On the binding of steroid sulfates to albumin

Update on Adrenarche-Still a Mystery

CONTEXT

Adrenarche marks the timepoint of human adrenal development when the cortex starts secreting androgens in increasing amounts, in healthy children at age 8-9 years, with premature adrenarche (PA) earlier. Because the molecular regulation and significance of adrenarche are unknown, this prepubertal event is characterized descriptively, and PA is a diagnosis by exclusion with unclear long-term consequences.

EVIDENCE ACQUISITION

We searched the literature of the past 5 years, including original articles, reviews, and meta-analyses from PubMed, ScienceDirect, Web of Science, Embase, and Scopus, using search terms adrenarche, pubarche, DHEAS, steroidogenesis, adrenal, and zona reticularis.

EVIDENCE SYNTHESIS

Numerous studies addressed different topics of adrenarche and PA. Although basic studies on human adrenal development, zonation, and zona reticularis function enhanced our knowledge, the exact mechanism leading to adrenarche remains unsolved. Many regulators seem involved. A promising marker of adrenarche (11-ketotestosterone) was found in the 11-oxy androgen pathway. By current definition, the prevalence of PA can be as high as 9% to 23% in girls and 2% to 10% in boys, but only a subset of these children might face related adverse health outcomes.

CONCLUSION

New criteria for defining adrenarche and PA are needed to identify children at risk for later disease and to spare children with a normal variation. Further research is therefore required to understand adrenarche. Prospective, long-term studies should characterize prenatal or early postnatal developmental pathways that modulate trajectories of birth size, early postnatal growth, childhood overweight/obesity, adrenarche and puberty onset, and lead to abnormal sexual maturation, fertility, and other adverse outcomes.

Cortisol and DHEA in development and psychopathology

Dehydroepiandrosterone (DHEA) and cortisol are the most abundant hormones of the human fetal and adult adrenals released as end products of a tightly coordinated endocrine response to stress. Together, they mediate short- and long-term stress responses and enable physiological and behavioral adjustments necessary for maintaining homeostasis. Detrimental effects of chronic or repeated elevations in cortisol on behavioral and emotional health are well documented. Evidence for actions of DHEA that offset or oppose those of cortisol has stimulated interest in examining their levels as a ratio, as an alternate index of adrenocortical activity and the net effects of cortisol. Such research necessitates a thorough understanding of the co-actions of these hormones on physiological functioning and in association with developmental outcomes. This review addresses the state of the science in understanding the role of DHEA, cortisol, and their ratio in typical development and developmental psychopathology. A rationale for studying DHEA and cortisol in concert is supported by physiological data on the coordinated synthesis and release of these hormones in the adrenal and by their opposing physiological actions. We then present evidence that researching cortisol and DHEA necessitates a developmental perspective. Age-related changes in DHEA and cortisol are described from the perinatal period through adolescence, along with observed associations of these hormones with developmental psychopathology. Along the way, we identify several major knowledge gaps in the role of DHEA in modulating cortisol in typical development and developmental psychopathology with implications for future research.

The importance of being dehydroepiandrosterone sulfate (in the blood of primates): a longer and healthier life?

The general aging sequence in tissues of healthy human beings is proposed to be: capillary endothelial cell damage --> arteriosclerosis --> decreased blood flow --> metabolic dysregulation --> secondary tissue damage. Molecular O2 is an obligatory substrate for the successive syntheses of 17alpha-OH pregnenolone and dehydroepiandrosterone (DHEA) by cytochrome P450c17 in the zona reticularis of the adrenal cortex, in which it is suggested that arteriosclerosis --> decreased blood flow --> O2 and glucose deficit --> decreased O2-requiring synthesis of DHEA --> eventual decrease in number of DHEA-synthesizing cells. Aging changes in the zona reticularis synergize with those in the hypothalamo-hypophyseal machinery that controls it neurally and hormonally, with ACTH-evoked pulsatile floods of cortisol coming from the adrenal zona fasciculata, with the onslaught of free radicals generated by the metabolism of catecholamines released from interdigitating cells of the adrenal medulla, and with age-correlated disabilities of erythrocytes to bind and release O2 to decrease the viability of the DHEA and dehydroepiandrosterone sulfate (DHEAS)-forming cells. One of the chief functions of serum DHEAS in the male may be to act as an allosteric facilitator of the binding of testosterone (T) to serum albumin, thereby helping target T to specific receptors and to allosteric sites for rapid and efficient action at the cellular level. There is reason to consider combining O2 therapy with appropriate administration of DHEA and T to optimize steroid functionality in the healthy aging male, and thus, possibly, to alleviate some of the age-related cognitive and physical decrements that occur.

