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Dynamic appearance of [4-14C] dehydroepiandrosterone and [7 alpha-3H] dehydroepiandrosterone sulphate metabolites in urine of normal and obese female subjects.

[4-14C]-Dehydroepiandrosterone and [7 alpha-3H]-Dehydroepiandrosterone sulphate were injected simultaneously to normal and obese female subjects. The percentage recovery of 14C and 3H radioactivies in dehydroepiandrosterone sulphate, androsterone sulphate, etiocholanolone sulphate, androsterone glucuronoside and etiocholanolone glucuronoside was determined in the day-to-day urine collections for 72 hr. Results showed a normal total 3H recovery and a poor 14C recovery in urinary conjugates of obese patients. The rate of appearance of 3H activity was not identical in the individual metabolites of normal subjects, and it was not normal in obesity. Overweight subjects exhibited an acceleration in [7 alpha-3H]-Dehydroepiandrosterone sulphate metabolism to androsterone glucuronoside. The observation regarding the rate of appearance of urinary conjugates bearing 14C isotope correlate with our previous finding in which a glandular overproduction of free dehydroepiandrosterone was found and an uptake of this steroid by the adipose tissue was suggested. Our results showed that the poor recovery of 14C radioactivity in urine of obese female subjects was not an aspecific consequence of illness.

Adult

Synthesis of dehydroepiandrosterone and dehydroepiandrosterone sulphate by the human adrenal.

The role of pregnenolone sulphate in adrenal steroid biosynthesis and the ability of the human adrenal gland to synthesize and secrete dehydroepiandrosterone (DNA) and dehydroepiandrosterone sulphate (DHA sulphate) was investigated. The presence of pregnenolone sulphate and DHA sulphate was demonstrated by measuring their concentrations in human adrenal tissue. Pregnenolone sulphate was metabolized in vitro mainly to free steroids, including DHA and cortisol, as well as directly to DHA sulphate in some cases. Similar results were obtained upon perfusion of the adrenal gland in situ with [14C]pregnenolone and [13H]prenenolone sulphate as the substrates and isolating the metabolites from the adrenal venous blood. Dehydroepiandrosterone sulphate was derived mainly from the sulphation of free DHA. The hydrolysis of DHA sulphate did not appear to make a significant contribution to the amounts of DHA synthesized under these conditions. The adrenal secretion of DHA and DHA sulphate by eight patients undergoing adrenal-ectomy was determined by measuring the concentrations of these compounds in samples of adrenal and peripheral venous blood taken simultaneously. In one patient secretion of DHA and DHA sulphate was equivalent whilst in the remainder there was much greater secretion of DHA.

17-alpha-Hydroxypregnenolone

Dehydroepiandrosterone and dehydroepiandrosterone sulfate dynamics in obesity.

Dehydroepiandrosterone (D) and dehydroepiandrosterone sulfate (DS) dynamics were studied in three obese female subjects following a single injection of [4-14-CA1D and [7 alpha-3-H]-DS tracers. Dynamic parameters were calculated simultaneously by both the urinary and blood method of compartmentalization; Estimates for the urinary secretion and production rates of D were found to be high, and those of DS varied within normal range. Calculation of the conversion factors, rho DDS and rho DSD, by the urinary method revealed a noraml extraglandular DS yields D conversion, while that for D yields DS appeared deficient in obese female subjects. Estimates of inner and outer pool distribution volumes were extremely increased for free D; in contrast to this, moderately increased inner and decreased outer pool volumes of DS were observed. The metabolic clearance rates of D were normal or decreased and those for DS were greater than normal. The blood production rates of both B and DS were higher in obese female subjects than those estimated for normal women in our previous study; These observations suggest a considerable uptake of unconjugated D by adipose tissue, an overall poor D yields DS conversion and an accelerated DS metabolism in obese female subjects.

Adult

Circulating concentrations of dehydroepiandrosterone and dehydroepiandrosterone sulfate during puberty.

