Steroids

ea0034p341 | Steroids | SFEBES2014

Defining contralateral adrenal suppression in primary aldosteronism: implications for diagnosis and outcome

Kline Gregory , Dias Valerian , So Benny , Harvey Adrian , Pasieka Janice

Unilateral forms of primary aldosteronism (PA) should, by inference, have a contralaterally normal and therefore suppressed adrenal zona glomerulosa. However, there is no agreed definition of expected adrenal suppression. We hypothesized two biochemical definitions of adrenal suppression based upon measurements done during adrenal vein sampling. These were then applied to a PAAVS-outcomes database to determine whether either definition proved useful for interpretation of...

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ea0034p342 | Steroids | SFEBES2014

Monitoring outcomes in congenital adrenal hyperplasia: have we been neglecting testosterone?

Sakai Naomi , Acerini Carlo

Background: Congenital adrenal hyperplasia (CAH) is a group of disorders caused by defects in one of the enzymes in the adrenal steroidigenic pathways. The most common form is 21-hydroxylase deficiency which leads to decreased production of cortisol and aldosterone and increased androgen production. Close monitoring of treatment is important so that adrenal suppression is achieved without excessive exposure to glucocorticoids. The current gold standard for monitoring in CAH is...

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ea0034p343 | Steroids | SFEBES2014

A large retrospective audit of adrenal incidentalomas

Zhyzhneuskaya Sviatlana , Wuerdemann Nora , Nag Sath , Arutchelvam Vijayaraman , Ashwell Simon

Objective: To determine whether people with an incidentally discovered adrenal mass are investigated according to regional and global standards (AACE guidelines); to determine the frequency of autonomous endocrine function.Methods: We did a retrospective analysis of clinical, pathology, and radiology records from January 2007 to December 2011. Patients were included if they were seen in the outpatient clinic for evaluation of an adrenal mass >1 cm in...

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ea0034p344 | Steroids | SFEBES2014

Biophenols-rich pomegranate extract intake inhibits salivary cortisol and 11β-HSD1 activity and improves overall quality of life scores in healthy volunteers

Stockton Angela , Al-Dujaili Emad

Background and aim: Biophenols can act as powerful antioxidants. Pomegranate (Punica granatum) provides a rich and varied source of biophenols with the most abundant being ellagitannins, tannins, anthocyanins, ellagic, and gallic acids. Recently, we have shown that pomegranate juice consumption may alleviate cardiovascular risk factors by reducing systolic and diastolic blood pressure and exercise-induced oxidative stress. The aim of study was to investigate the effec...

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ea0034p345 | Steroids | SFEBES2014

Role of estrogen hormone in lipopolysaccharide: induced Alzheimer's disease in female rats; possible underlying mechanisms and modulation by progesterone hormone

Abdelwahed O M , Gamal M , Abdelwahab Z , Zickri M , El Eraky W , Saleh D O

The incidence of Alzheimers disease (AD) is higher in women than men. Our study aimed to investigate the behavioral, biochemical, and histological changes in lipopolysaccharide (LPS)-induced AD, to study effect of estrogen in AD clarifying the possible involved underlying mechanisms and its modulation by progestsserone. Groups: Female albino rats were divided into control, AD, AD+ovariectomy (OVX), AD+OVX+estrogen replacement and AD+OVX+estrogen+pr...

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ea0034p346 | Steroids | SFEBES2014

A rapid and sensitive LC–MS/MS method for the simultaneous analysis of testosterone, androstenedione, 17-OHP, and DHEAS

Keevil Brian

Introduction: Measurement of serum testosterone is necessary for the investigation of androgen disorders in males and females. Measurement of other androgens such as DHEAS and androstenedione (A4) may also be important in the investigation of PCOS and 17-hydroxyprogesterone (17-OHP) is useful to differentiate late onset CAH in patients with raised A4. Although it would be advantageous to measure all four steroids simultaneously this is not always easy because...

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ea0034p347 | Steroids | SFEBES2014

A case of recurrent, re-admissions with severe hyperemesis gravidarum

Jinadev Pushpa , Jacob Koshy

Mrs XY, 29 years. (gravida: 3 and para 2) was admitted under the obstetricians with severe hyperemesis gravidarum (HG). An ultrasonogram revealed single live foetus of 8 weeks gestation. Her two previous pregnancies were normal with no history of HG. Mrs XY was on levothyroxine 150 μg OD for autoimmune primary hypothyroidism with TPO antibodies of 259 kU/l (05.6). She was also taking sertraline 200 mg OD for depression. The hyperemesis settled with i.v. fluids as we...

