Rapid Immunoassay for Pregnenolone Sulfate and Its Applications in Endocrinology

Determination of 17alpha-hydroxypregnenolone sulfate and its application in diagnostics

New combined radioimmunoassay for determination of 17-hydroxypregnenolone sulfate (17-PregS) involving the hydrolysis of analyte by methanolysis was developed. 17-PregS, in addition to being secreted by the adrenals, is also formed by peripheral sulfoconjugation of 17-hydroxypregnenolone (17-Preg) or directly by hydroxylation of pregnenolone sulfate with 17alpha-hydroxylase/C17-20lyase. The measurement of 17-PregS can be used as a tool for detection of enzymatic deficiency particularly in pregnancy and for detection of congenital adrenal hyperplasia or gonadal dysfunction. The serum levels of 17-PregS, 17-Preg, dehydroepiandrosterone, dehydroepiandrosterone sulfate, pregnenolone and pregnenolone sulfate were measured in different age groups of human and in pregnant women respecting the age of gestation. The levels of 17-PregS are approximately three times higher than the levels of free 17-Preg in all subject groups. The levels of 17-PregS during pregnancy reached the local minimum in the 3rd month of gestation. The ratio of 17-PregS to free 17-Preg showed increasing profile during pregnancy with a maximum in the 8th month of gestation. These findings indicate that, the conversion of pregnenolone sulfate to 17-PregS is the major metabolic pathway for biosynthesis of 17-PregS.

Reinstatement of serum pregnanolone isomers and progesterone during alcohol detoxification therapy in premenopausal women

BACKGROUND

Alcohol abuse is associated with menstrual irregularities related to the inhibition of progesterone secretion involved in regulation of the menstrual cycle. Reduced progesterone metabolites, including pregnanolone isomers (PIs), are efficient neuromodulators. The authors attempted to evaluate whether levels of PIs reflect impairment in progesterone biosynthesis in premenopausal women treated for alcohol addiction and whether alcohol detoxification therapy contributes to the restoration of their reproductive functions and psychosomatic stability by influencing steroid biosynthesis.

METHODS

Serum allopregnanolone (3alpha-hydroxy-5alpha-pregnan-20-one; P3alpha5alpha), pregnanolone (P3alpha5beta), isopregnanolone (P3beta5alpha), epipregnanolone (P3beta5beta), progesterone, pregnanolone sulfate (PregS), pregnanolone, and estradiol were measured in 20 women during therapy (at start, three days, 14 days, one month, and four months) by gas chromatography-mass spectrometry or radioimmunoassay. The results were evaluated by a linear mixed model for longitudinal data, with stage of the treatment and subject as categorical factors, phase of the menstrual cycle as a time-varying covariate, and age of the subject as a covariate and by regression in individual stages of the menstrual cycle.

RESULTS

During detoxification treatment, progesterone increased in the luteal phase. P3alpha5alpha, P3beta5alpha, and P3beta5beta rose in both phases of the menstrual cycle.

DISCUSSION

Given the similar mechanism in the effects of alcohol and steroids in activating gamma-aminobutyric acid A receptors, the restoration of progesterone and PIs during therapy could be explained by an adaptation to increasing requests for gamma-aminobutyric acid A-receptor activating substances owing to the cessation of alcohol intake or by the regeneration of progesterone formation. In conclusion, the reinstatement of progesterone, P3alpha5alpha, and P3beta5beta serum levels demonstrates the favorable effect of detoxification therapy on both reproductive functions and the psychosomatic stability of premenopausal women treated for alcohol addiction.