition in vitro of steroid synthesis.

o,p'-DDD is an inhibitor of adrenal steroid synthesis currently used for therapy of Cushing's syndrome. Conflicting data have been published on the relationship between the plasma level of the drug and its clinical and biological effects. The levels of o,p'-DDD and o,p'-DDE in various tissues obtained from treated patients have been measured and are compared with data on in vitro steroidogenesis in adrenal tissues from the same patients. o,p'-DDD was found in all samples and o,p'-DDE in half of them, both levels being high when the tissue lipid concentration was high. There was considerable variability in lipid content from one tissue to another and within a tissue from one sample to another; only the drug to lipid ratio seems able to provide a reproducible index of drug entry into a tissue. No relationship was found between the tissue concentration of the drug and the total dose administered or inhibition of the steroid biosynthetic step studied.

17-alpha-Hydroxyprogesterone↗

Compounds in the urinary pH 1 extract reacting with corticosteroid and tetrahydrocorticosteroid antisera. Separation of a nonpolar substance with affinity to a tetrahydroaldosterone antiserum.

In human urinary pH 1 extracts prepared for the aldosterone-18-glucuronide estimation, several other substances are present, crossreacting not only with aldosterone antisera, but also with various corticosteroid and tetrahydrocorticosteroid antisera. Aldosterone was measured before and after chromatographic purification. Further characterization of the non-aldosterone immunoreactive material was made by immunological analysis of paper chromatogram eluats. Pregnancy, and administration of ACTH, dexamethasone, and metopirone led to a change of excretion in the antigenic equivalents. A method for the separation of the antigenic material is described. For structural elucidation the gaschromatography-mass spectrometry (GC-MS) method was applied.

Adrenal Cortex Hormones↗

Delta'-dehydrogenation of steroids by Arthrobacter simplex immobilized in calcium polygalacturonate beads.

Arthrobacter simplex ATCC 6946 (viable cells) was immobilized in a calcium polygalacturonate gel. The trapped cells were used for repeated batchwise bioconversion of steroids. Reichstein's compound S and hydrocortisone were dehydrogenated introducing a double bond between C1 and C2 of ring A. The products 1-dehydro S and prednisolone, respectively, were identified by high pressure liquid chromatography. Steroid dehydrogenase activity increased in the system when an artificial electron acceptor, such as menadione (vitamin K3) was present in the reaction mixture. An airlift-type reactor was used to bioconvert up to 90% of substrate in 15 min, under optimal conditions. The gel entrapped cell preparations were used for repeated batch bioconversion during 30 days; 69 batch bioconversions for Reichstein's compound S were performed during 15 days of operation of the reactor. The operational stability of the process and the feasibility of repeated batch bioconversions was shown to be comparable to similar processes.

Arthrobacter↗

Etomidate: a selective adrenocortical 11 beta-hydroxylase inhibitor.

To investigate the adrenocortical suppression caused by the anesthetic etomidate, plasma levels of progesterone (P), 17-hydroxyprogesterone (17-OHP), 11-deoxycorticosterone (DOC), corticosterone (B), aldosterone (Aldo), 11-deoxycortisol (S), cortisol (F), and cortisone (E) were measured simultaneously before and after a short-term ACTH stimulation test in a 6.5-year-old boy whose convulsions could be kept under control only with constant etomidate infusions. During etomidate therapy, plasma levels of DOC and S were extremely elevated, the progestins P and 17-OHP were slightly elevated, whereas B and Aldo were in the lower normal range, and F and E were markedly decreased. A short-term ACTH stimulation test during etomidate infusion gave a blunted response of B, Aldo, F and E, whereas the level of DOC remained high and S even further increased. P and 17-OHP showed a positive response to ACTH. The ratios of B/DOC and F/S, which reflect adrenocortical 11 beta-hydroxylase activity, were extremely decreased during etomidate and did not change after ACTH stimulation. In contrast, the ratios of DOC/P and S/17-OHP, which reflect 21-hydroxylase activity, were elevated and remained elevated after ACTH stimulation. After discontinuation of etomidate therapy, all the baseline steroid levels were somewhat elevated, but responded normally to ACTH. These results demonstrate that etomidate causes a specific and reversible blockade of the 11 beta-hydroxylation of adrenal steroid synthesis.

17-alpha-Hydroxyprogesterone↗

Ketoconazole blocks cortisol secretion in man by inhibition of adrenal 11 beta-hydroxylase.