In order to quantitate the chronological change in circulating dehydroepiandrosterone (DHEA) and dehydroepiandrosterone sulfate (DS) levels during the period of sexual maturation, serum DHEA and DS concentration (3-5 PM) in 76 boys and 65 girls (ages 8 to 15) as well as in adult male and female subjects were measured by a specific and sensitive radioimmunoassay technique. Our data show a progressive and parallel increase in serum DHEA and DS concentrations in boys, and adult male levels were reached earlier for DHEA (age 13) than for DS (age 14). From age 8 to adult male, there was a 2.6-fold increase in DHEA (1.52 plus or minus 0.16 ng/ml to 3.91 lus or minus 0.34 ng/ml) and a 7.7-fold increase in DS (0.40 plus or minus 0.08 mug/ml to 3.09 plus or minus 0.36 mug/ml). The rise of DHEA and DS was not in a parallel fashion in girls; while DS rose progressively, DHEA showed an abrupt increase between 11 and 12 yr of age. Adult female range was reached by age 12 for DHEA and by age 15 for DS. From age 8 to adultfemale there was a 2.3-fold increase in DHEA (1.93 plus or minus 0.19 ng/ml to 4.49 plus or minus 0.76 ng/ml) and a 7.5-fold increase in DS (0.29 PLUS OR MINUS 0.05 MUg/ml to 2.17 plus or minus 0.34 mug/ml). The role of increased adrenal androgens inthe sexual development during early stages of puberty is discussed.

Adolescent

Interrelationships of circulating maternal steroid concentrations in third trimester pregnancies. II. C18 and C19 steroids: estradiol, estriol, dehydroepiandrosterone, dehydroepiandrosterone sulfate, delta 5-androstenediol, delta 4-androstenedione, testosterone, and dihydrotestosterone.

This report describes aggregate time trend effects of advancing gestational age on circulating maternal concentrations of 17beta-estradiol (E2), estriol (E3), dehydroepiandrosterone (D), dehydroepiandrosterone sulfate (D-S), delta 5-androstenediol (delta 5 diol), delta 4-androstenedione (delta 4 A), testosterone (T), and dihydrotestosterone (DHT) in a sequential series of 155 blood samples obtained from 19 normal pregnant women ranging from 26-40 weeks gestational age. Only E2, E3, and D-S show aggregate time trend effects. Log (E2) plots as a linear positive sloping curve from 26-40 weeks. Log (E3) plots as a positive sloping curve that is significantly steeper than log (E2) (P less than 0.05). Log (D-S) plots into a negative sloping curve which mirrors the pattern for log (E2) but cannot be statistically associated with log (E2) except for the opposite sign of their slopes, which are both significantly different from a zero slope (P less than 0.05). delta 4 A, T, DHT, delta 5 diol, and D show no aggregate time trends; however wide, comoving undulations for delta 4 A, T, DHT, and delta 5 diol between 26-28 and 38-40 weeks are confirmed in time by comparison of log mean plots and in magnitude by regressing the C19 steroids on one another. D shows virtually no association with the other C19 steroids. All C19 steroids, except for T, circulate at nonpregnant concentrations, implying that there is little placental secretion of these steroids into the maternal circulation.

Androgens

[A radioimmunoassay method for simultaneous determination of pregnenolone, pregnenolone sulfate, dehydroepiandrosterone and dehydroepiandrosterone sulfate in human plasma (author's transl)].

