Adrenocortical steroids mineralocorticoids

Adrenocortical hormone (Section 27.6) A steroid hormone secreted by the adrenal glands. There are two types of adrenocortical hormones mineralocorticoids and glucocorticoids. 

Adrenocortical steroids are used for their action on specific cancers and also to treat some of the complications of cancer, e.g. hypercalcaemia, raised intracranial pressure. Their principal use is in cancer of the lymphoid tissues and blood. In leukaemias they may also reduce the incidence of complications such as haemolytic anaemia and thrombocytopenia. A glucocorticoid is preferred, e.g. prednisolone, as high doses are used and mineralocorticoid actions are not needed and cause fluid retention. 

Mineralocorticoid refers to those steroids that regulate salt homeostasis (sodium conservation and potassium loss) and extracellular fluid volume.Aldosterone is the most potent naturally occurring mineralocorticoid and is synthesized exclusively in the zona glomerulosa region of the adrenal cortex. This zone uniquely contains the enzyme aldosterone synthase, an obligatory enzyme in the synthetic pathway to aldosterone. Other adrenocortical steroids that have mineralocorticoid properties with varying degrees of potency include DOC, 18-hydroxy-DOC, corticosterone,... 

It has been emphatieally and logieally determined to elassify the steroidal hormone products belonging speeifically to the adrenal cortex (z.e., adrenocortical steroids) into two major groups the corticosteroids (viz., glucocorticoids and mineralocorticoids, which essentially possess 21 C-atoms, and the androgens having 19 C-atoms. 

In general, the adrenocortical steroids (or adrenal corticosteroids) distinctly differ in their respective glucocorticoid activities i.e., carbohydrate-regulating), and mineralocorticoid activities (i.e., electrolyte-regulating). It has been observed that in human beings the following two compounds occur commonly ... 

Desoxycorticosterone is a mineralocorticoid belonging to the class of adrenocortical steroid. Dose Adult IM 10 to 20 mg (once or twice per week) sub-lingual (SL) 0.25 mg. 

Adrenocortical steroid hormones which influence sodium and potassium transport across cell membranes. This is particularly important in the renal tubules where they promote sodium reabsorption and potassium excretion. Aldosterone is the main adrenal mineraldcorticoid. 11-Deoxycorticosterone and 11-deoxycortisol also have mineralocorticoid activity. 

Pharmacology The naturally occurring adrenal cortical steroids have both anti-inflammatory (glucocorticoid) and salt-retaining (mineralocorticoid) properties. These compounds are used as replacement therapy in adrenocortical deficiency states and may be used for their anti-inflammatory effects. 

The steroidal nature of adrenocortical hormones was established in 1937, when Reichstein synthesized desoxycorticosterone. Eventually it was clearly established that the adrenal cortex elaborated a number of hormones and that these compounds differed in their amount of inherent metabolic (glucocorticoid) and electrolyte regulating (mineralocorticoid) activity. The actions of these hormones extend to almost every cell in the body. In humans, hydrocortisone (cortisol) is the main carbohydrate-regulating steroid, and aldosterone is the main electrolyte-regulating steroid. 

The remaining steroid lipids constitute two main classes of steroid hormones sex hormones and adrenocortical hormones. The sex hormones include androgens (testosterone, androsterone), estrogens (estrone, estradiol), and progestins (progesterone). The adrenocortical hormones include mineralocorticoids (aldosterone) and glucocorticoids (hydrocortisone). 

This compound, a potent steroid with both glucocorticoid and mineralocorticoid activity, is the most widely used mineralocorticoid. Oral doses of 0.1 mg two to seven times weekly have potent salt-retaining activity and are used in the treatment of adrenocortical insufficiency associated with mineralocorticoid deficiency. These dosages are too small to have important anti-inflammatory or antigrowth effects. 

The short-term action of ACTH on the adrenocortical cell is the stimulation of the conversion of cholesterol to glucocorticoid, mineralocorticoid or androgen-precursor steroids (Fig. 2). The conversion of cholesterol to the end-product steroids involves two mitochondrial cytochrome P-450 enzymes, cytochrome P-450scc (cho-... 

The adrenal cortex (AC) produces the glucocorticoid cortisol (hydrocortisone) in the zona fasciculata and the mineralocorticoid aldosterone in the zona glomerulosa. Both steroid hormones are vitally important in adaptation responses to stress situations, such as disease, trauma, or surgery. Cortisol secretion is stimulated by hypophyseal ACTH aldosterone secretion by angiotensin II in particular (p. 128). In AC failure (primary adrenocortical insuf ciency, Addison disease), both cortisol and aldosterone must be replaced when ACTH production is deficient (secondary adrenocortical insuf ciency), cortisol alone needs to be replaced. Cortisol is effective when given orally (30 mg/day, 2/3 a.m 1 /3 p.m.). In stress situations, the dose is raised 5- to 10-fold. Aldosterone is poorly effective via the oral route instead, the mineralocorticoid fludrocortisone (0.1 mg/day) is given. 

DE Avalos, S.V., Lima, C., Martin, C., Lederkremer, R.M., and Vila, M.C. ACTH-mediated glucocorticoid and mineralocorticoid production is inhibited by an inositolphosphoglycan and a glyco-sylphosphatidylinositol-phospholipase C is activated by the hormone in mammalian adrenocortical cells. Steroids, 1998,... 

Steroid hormones (Section 21.8) are produced by the adrenal cortex and the gonads (testes in males, ovaries in females). The adrenocortical hormones include glucocorticoids, which affect carbohydrate metabolism, modulate inflammatory reactions, and are involved in reactions to stress. The mineralocorticoids control the level of excretion of water and salt by the kidneys. If the adrenal cortex does not function adequately, one result is Addison s disease, characterized by hypoglycemia, weakness, and increased susceptibility to stress. This disease is eventually fatal unless it is treated by administration of mineralocorticoids and glucocorticoids to make up for what is missing. The opposite condition, hyperfunction of the adrenal cortex, is frequently caused by a tumor of the adrenal cortex or of the... 

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