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11-Deoxycortisol, also known as cortodoxone or compound S, is a steroid hormone that plays an essential role in the biosynthesis of cortisol. It is a glucocorticoid precursor situated in the steroidogenesis pathway, where it is directly converted from 17α-Hydroxyprogesterone by the action of the enzyme CYP21A2 and subsequently converted to cortisol by the enzyme CYP11B1. This process occurs primarily in the adrenal cortex, highlighting the importance of 11-Deoxycortisol in the body's response to stress and in the regulation of metabolism, immune response, and blood pressure.

Biosynthesis and Regulation[edit | edit source]

The biosynthesis of 11-Deoxycortisol is a critical step in the production of cortisol, which is a key hormone in the body's response to stress. The conversion of 17α-Hydroxyprogesterone to 11-Deoxycortisol is mediated by the enzyme CYP21A2, a member of the cytochrome P450 family. This step is part of the larger process of steroidogenesis, which transforms Cholesterol into various steroid hormones.

Regulation of 11-Deoxycortisol levels is closely linked to the hypothalamic-pituitary-adrenal (HPA) axis, through which the body regulates stress response. The Adrenocorticotropic hormone (ACTH) from the Pituitary gland stimulates the production of cortisol from 11-Deoxycortisol, ensuring that the body can respond to stress appropriately.

Clinical Significance[edit | edit source]

Abnormal levels of 11-Deoxycortisol can indicate issues with adrenal or pituitary function. Elevated levels may be observed in conditions such as Congenital adrenal hyperplasia (CAH), particularly in the form caused by 21-hydroxylase deficiency. In this condition, the body cannot efficiently convert 17α-Hydroxyprogesterone to 11-Deoxycortisol, leading to an accumulation of precursor steroids and a deficiency in cortisol and, often, Aldosterone.

Measurement of 11-Deoxycortisol levels can be used in the diagnosis and management of CAH and in the differential diagnosis of adrenal insufficiency. It is also used in the ACTH stimulation test to assess adrenal gland function and in the diagnosis of Cushing's syndrome.

Pharmacology[edit | edit source]

While 11-Deoxycortisol itself is not used therapeutically, understanding its role in the steroidogenesis pathway is crucial for the development of drugs that can influence cortisol levels. Inhibitors of CYP21A2 or CYP11B1, for example, can be used to manage conditions like Cushing's syndrome by reducing cortisol production.

Conclusion[edit | edit source]

11-Deoxycortisol is a vital precursor in the biosynthesis of cortisol, playing a significant role in the body's stress response and metabolic regulation. Its levels are indicative of adrenal gland function and can be used in the diagnosis and management of various endocrine disorders. Understanding its role and regulation is essential for the development of therapeutic strategies targeting cortisol-related conditions.


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Contributors: Prab R. Tumpati, MD