A radioimmunoassay method has been developed for the simultaneous determination of pregnenolone, pregnenolone sulfate, dehydroepiandrosterone(DHA) and dehydroepiandrosterone sulfate (DHA sulfate). The method consists of the following procedures: 1) ether extraction of unconjugated compounds, 2) extraction of sulfates fromaqueous residue with ethyl acetate, 3) solvolysis with sulfuric acid at 40 degree C for 60 minutes, 4) celite column chromatography to separate individual compounds, 5) radioimmunoassay. Efficiencies of solvolysis for pregnenolone sulfate and DHA sulfate are 94 and 80%, Precision and accuracy studies have shown that the assays of sulfates as well as unconjugates are reproducible and accurate. Specificity was ascertained by parallelism and linearity studies. No interfering substance was detected in appreciable quantity. Plasma levels of these four compounds were determined in specimens obtained from 15 normally ovulating women. To represent the whole menstrual cycle, samples were taken 8 days before LH peak (LH-8), the day of LH peak (LH = O) and 8 days after LG peak (LH+8). Plasma contents of these compounds (geometric mean in ng/ml and 95% confidence limits in parentheses) are as follows: pregnenolone, LH-8: 1.33 (1.02-1.74), LH = 0: 1.45 (1.22-1.72), LH+8: 1.88(1.70-2.21); pregnenolone sulfate, LH-8: 70.0 (55.9-89.2), LH = 0 57.5 (40.0-82.7), LH+8: 102 (81.5-129); DHA, LH-8: 5.38 (3.90-7.43), LH = 0: 4.90 (3.58-6.79), LH+8: 4.58 (3.12-6.83), DHA sulfate, LH-8: 1480 (1110-1980), LH = 0: 1570 (1150-2140), LH+8: 1590 (1150-2190). Both pregnenolone and pregnenolone sulfate levels of 8 days after LH peak are significantly higher than those of other two days. Conversely, plasma DHA and DHA sulfate levels fluctuate over wide range with no consistent trend.

Adult

Free and solvolysable dehydroepiandrosterone and androsterone in blood of mammals under physiological conditions and following administration of dehydroepiandrosterone.

A gas chromatographic method has been empolyed for the determination of dehydroepiandrosterone (D), androsterone (A), dehydroepiandrosterone sulphate (DS) and androsterone sulphate (AS) in the peripheral blood of human subjects and in various mammals under physiological conditions and after the administration of D or DS. Unconjugated D has been isolated and the resting level determined in the rat, rabbit, dog , sheep, pig and cow, while DS was detectable in the peripheral circulation of the rat, dog and pig. Unconjugated A was present in blood of the rodents and domestic ungulates studied, while the parent sulphate could be demonstrated only in rat, dog, pig and cow. The plasma of lower mammals contained D in higher (0.8-10.9 microng/100 ml) and DS, if any, in lower level (1.5-5.7 microng/100 ml) than the human plasma samples (0.1-2.7 and 86-308 microng/100 ml, respectively). There was a more pronounced increase in D and A than in the DS and AS level in the rat and dog following administration of D. On the contrary, exogenous D hardly affected unconjugated D and appreciably enhanced the DS level in human plasma. The conclusion drawn for human subjects, that D is the metabolically active and DS the reserve hormone, does not seem to be valid for all the animals here studied.

Administration, Oral

Serum dehydroepiandrosterone and dehydroepiandrosterone sulphate in baboon (Papio Papio) pregnancy.

Dehydroepiandrosterone (D) and dehydroepiandrosterone sulphate (DS) concentrations were determined by radioimmunoassay in peripheral sera of non-pregnant, pregnant (55 days to term) and newborn baboons and in umbilical sera of animals delivered by Caesarean section close to term. D concentrations (mean +/- SD, microng/100 ml, N) in non-pregnany animals (1.61 +/- 1.32, 23) were not different (P greater than 0.05) from those during pregnancy (1.80 +/- 1.21, 101). DS concentrations, expressed as unconjugated D, in non-pregnant (13.5 +/- 6.0, 23) and pregnant (15.1 +/- 7.5, 101) animals were also similar (P greater than 0.05). However, both D (P less than 0.01) and DS (P less than 0.005) levels increased with gestational age such that serum D (2.46 +/- 1.39, 23, P less than 0.05) and DS (18.9 +/- 5.7, 23, P less than 0.001) levels between 150 and 180 days gestation were greater than in non-pregnant animals. These increases may be important since oestrogen production rises rapidly during late gestation and both D and DS can serve as oestrogen precursors. In both non-pregnant (P less than 0.005) and pregnant (P less than 0.001) animals D and DS concentrations (ratio 1:8) were correlated. Cord serum D levels (2.4 +/- 1.4, 5) were not different from those of maternal serum (P greater than 0.05), while cord DS levels (40.3 +/- 14.8) were greater (P less than 0.001) than those of maternal serum. This may reflect rapid equilibration of D but not DS between foetal and maternal circulations. In sera from neonates, D (19.4 +/- 14.6, 8) and DS 567 +/- 570, 8) concentrations were greater (P less than 0.001) than those in maternal serum, indicating marked post-partal changes in clearance or production of both compounds. The high levels of D and DS in cord and newborn wera are compatible with the view that the baboon foetus makes appreciable contributions of oestrogen precurosrs in pregnancy.