We investigated basal and ACTH stimulated levels of cortisol, corticosterone, 17 alpha-hydroxyprogesterone, 11-deoxycortisol and 11-deoxycorticosterone as well as plasma levels of ACTH before and during the oral administration of ketoconazole in five patients with Cushing's syndrome (3 with bilateral adrenal hyperplasia, 1 with adrenal adenoma and 1 with adrenal carcinoma) and in three controls. The influence of ketoconazole on the transformation of 3H-17 alpha-hydroxyprogesterone to 3H-11-deoxycortisol and 3H-cortisol and of 3H-11-deoxycortisol to 3H-cortisol as well as of 3H-11-deoxycorticosterone to 3H-corticosterone was also examined in slices or homogenates of normal and hyperplastic adrenal tissue from four patients. Ketoconazole induced a rise of 11-deoxycortisol and 11-deoxycorticosterone, but not of cortisol and inconsistently of corticosterone which were increased by ACTH. Thus the ratio 11-deoxycortisol/cortisol rose more after ketoconazole than after ACTH and the ratio 11-deoxycorticosterone/corticosterone rose after ketoconazole but fell after ACTH. Plasma ACTH levels were stimulated 2-50 fold by ketoconazole. Incubation studies of adrenal tissue slices with 3H-17 alpha-hydroxyprogesterone showed that ketoconazole inhibited the transformation of 3H-17 alpha-hydroxyprogesterone to 3H-cortisol but not to 3H-11-deoxycortisol so that the ratio 3H-11-deoxycortisol/3H-cortisol increased 15-80 fold. After incubation of adrenal slices with 3H-11-deoxycortisol or 3H-11-deoxycorticosterone and ketoconazole, a 2-260 fold increase of the ratios 3H-11-deoxycortisol/3H-cortisol and 3H-11-deoxycorticosterone/3H-corticosterone were also found.

17-alpha-Hydroxyprogesterone↗

Comparison of insulin hypoglycemia and short metyrapone tests in patients with pituitary disease.

In a retrospective study on 59 patients (2 hypothalamic, 44 pituitary, 13 no confirmed disease) 69 pairs of insulin hypoglycemia tests (IHT) and short metyrapone tests (SMT) were evaluated. Cortisol and 11-desoxy-cortisol rsp. were compared as the endpoints. In 6 cases, the IHT was a technical failure because of insufficient hypoglycemia. In 25% of 63 pairs of tests, both tests were normal, (Group I), in 30% both abnormal (Gr. II). In 21%, IHT was normal, SMT abnormal (Gr. III) and in 24% IHT was abnormal and SMT normal (Gr. IV). The 2 patients with hypothalamic disease were in Group IV with completely normal SMT and severely pathological IHT. Other discrepancies could not be attributed to special pituitary disorders. In 9 patients of Group III and in 8 patients of Group IV (n = 17), the IHT alone was repeated 6-48 months after the original pair of tests which had been performed in most cases early after pituitary surgery. In 12 cases, the repeat IHT followed the trend of the SMT of the original test pair. In 5 cases, the IHT was unchanged. 14 of 19 patients of Group II, but only 5 of 28 patients of Group III and IV required permanent substitution with hydrocortisone.

Blood Glucose↗

Missing effect of etomidate on testosterone secretion in man.

We studied the effect of low dosage (0.26 mg/kg as a single induction dose) and high dosage (30 mg/h for long term sedation) etomidate on serum testosterone and serum luteinizing hormone (LH) concentrations in males. During high dose etomidate we found inhibition of both 11 beta-hydroxylase and cholesterol-side-chain cleavage enzyme with unresponsiveness of progesterone, 17 alpha OH-progesterone and 11-deoxycortisol to stimulation with ACTH. However, neither high dosage nor low dosage etomidate had any influence on serum testosterone or LH concentrations. We conclude that, in contrast to other substituted imidazole derivatives, etomidate does not interfere with testicular testosterone synthesis. It therefore may be possible to find clinically useful imidazole derivatives with endocrine actions confined to either the adrenals or the testes.

17-alpha-Hydroxyprogesterone↗

Effect of cortexolone on the feedback action of dexamethasone.

Cortexolone in a dose of 1 mg/100 g body wt., administered to rats prior to dexamethasone, prevented dexamethasone from suppressing stress-induced ACTH-release without interfering with the effect of dexamethasone on the resting plasma corticosterone level.

17-Hydroxycorticosteroids↗

Effect of progesterone on human corticosteroid 21-hydroxylation.

