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Adrenal steroids such as glucocorticoids and mineralocorticoids are commonly used as treatments in diseases such as Congenital adrenal hyperplasia. [2] CAH commonly causes overproduction of androgens, glucocorticoid treatment is used to reduce Adrenocorticotropic hormone (ACTH) and reduce the production of androgens allowing for symptoms of CAH to be managed though treatment is required to be ...
If CAH is caused by the deficiency of the 21-hydroxylase enzyme, then treatment aims to normalize levels of androstenedione, but normalization of 17α-hydroxyprogesterone is a sign of overtreatment. [32] Treatment can be monitored by measuring androstenedione and 17α-hydroxyprogesterone levels in blood or saliva. [32]
Serum levels of 17OHP, testosterone, androstenedione, and other adrenal steroids are followed for additional information, but may not be entirely normalized even with optimal treatment. As regular monitoring is needed, patients can be monitored non-invasively by measuring 17OHP and androstenedione in saliva. [ 211 ] (
The enzyme itself is attached to the smooth endoplasmic reticulum of the steroid-producing cells of the adrenal cortex and gonads. CYP17A1 functions as both a 17α-hydroxylase and a 17,20-lyase. The dual activities mediate three key transformations in cortisol and sex hormone synthesis: [citation needed]
DHEA and other adrenal androgens such as androstenedione, although relatively weak androgens, are responsible for the androgenic effects of adrenarche, such as early pubic and axillary hair growth, adult-type body odor, increased oiliness of hair and skin, and mild acne.
The adrenal cortex is the outer region and also the largest part of the adrenal gland. It is divided into three separate zones: zona glomerulosa, zona fasciculata and zona reticularis. Each zone is responsible for producing specific hormones. It is also a secondary site of androgen synthesis. [2]
Because 11β-hydroxylase activity is not necessary for the production of sex steroids (androgens and estrogens), the hyperplastic adrenal cortex produces excessive amounts of DHEA, androstenedione, and especially testosterone. These androgens produce effects that are similar to those of 21-hydroxylase deficient CAH.
Dehydroepiandrosterone (DHEA) is a steroid hormone produced in the adrenal cortex from cholesterol. [5] It is the primary precursor of both the androgen and estrogen sex hormones. DHEA is also called dehydroisoandrosterone or dehydroandrosterone. Androstenedione (A4) is an androgenic steroid produced by the testes, adrenal cortex, and ovaries.