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ea0034p348 | Steroids | SFEBES2014

The effect of green tea extracts on steroidogenesis, proliferation and apoptosis in ovarian granulosa cells

Kadasi Attila , Maruniakova Nora , Kolesarova Adriana , Stochmalova Aneta , Alexa Richard , Grossmann Roland , Sirotkin Alexander V

The aim of our study was to examine the influence of green tea molecules on basic ovarian functions. For this purpose we have examine the effect of green tea extract, fraction of antioxidants (GTAO) and green tea fraction of polyphenols (GTPP) (at the doses 0, 1, 10, and 100 μg/ml) on proliferation, apoptosis, and steroidogenesis by cultured porcine ovarian granulosa cells. Markers of proliferation (PCNA) and apoptosis (bax) were detected by immunocytochemistry. Secretion...

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ea0034p349 | Steroids | SFEBES2014

Hyperandrogenaemia predicts metabolic phenotype in polycystic ovary syndrome: the utility of serum androstenedione

O'Reilly Michael , Taylor Angela , Crabtree Nicola , Hughes Beverly , Capper Farfia , Crowley Rachel , Stewart Paul , Tomlinson Jeremy , Arlt Wiebke

Polycystic ovary syndrome (PCOS) is a clinical triad of anovulation, insulin resistance, and androgen excess. Hyperandrogenism may correlate with metabolic risk but PCOS consensus criteria currently define androgen excess on the basis of serum testosterone only. Here we studied the utility of the androgen precursor serum androstenedione in conjunction with serum testosterone as a predictor of metabolic dysfunction in PCOS.86 PCOS patients fulfilling Rott...

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ea0034p350 | Steroids | SFEBES2014

Upregulation of subcutaneous adipose AKR1C3 expression in obese females: evidence for depot- and sex-specific effects

O'Reilly Michael , Gathercole Laura , Arlt Wiebke , Tomlinson Jeremy

Polycystic ovary syndrome (PCOS) is a clinical triad of anovulation, insulin resistance, and androgen excess in women. Adipose androgen generation of testosterone from androstenedione by aldo-ketoreductase type 1C3 (AKR1C3) may contribute to hyperandrogenism, particularly in the setting of obesity. We aimed to determine the effects of BMI and age on AKR1C3 expression in subcutaneous (SC) and omental (OM) fat depots in both women and men.Paired SC and OM ...

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ea0034p351 | Steroids | SFEBES2014

High 11β-HSD1 activity is associated with progression to rheumatoid arthritis in patients first presenting with inflammatory arthritis

Nanus Dominika , Filer Andrew D , Yeo Lorraine , Scheel-Toellner Dagmar , Hardy Rowan , Lavery Gareth L , Stewart Paul M , Buckley Christopher D , Cooper Mark S , Raza Karim

Variation in endogenous glucocorticoid (GC) activity during inflammation has been linked to susceptibility to developing rheumatoid arthritis (RA). It has been shown that in patients with RA inflamed synovial tissue can generate active GCs through the expression of the 11β-hydroxysteroid dehydrogenase type 1 enzyme (11β-HSD1), which converts cortisone to cortisol. We examined whether the total body activity of 11β-HSD1 or its expression within synovium was assoc...

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ea0034p352 | Steroids | SFEBES2014

Urinary steroid profiling by Gas-Chromatography Mass-Spectrometry (GC–MS) is not helpful in the diagnosis of Cushing's Syndrome

Johns Emma , Shapiro David , McManus Frances , Freel Marie

Introduction: The diagnosis of Cushings syndrome (CS) can be challenging and there is no single gold standard diagnostic test. Endocrinologists rely on a combination of plasma cortisol (before and after dexamethasone), midnight salivary cortisol and urinary free cortisol (UFC) to make the diagnosis. Assessment of urinary corticosteroids and their metabolites, measured by gas chromatographymass spectrometry (GCMS), provide a comprehensive picture of corticoste...

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ea0034p353 | Steroids | SFEBES2014

A novel UPLC–MS/MS method to extract and quantify sulphated and non-sulphated oestrogens automatically optimised using MUSCLE software

Gilligan Lorna , Bradbury James , Taylor Angela , He Shan , O'Neil Donna , Viant Mark , Foster Paul

Oestradiol (E2) and oestrone (E1) are implicated in many diseases and drive cell proliferation in breast, ovarian, and endometrial cancer. Inactive sulphated oestrogens (E2S and E1S) represent a circulating reservoir forming active de-sulphated oestrogens. Therefore, new methods that accurately measure both sulphated and non-sulphated oestrogen concentrations have potential value for understanding oestrogen-related cancer. We present...

