Steroid Biosynthesis Flashcards

(35 cards)

1
Q

How do you make steroid hormones from cholesterol?

A

cholesterol – desmolase –> pregnenolone –> progesterone

then either corticosteroids = aldosterone and cortisol

or sex hormones = testosterone and estradiol

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2
Q

How is progesterone related to pregnancy?

A

regulates voltage-gated Ca channels on spermatozoa

prepares uterus for implantation

causes smooth muscle relaxation

decreases maternal immune response

decrease in progesterone precedes menstruation, labor, and lactation

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3
Q

How are glucocorticoids linked to infant respiratory distress syndrome?

A

in normal-term babies: burst of glucocorticoids during delivery –> surfactant, normal lung expansion

in preterm babies, this is lost –> give mothers glucocorticoids to prevent

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4
Q

What is the significance of cortisone?

A

target tissues of mineralcorticoids have receptors w/ affinity for both gluco and mineralcorticoids

avoid excessive Na and H2O retention from cortisol by metabolizing cortisol – 11Beta-hydroxysteroid dehydrogenase –> cortisone = lower affinity

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5
Q

Why can licorice cause hypertension?

A

natural licorice has isoflavones = inhibitors of 11beta-dehydrogenase

cant convert cortisol to cortisone –> excess Na and H2O retention –> HTN

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6
Q

How is testosterone metabolized for signalling?

A

Testosterone – 5alpha-reductase –> DHT = higher affinity for T receptor, potentiates T effects

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7
Q

What does finasteride do?

A

inhibits 5alpha-reductase that converts T to DHT

used to treat male pattern baldness and benign prostate hyperplasia

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8
Q

What is CBG?

A

human corticosteroid-binding globulin

involved in the transport and release of the majority of plasma glucocorticoid hormones and also progesterone

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9
Q

What is SHBG?

A

sex hormone binding globuline

transports sex steroids (T, DHT, and estradiol)

only partially saturated in women

binding sites are mostly occupied by testosterone in men

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10
Q

How do glucocorticoids suppress the immune system?

A

induce i-KBA inhibitory protein –> sequestors NF-KB (needed for cytokines)

also promotes T cell apoptosis

decreased IL-2 and receptor –> inhibition of clonal expansion of B cells

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11
Q

What is significant about the CYP3A4 enzyme?

A

nearly 60% of all drugs are metabolized by it in the liver

have to consider interactions w/ this enzyme and how it might affect other drugs a pt is taking

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12
Q

What is significant about desmolase (cyp11A1)?

A

catalyzes cholesterol –> pregnenolone = 1st and rate limiting step of steroid synthesis

Positively regulated by ACTH

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13
Q

How does cortisol affect ACTH release?

A

negative feedback to hypothalamus and Ant pit = inhibits release

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14
Q

What are the short-term actions of ACTH?

A

stimulates lipoprotein uptake into cortical cells

increases bioavailability of cholesterol in adrenal cortex

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15
Q

What are the long-term actions of ACTH (hours)?

A

stimulation of transcription of the genes coding for steroidogenic enzymes

P450scc

11Beta-hydroxylase

associated e- transfer proteins

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16
Q

What type of receptor does ACTH bind?

17
Q

What can occur in a tumor that secretes cortisol?

A

PKA that is normally signaled by ACTH binding Gs is always active –> get too much cortisol and cell proliferation

18
Q

What in general, does cortisol do?

A

Binds and activates glucocorticoid receptor (GR)

increases gluconeogenesis and BP

anti-inflammatory

19
Q

What, in general, does aldosterone do?

A

binds and activates mineralcorticoid receptor (MR)

increases Na and H2O retention

raises BP

20
Q

What receptor does testosterone bind?

A

androgen receptor (AR)

21
Q

What do women with congenital adrenal hyperplasia present with?

A

hirsuitism

general oligomenorrhea = infrequent or very light menstruation

infertility

22
Q

What are the 3 main enzyme deficiencies that can lead to congenital adrenal hyperplasia?

A

21alpha-hydroxylase = 95%

11beta hydroxylase = 5%

17alpha-hydroxylase = unknown %

23
Q

What occurs biochemically in CAH due to mutant 11-beta-hydroxylase?

A

cant do 11-deoxycorticosterone –> corticosterone (don’t make aldosterone)

can’t do 11-deoxycortisol –> cortisol

get buildup of precursors –> excess androgen production

increased DOC –> has mineralcorticoid activity –> high BP

low K+ (bc of water retention)

24
Q

What occurs to cause hypertension in CAH w/ mutant 11-beta-hydroxylase?

A

get buildup of 11-deoxycortisol –> can bind to MR w/ high affinity –> HTN

25
What do you see clinically in CAH due to mutant 11-beta-hydroxylase?
masculinization virilization high BP low potassium
26
What occurs biochemically in CAH due to mutant 21-alpha-hydroxylase?
can't do progesterone --\> 11-DOC (can't make aldosterone) can't do 17-alpha-hydroxyprogesterone --\> 11-DOC (can't make cortisol) get buildup of precursors --\> shunted to androgen production
27
What do you see clinically in CAH due to mutant 21-alpha-hydroxylase?
low aldosterone and cortisol increased androgens --\> masculinization low BP high K
28
What occurs in CAH due to mutant 17-alpha-hydroxylase?
can't do progesterone --\> 17-alpha-hydroxyprogesterone --\> can't make cortisol buildup of progesterone --\> shifted to aldosterone synthesis
29
What do you see clinically in CAH due to mutant 17-alpha-hydroxylase?
high aldosterone low cortisol decreased androgens --\> lack of secondary sex characteristics high BP low serum K
30
where are CBG and SHBG made?
in the liver
31
What do FSH and LH do in females?
promote production of estradiola and progesterone
32
What do FSH and LH do in men?
FSH --\> stimulates inhibin production LG --\> stimulates testosterone production
33
What enzyme catalyzes Vit D3 --\> 25 OH Vit D? Where does this occur?
25-hydroxylase in the liver
34
What enzyme catalyzes 25-OH Vit D --\> 1,25 Vit D (calcitriol)? Where does this occur?
1-alpha hydroxylase in the kidneys
35
What occurs with an excess of vitamin D?
elevated blood and urine Ca dazed, loss of apepetite