Potentially predictive and manipulable blood serum correlates of aging in the healthy human male: progressive decreases in bioavailable testosterone, dehydroepiandrosterone sulfate, and the ratio of insulin-like growth factor 1 to growth hormone

A cross-sectional survey was made in 56 exceptionally healthy males, ranging in age from 20 to 84 years. Measurements were made of selected steroidal components and peptidic hormones in blood serum, and cognitive and physical tests were performed. Of those blood serum variables that gave highly significant negative correlations with age (r > -0.6), bioavailable testosterone (BT), dehydroepiandrosterone sulfate (DHEAS), and the ratio of insulin-like growth factor 1 (IGF-1) to growth hormone (GH) showed a stepwise pattern of age-related changes most closely resembling those of the age steps themselves. Of these, BT correlated best with significantly age-correlated cognitive and physical measures. Because DHEAS correlated well with BT and considerably less well than BT with the cognitive and physical measures, it seems likely that BT and/or substances to which BT gives rise in tissues play a more direct role in whatever processes are rate-limiting in the functions measured and that DHEAS relates more indirectly to these functions. The high correlation of IGF-1/GH with age, its relatively low correlation with BT, and the patterns of correlations of IGF-1/GH and BT with significantly age-correlated cognitive and physical measures suggest that the GH-IGF-1 axis and BT play independent roles in affecting these functions. Serial determinations made after oral ingestion of pregnenolone and data from the literature suggest there is interdependence of steroid metabolic systems with those operational in control of interrelations in the GH-IGF-1 axis. Longitudinal concurrent measurements of serum levels of BT, DHEAS, and IGF-1/GH together with detailed studies of their correlations with age-correlated functional measures may be useful in detecting early age-related dysregulations and may be helpful in devising ameliorative approaches.

Metabolic conversion of six steroid hormones by human plasma high-density lipoprotein

Sixteen different steroid hormones were individually tested in equilibrium dialysis against plasma high-density, low-density and very-low-density lipoproteins (HDL, LDL, VLDL) under physiological conditions. Six steroid hormones (androstenediol (AEDOL), estradiol (E2), dehydroepiandrosterone (DHEA), dihydrotestosterone (DHT), pregnenolone (P5), and progesterone (P4)) demonstrated metabolic interaction with HDL, particularly HDL3. In four cases (AEDOL-HDL, E2-HDL, DHEA-HDL and P5-HDL) the interaction products were more lipophilic, while in the other two cases (DHT-HDL, P4-HDL) they were hydrophilic compared to the original steroid hormone substrates. The lipophilic products appeared to be long-chain fatty acid steroid hormone esters at the C-3 position of the steroid hormone. This was confirmed, in preparative incubations, for the two strongest steroid hormone reactants (DHEA and P5) by gas chromatography-mass spectroscopy (GC-MS). Naturally occurring DHEA and P5 esters were identified in normal fresh human plasma by GC-MS, and their fatty acid compositions were similar to that of native HDL3 cholesterol esters. It was deduced that lecithin-cholesterol acyl transferase enzyme was responsible for the lipophilic type conversion activity with P5 greater than DHEA greater than AEDOL greater than E2. For DHT and P4, which exhibit a fundamentally different (hydrophilic) type of metabolic conversion, a totally different form of HDL-associated metabolic activity is indicated. These newly discovered steroid hormone-lipoprotein interactions may be important for steroid hormone processing in plasma and/or steroid hormone delivery to cells.

Biases in the assays of steroids and their binding proteins

Many immunoassays exhibit a bias. In such assays, the results are inaccurate, i.e. they deviate from the true value. The biases are mostly due to interfering compounds originating from the biological material assayed and/or from reagents. Sometimes systematic errors in calculation are also involved. The magnitude of the bias should be determined for every assay method, in order to make possible an assessment of reliability of the method. Biases frequently occur also in the measurements of steroid binding proteins, such as receptors, sex hormone binding globulin, corticosteroid binding globulin, etc. These biases are mostly due to the assumption that the measurements are performed under saturation conditions. These biases can be avoided by conducting the measurements at several concentrations of the ligand and by an appropriate correction for non-specific (low affinity) binding. In the assays of "free" steroids, biases are frequently encountered because of the disturbance of equilibrium in the course of the measurement proper. These biases can be minimized by a careful choice of experimental conditions.