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ea0034p354 | Steroids | SFEBES2014

Dexamethasone-related adrenal insufficiency in patients with solid brain tumours

Currie Helen , Ali Muzzammil

Dexamethasone is used to reduce cerebral oedema thus relieve symptoms of raised intracranial pressure. Long-term use causes suppression of the hypothalamicpituitaryadrenal axis, which can lead to adrenal insufficiency. Undiagnosed, significant morbidity and mortality can occur from Addisonian crisis. The aim of this audit was to discover the relationship between adrenal insufficiency and long-term steroid use, in order to make recommendations for the use and withdr...

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ea0034p355 | Steroids | SFEBES2014

Patient education and steroid replacement regimens in adrenal insufficiency

Ameen Zana , Ulnasah Sadaf , Rees Jo , Shepherd Lisa , Bates Andrew , Rahim Asad

Introduction: Adrenal insufficiency (primary/secondary) is a rare and potentially life-threatening condition which can be easily overlooked. Patient awareness and management of problems is critical and central to effective treatment. The NICE Clinical Knowledge Summaries for patients identifies and recommends critical areas that require attention in adrenal insufficiency. In particular, patients should:i) Realize the need for lifelong glucocorticoid repl...

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ea0034p356 | Steroids | SFEBES2014

Evaluating progesterone as a novel neuroprotective drug after ocular injury

Mccance Eleanor , Blanch Richard

Background: Blunt ocular trauma causes commotio retinae, a retinal opacification that accounts for over a third of all retinal injuries. Poor outcomes occur when the macula is affected, which accounts for 1/3 of cases and 3/4 cases in those at high injury risk, causing permanent visual loss due to selective photoreceptor death. This is seen in humans, and reproduced in our animal model, as loss of the outer nuclear layer (ONL) on histological and optical coherence tomography (...

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ea0034p357 | Steroids | SFEBES2014

Steroid sulfatase contributes to systemic androgen activation in pre-pubertal boys: lessons from steroid sulfatase deficiency

Idkowiak Jan , Taylor Angela E , O'Neil Donna M , Subtil Sandra , Vijzelaar Raymon , Dias Renuka P , Amin Rakesh , Barrett Timothy G , Kirk Jeremy W , Shackleton Cedric H L , Moss Celia , Arlt Wiebke

Steroid sulfatase (STS) cleaves the sulfate moiety off steroid sulfates, including DHEAS, the inactive sulfate ester of the adrenal androgen precursor DHEA. Deficient DHEA sulfation, the opposite enzymatic reaction to that catalysed by STS, results in androgen excess by increased conversion of DHEA to active androgens. STS deficiency (STSD) due to deletions or inactivating mutations in the X-linked STS gene manifests with ichthyosis, but androgen homeostasis in STSD h...

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ea0034p358 | Steroids | SFEBES2014

Glucocorticoid receptor interactome

Bakker Emyr , Tian Kun , Andrews James , Demonacos Constantinos , Schwartz Jean-Marc , Krstic-Demonacos Marija

Glucocorticoid hormones are used in the treatment of variety of diseases, due to their diverse range of effects. Acute lymphoblastic leukaemia (ALL), the most common form of childhood cancer, is one such disease treated by glucocorticoids (GCs). Although there has been much success in the treatment of ALL with GCs, drug resistance remains a problem, despite the detailed knowledge of the signalling networks underlying the GC actions through the glucocorticoid receptor (GR). Sys...

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ea0034p359 | Steroids | SFEBES2014

Does recurrent hypoglycaemia, a known activator of the HPA axis, alter the diurnal pattern of cortisol release?

George Priya , Mackie Alasdair , Connell John , McCrimmon Rory

In population studies, premature cardiovascular disease is associated with cortisol dysregulation. Recently, recurrent hypoglycaemia in individuals with type 1 diabetes (T1D) was reported to be associated with increase carotid intimamedia thickness. Hypoglycaemia is a potent activator of the hypothalamo-pituitaryadrenal axis (HPA axis) with eventual release of cortisol. We hypothesized that individuals with T1D who experience recurrent hypoglycaemia might demonstra...

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ea0034p360 | Steroids | SFEBES2014

Systemic availability of placental growth factor correlates with urinary tetrahydroaldosterone excretion in normal and preeclamptic pregnancy

Currie Gemma , Eisele Nicole , Small Heather , Escher Genevieve , Gennari-Moser Carine , Carty David , Mohaupt Markus , Christian Delles

Background: Aldosterone levels are elevated in normal pregnancy but fall despite volume contraction in preeclampsia. Vascular endothelial growth factor (VEGF) and soluble fms-like tyrosine kinase 1 (sFlt-1) have been implicated in this phenomenon in vitro and in animal work. Low placental growth factor (PlGF), which is closely linked to VEGF signalling, identifies women at risk of preeclampsia between 20 and 35 weeks gestation. We aimed to examine these relationships ...

