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11-Deoxycorticosterone (DOC), also known as cortexone, 11-deoxycorticoesterone, and desoxycorticosterone, is a steroid hormone produced by the adrenal gland that possesses mineralocorticoid activity and acts as a precursor to corticosterone. It plays a crucial role in the body's electrolyte and fluid balance by increasing sodium reabsorption and potassium excretion in the kidneys. This hormone is part of the renin-angiotensin system (RAS), which regulates blood pressure and fluid balance.

Biosynthesis[edit | edit source]

11-Deoxycorticosterone is synthesized from pregnenolone, a sterol that serves as a precursor for the synthesis of other steroids, including cortisol, aldosterone, and sex steroids. The conversion of pregnenolone to 11-Deoxycorticosterone is catalyzed by the enzyme 3β-hydroxysteroid dehydrogenase.

Function[edit | edit source]

The primary function of 11-Deoxycorticosterone is in the mineralocorticoid pathway, where it acts to regulate the balance of sodium and potassium in the body. This regulation is critical for maintaining blood pressure, blood volume, and pH balance. Although 11-Deoxycorticosterone has intrinsic mineralocorticoid activity, it is much less potent than aldosterone, the body's main mineralocorticoid. However, in certain pathological conditions, such as Congenital Adrenal Hyperplasia due to 11β-hydroxylase deficiency, 11-Deoxycorticosterone levels can become elevated, leading to hypertension and hypokalemia.

Clinical Significance[edit | edit source]

Elevated levels of 11-Deoxycorticosterone have been implicated in the development of hypertension and hypokalemia in conditions such as Congenital Adrenal Hyperplasia (CAH) due to 11β-hydroxylase deficiency. In this disorder, the enzyme deficiency leads to impaired cortisol production, resulting in compensatory overproduction of 11-Deoxycorticosterone. The excess 11-Deoxycorticosterone causes increased sodium retention and potassium excretion, leading to the development of hypertension and hypokalemia.

Pharmacology[edit | edit source]

11-Deoxycorticosterone has been used in the past as a medication in the form of its acetate ester, desoxycorticosterone acetate (DOCA), for its mineralocorticoid activity. DOCA was used to treat conditions such as Addison's disease, where there is insufficient production of adrenal steroids. However, it has largely been replaced by more effective and selective therapies.

See Also[edit | edit source]


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Contributors: Prab R. Tumpati, MD