Animals

A physiologic model of the dehydroepiandrosterone to estrogen conversion system in the fetoplacental unit. II. Preliminary clinical application--the dehydroepiandrosterone loading test.

A dehydroepiandrosterone (DHEA) loading test (DLT) is described. The results of 19 DHEA loading tests in as many third-trimester obstetric patients are presented. Analysis involves inspection of the raw data and the application of the physiologic model of the DHEA to estrogen conversion system described in the preceding paper (Part I). The DLT results show that within the population studied, the conversion rate of DHEA to estrogens is lower in patients with placental insufficiency than in normal patients (N = 5, p = 0.002) or in patients with various complications of pregnancy who deliver normally grown, undistressed infants (N = 6, p = 0.001). Routine clinical application must await more extensive evaluation to preclude the existence of forms of placental insufficiency not detected by this means, or normal states resulting in "false-positive" tests. These initial clinical results are intended primarily to demonstrate the potential clinical applicability of the physiologic model described in Part I.

Dehydroepiandrosterone

The effect of repeated intramuscular gonadotrophin-releasing hormone injections on luteinizing hormone, follicle-stimulating hormone, testosterone, oestrogens, dehydroepiandrosterone and dehydroepiandrosterone sulfate in normal men.

The endocrine response to three daily intramuscular injections of 500 microgram LH-RH was measured in 9 normal men during a period of 3 days. A marked but declining response in LH was seen in addition to a significant increase in the serum concentration of FSH, testosterone, oestradiol and the urinary excretion of oestrogenic substances. No change could be demonstrated in the DHA, DHAS or cortisol secretion which confirms our previous results of a direct effect of clomiphene on adrenal steroidogenesis.

Adrenal Cortex

Studies of the human testis. V. Properties of delta-5-3beta and 17beta-hydroxysteroid dehydrogenases in the biosynthesis of testosterone from dehydroepiandrosterone.

The properties of delta-5-3beta-hydroxysteroid dehydrogenase and 17beta-hydroxysteroid dehydrogenase in the human testis were examined using cell-free homogenates with added cofactors. Michaelis constants of the delta-5-3beta-hydroxysteroid dehydrogenase enzyme at 37 C and pH 7.4 were 8.2 times 10 minus 7M for dehydroepiandrosterone and 2.9 times 10 minus 6M for androstenediol. The optimal pH for both substrates was approximately 8.15. Dehydroepiandrosterone and androstenediol are competitive substrates for the enzyme. When free and conjugated C19 steroids in the order of 10 minus 6 were added, androstenedione and testosterone inhibited the enzyme activity for dehydroepiandrosterone while the activity for androstenediol was inhibited by addition of dehydroepiandrosterone and its sulfate as well as by androstenedione and testosterone. 17beta-Hydroxysteroid dehydrogenase had two apparent Michaelis constants for dehydroepiandrosterone, 3.3 times 10 minus 6M at low substrate concentrations and 1 times 10 minus 5M at high substrate concentrations. The enzyme activities for dehydroepiandrosterone and androstenedione were found to be enhanced by addition of the 17beta-hydroxysteroids examined and slightly inhibited by addition of dehydroepiandrosterone-sulfate and androstenediol-3-monosulfate. Androstenedione caused an inhibition of the 17beta-hydroxysteroid dehydrogenase for dehydroepiandrosterone. The interconversion between androstenedione and testosterone by the enzyme favored testosterone formation. Following simultaneous incubation of 3H-dehydroepiandrosterone and 14C-androstenediol in equal amounts, initially more testosterone was produced from dehydroepiandrosterone than from androstenediol under the conditions employed, while subsequently with accumulation of androstenediol more testosterone was produced from androstenediol.

Aged

Dehydroepiandrosterone sulfotransferase as a possible shunt for the control of steroid metabolism in human mammary carcinoma.

