PMID- 8116018
OWN - NLM
STAT- MEDLINE
DCOM- 19940325
LR  - 20190821
IS  - 0039-128X (Print)
IS  - 0039-128X (Linking)
VI  - 58
IP  - 12
DP  - 1993 Dec
TI  - Steroid hormones and hypertension: the cortisol-cortisone shuttle.
PG  - 614-20
AB  - The role of adrenal steroid hormones in hypertension has, until recently, focused 
      on disorders of secretion. We describe a new form of mineralocorticoid 
      hypertension which arises from impaired metabolism of physiological 
      glucocorticoid. 11 beta-hydroxysteroid dehydrogenase (11 beta-HSD) is responsible 
      for the inactivation of cortisol to cortisone. Congenital absence of this enzyme 
      (the syndrome of apparent mineralocorticoid excess) results in cortisol acting as 
      a potent mineralocorticoid. Furthermore, inhibition of this enzyme by 
      glycyrrhizic and glycyrrhetinic acids also accounts for the mineralocorticoid 
      excess states seen following licorice and carbenoxolone ingestion. Whilst 
      impaired 11 beta-HSD activity has been shown in patients with "essential" 
      hypertension, the significance of this finding remains unknown. These clinical 
      studies, however, have uncovered a novel physiological mechanism, whereby the 
      mineralocorticoid receptor (which in vitro has an equal affinity for cortisol and 
      aldosterone) is protected from cortisol excess by the action of 11 beta-HSD. Thus 
      11 beta-HSD plays a crucial role in determining the in vivo specificity for this 
      receptor.
FAU - Stewart, P M
AU  - Stewart PM
AD  - Department of Medicine, University of Birmingham, Queen Elizabeth Hospital, 
      Edgbaston, United Kingdom.
FAU - Whorwood, C B
AU  - Whorwood CB
FAU - Walker, B R
AU  - Walker BR
LA  - eng
PT  - Journal Article
PT  - Review
PL  - United States
TA  - Steroids
JT  - Steroids
JID - 0404536
RN  - 0 (Mineralocorticoids)
RN  - 0 (Receptors, Mineralocorticoid)
RN  - EC 1.1.- (Hydroxysteroid Dehydrogenases)
RN  - EC 1.1.1.146 (11-beta-Hydroxysteroid Dehydrogenases)
RN  - MM6384NG73 (Carbenoxolone)
RN  - V27W9254FZ (Cortisone)
RN  - WI4X0X7BPJ (Hydrocortisone)
SB  - IM
MH  - 11-beta-Hydroxysteroid Dehydrogenases
MH  - Animals
MH  - Carbenoxolone/pharmacology
MH  - Cortisone/*metabolism
MH  - Glycyrrhiza
MH  - Humans
MH  - Hydrocortisone/*metabolism
MH  - Hydroxysteroid Dehydrogenases/deficiency/metabolism
MH  - Hypertension/*etiology/metabolism
MH  - Metabolism, Inborn Errors/metabolism/physiopathology
MH  - Mineralocorticoids/metabolism
MH  - Plants, Medicinal
MH  - Receptors, Mineralocorticoid/metabolism
RF  - 45
EDAT- 1993/12/01 00:00
MHDA- 1993/12/01 00:01
CRDT- 1993/12/01 00:00
PHST- 1993/12/01 00:00 [pubmed]
PHST- 1993/12/01 00:01 [medline]
PHST- 1993/12/01 00:00 [entrez]
AID - 0039-128X(93)90104-U [pii]
AID - 10.1016/0039-128x(93)90104-u [doi]
PST - ppublish
SO  - Steroids. 1993 Dec;58(12):614-20. doi: 10.1016/0039-128x(93)90104-u.