Progesterone inhibits the 21-hydroxylation of 17alpha-hydroxyprogesterone by human adrenal cortex microsomes. The possible light this finding may shed on the genetic condition, the 'adrenogenital syndrome' is discussed. Km and Vmax data for the above hydroxylation reaction are given.

Adrenal Cortex↗

In vitro precocious accumulation of calcium and matrix vesicles formation in young cartilage cells: specific effects of corticosteroids.

The present study examined the effects of various corticosteroid and noncorticosteroid hormones upon the ultrastructure of chondroprogenitor cells and chondroblasts in an organ-culture system of late fetal condylar cartilage. Corticosteroids, (triamcinolone acetonide, dexamethasone, corticosterone) at concentrations of 10(-6) - 10(-8)M stimulated markedly a precocious formation of matrix vesicles by chondroblasts. This stimulation was accompanied by a significant accretion of calcium complexes intra- and extracellularly in both the chondroprogenitor cell population and chondroblasts in vitro, as well as in the newly induced matrix vesicles. Nonglucocorticoid steroids (progesterone, estradiol, testosterone, cortexolone) did not evoke similar effects. Progesterone and testosterone, however, seemed to adversely affect the ultrastructure of the cartilage cells, whereas estradiol appeared to have a favorable effect on the morphology of cultured condylar cartilage.

Adrenal Cortex Hormones↗

In vitro glucocorticosteroid and mineralocorticosteroid biosynthesis in Conn's adenoma tissues.

The in vitro metabolism of [1,2-3H] deoxycorticosterone (DOC), [1,2-3H] 18-hydroxy-11-deoxycorticosterone (18-OHDOC) and [1,2-3H] 11-deoxycortisol (S) was studied in adrenal adenoma homogenates from patients with primary hyperaldosteronism. Tumor tissues actively converted deoxycorticosterone and 18-hydroxy-11-deoxycorticosterone to 18-hydroxycorticosterone and aldosterone. Yields of cortisol and cortisone were also large showing that the tissues did not lack the zona fasciculata-like 11 beta-hydroxylation ability.

18-Hydroxycorticosterone↗

Serum 21-deoxycortisol and 17-hydroxypregnenolone in parents of patients with congenital adrenal hyperplasia.

The response of serum 21-deoxycortisol (21-DF), 17-hydroxypregnenolone (17-OHPE), 11-deoxycortisol and cortisol to iv ACTH, was compared in 14 adult controls ane and post stimulation concentrations of hormones were similar in controls and parents, except for those of 21-DF, which were significantly greater in heterozygotes 30 min (p less than 0.005), 60 min (p less than .0025) and 90 min (p less than 0.005) after stimulation with ACTH. When rates of increase were determined, those of 21-DF at 30, 60 and 90 min were significantly higher in the parents. Sixteen of the 26 parents (62%) had a rate of increase of 21-DF from 0 to 60 min greater than the mean plus two standard deviations of the control group. Using this same criteria, 11 of the 13 mothers (85%) of affected children could be identified as heterozygotes. The rate of increase of 21-DF from 0 to 60 min following ACTH provides a method for the detection of some heterozygote carriers of congenital adrenal hyperplasia and may be useful particularly in the identification of female carriers.

17-Hydroxycorticosteroids↗

Short-term kinetics of serum adrenal steroids and plasma ACTH after a single dose of metyrapone in man.

The in vivo influence of metyrapone (M) on different adrenal enzymes has been studied by simultaneous measurement of serum progesterone (P), 17-hydroxyprogesterone (17-OHP), deoxycorticosterone (DOC), corticosterone (B), deoxycortisol (S), 18-hydroxydeoxycorticosterone (18-OHDOC), aldosterone and cortisol (F) as well as by the measurement of plasma ACTH before and after oral administration of 40 mg of M/kg at 08:15 in four healthy male subjects. The well known inhibitory effect of M on adrenal 11-hydroxylase is demonstrated by a decrease of serum F and B and synchronous increase of serum S and DOC after administration of M. The additional inhibition of 18-hydroxylase by M is documented by a decrease of serum 18-OHDOC in spite of a marked increase of serum DOC after M. The moderate increase of serum P and 17-OHP soon after drug administration, although plasma ACTH is highly elevated at this time, as well as the marked increase of these steroids in the afternoon synchronously to a rise of serum F and B suggest a further inhibitory effect of M on the enzyme prior to the total corticosteroid biosynthesis. This effect of M should be taken into account if ACTH activity is monitored in terms of adrenal steroid output in the metyrapone test.

Adrenal Cortex↗