Progestins, binding

Mifepristone. After oral adininistration, peak plasma levels of mifepristone (84) (RU 486) are reached in 1 h and over 95% was bound to plasma proteins (351,352). The plasma half-life of RU 486 is approximately 24 h (352,353). In humans, monodemethylated (98), didemethylated (99) and alcohoHc nondemethylated (100) metaboHtes of RU 486 have been identified (351). These metaboHtes show some progestin-binding affinity, approximately five to ten times lower than that of RU 486 itself. RU 486 and its metaboHtes can be measured by radioimmunoassay and hplc (353,354). 

In the absence of a ligand, PR is associated with a complex of heat shock proteins as a monomer in an inactivated state in the cytosol. When a progestin binds to the receptor, the overall conformation changes. Heat shock proteins are liberated, and the receptor dimerizes, enters into the cell nucleus and binds to selective progesterone-responsive elements (PREs) on the DNA to induce transcriptional activity. 

Quantitative Structure—Activity Relationships. Many quantitative stmcture—activity relationship (QSAR) studies of progestins have appeared in the Hterature and an extensive review of this work is available (174). QSAR studies attempt to correlate electronic, steric, and/or hydrophobic properties to progestational activity or receptor binding affinity. A review focusing on the problems associated with QSAR of steroids has been pubUshed (175). 

Estrogens are bound to SHBG and progestins to CBG. SHBG binds estradiol about five times less avidly than it binds testosterone or DHT, while progesterone and cortisol have little affinity for this protein (Table 42-8). In contrast, progesterone and cortisol bind with nearly equal affinity to CBG, which in turn has little avidity for estradiol and even less for testosterone, DHT, or estrone. 

Estrogen may increase hepatic production of thyroxine-binding globulin (TBG) and decrease TBG clearance, thus increasing serum total thyroxine (tT4) and, to a lesser extent, total triiodothyronine (tT3). As a result, increased tT4 and tT3 are seen in states of excessive estrogen and/or progestin, such as... 

---