Human primary mammary tumors were examined to determine what factors were of importance in deciding relative rates of sulfurylation of dehydroepiandrosterone and 17beta-estradiol, such rates having been shown to correlate with the patient's prognosis and response to adrenalectomy (T. L. Dao and P.R. Libby. Enzymic Synthesis of Steroid Sulfate by Mammary Cancer and Its Clinical Implications. Natl. Cancer Inst. Monographs, 34: 205-210, 1971). The sulfurylation of dehydroepiandrosterone and 17beta-estradiol was studied in 41 tumors in vitro using tumor cytosol, adenosine triphosphate, [35S]SO42-, Mg2+, and added steroid. Six tumors showed no sulfurylating ability, 9 sulfurylated dehydroepiandrosterone at a rate greater than that for 17beta-estradiol (ratio, greater than 1), and 26 sulfurylated dehydroepiandrosterone at a rate lower than that for 17beta-estradiol (ratio, less than 1). Evidence was obtained that low levels of dehydroepiandrosterone sulfotransferase were responsible for ratios of less than 1, in many instances. Adenosine 3'-phosphate 5'-phosphosulfate synthesis and steroid sulfotransferase activities were measured in 30 tumors. A significant correlation was found between synthesis of the former and levels of estrogen sulfotransferase, but this relationship did not hold for dehydroepiandrosterone sulfotransferase, again due to low levels of this enzyme in many tumors. It is suggested that dehydroepiandrosterone sulfate formation in the tumors is mainly controlled by the sulfotransferase, which acts as a shunt in regulating the level of free dehydroepiandrosterone, and related compounds, available for metabolism to steroids influencing the growth of mammary epithelial cells.

Adrenalectomy

Hepatocarcinogenicity of dehydroepiandrosterone in the rat.

Dehydroepiandrosterone, a major secretory steroid hormone of the human adrenal gland, possesses mitoinhibitory and anticarcinogenic properties. It also induces peroxisome proliferation in the livers of rats and mice. Because peroxisome proliferators exhibit hepatocarcinogenic potential, it is necessary to examine the long term hepatic effects of dehydroepiandrosterone since this hormone is contemplated for use as a potential cancer chemopreventive agent in humans. Dehydroepiandrosterone was administered in the diet at a concentration of 0.45% to F-344 rats for up to 84 weeks. At the termination of the experiment, 14 of 16 rats developed hepatocellular carcinomas. Liver tumors induced by dehydroepiandrosterone lacked gamma-glutamyl transpeptidase and glutathione S-transferase (placental form); these phenotypic properties are identical to the features exhibited by liver tumors induced by other peroxisome proliferators. Dehydroepiandrosterone was also shown to markedly inhibit liver cell [3H]thymidine labeling indices, suggesting that cell proliferation is not a critical feature in liver tumor development with this agent. These results show that although dehydroepiandrosterone exerts anticarcinogenic effects in a variety of tissues, the peroxisome-proliferative property makes it a hepatocarcinogen.

Animals

The influence of combined cyproterone acetate-ethinyl oestradiol therapy on serum levels of dehydroepiandrosterone, androstenedione, and testosterone in hirsute women.

Serum levels of dehydroepiandrosterone, androstenedione, and testosterone in hirsute women suffering from either idiopathic hirsutism or the polycystic ovary syndrome were determined before and during treatment with cyproterone acetate combined with ethinyl oestradiol. During this treatment the hirsutism decreased markedly. In untreated hirsute women serum dehydroepiandrosterone levels do not differ from those in normal women and do not change during therapy; androstenedione levels are higher than normal and decrease markedly during treatment, and the testosterone levels are elevated compared to normals, with a considerable overlap, and show only a tendency to decrease. There is no correlation between dehydroepiandrosterone and androstenedione levels or between androstenedione and testosterone levels in the serum of untreated hirsute women. After 12-14 months of cyproterone acetate-ethinyl oestradiol therapy a linear correlation is found between dehydroepiandrosterone and androstenedione levels. This can be explained by the relatively higher contribution of the peripheral conversion of dehydroepiandrosterone to androstenedione to the occurrence of lower androstenedione levels. The linear correlation between androstenedione and testosterone after treatment, also found in normal women, indicates the restoration of the role of androstenedione as the major peripheral precursor of testosterone.

Adolescent