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ea0034p361 | Steroids | SFEBES2014

Endogenous androgen-mediated modulation of neointima formation is independent of vascular androgen receptor

Wu Junxi , Hadoke Patrick , Mair Iris , Lim Win Gel , Millar Eileen , Milne Laura , Denvir Martin , Smith Lee

Aims: Low circulating testosterone levels are associated with increased cardiovascular risk and there is evidence that androgens inhibit arterial lesion formation. This investigation addressed the hypothesis that androgens directly inhibit neointimal lesion formation by stimulation of vascular androgen receptor.Methods and results: Mice were generated with selective deletion of androgen receptor from vascular (endothelial or smooth muscle) cells. Castrat...

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ea0034p362 | Steroids | SFEBES2014

An audit on the outcomes of bloodspot 17-OHP results on the management of patients with CAH

Mozley Erin , Salter Simon , Davies Justin , Armston Annie

Introduction: Measurement of bloodspot 17-OHP is the current method of assessing hydrocortisone replacement in patients with congenital adrenal hyperplasia (CAH). Bloodspot 17-OHP has been measured in Southampton by LCMS/MS since August 2011. Clinical observations of signs and symptoms of under- and over-treatment are equally as important.The aim of this audit was to assess whether the 17-OHP profile results are being appropriately used for adjustm...

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ea0034p363 | Steroids | SFEBES2014

Androgen receptor over expression drives lipid accumulation in human hepatocytes

Nikolaou Nikolaos , Nasiri Maryam , Gathercole Laura , Castro Silvia Parajes , Krone Nils , Valsamakis George , Mastorakos George , Tomlinson Jeremy

Non-alcoholic fatty liver disease NAFLD has been associated with androgen deficiency, yet in the majority of patients with non-alcoholic steatohepatitis NASH, androgens levels are normal. In contrast, women with polycystic ovarian syndrome PCOS, which is characterised by androgen excess, have evidence of increased liver fat. Our hypothesis is that androgen exposure to the liver may be crucial in the amount of lipid that can accumulate in hepatocytes. C3A human hepatoma cells w...

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ea0034p364 | Steroids | SFEBES2014

Bioinformatic analysis of altered microRNA production in normal adrenal tissue and aldosterone-producing adenoma

Razak Nur Izah Ab , Diver Louise , Alvarez-Madrazo Samantha , Robertson Stacy , McBride Martin , Stewart Paul , Connell John , MacKenzie Scott , Davies Eleanor

Hypertension is a common risk factor for cardiovascular disease and up to 15% of hypertensive patients are now known to have primary aldosteronism (PA), where the adrenal glands secrete inappropriately high levels of the steroid hormone aldosterone. Of these cases, almost half are due to the presence of unilateral aldosterone-producing adenoma (APA). Aldosterone is synthesised in the zona glomerulosa of the adrenal cortex, with the final stages of production catalysed by aldos...

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ea0034p365 | Steroids | SFEBES2014

¹¹C-metomidate PET–CT in primary hyperaldosteronism: a valuable alternative to AVS

Powlson Andrew S , Koulouri Olympia , Challis Benjamin G , Cheow H K , Buscombe John , Koo Brendan , Brown Morris J , Gurnell Mark

Although adrenal vein sampling (AVS) remains the gold-standard for distinguishing unilateral and bilateral disease in primary hyperaldosteronism (PHA), it is technically demanding and not always feasible. Metomidate (MTO), a potent inhibitor of CYP11B1 and CYP11B2, can be C11H3-labelled as a PET tracer (11C-MTO), and we have previously shown it to be an alternative to AVS for localising unilateral aldosterone-producing adenomas (APAs) (Burton <...

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ea0034p366 | Steroids | SFEBES2014

Testosterone regulates glucose control in liver and muscle of Tfm mice as a mechanism to improve type 2 diabetes

Kelly Daniel , Akhtar Samia , Muraleedharan Vakkat , Sellers Donna , Brooke Johnathan , McLaren David , Jones Hugh

Introduction: There is a strong association between testosterone deficiency and the incidence of type 2 diabetes (T2D) in men. Physiological testosterone replacement (TRT) improves insulin resistance and glycaemic control in hypogonadal men. The mechanism by which testosterone mediates these beneficial actions are unknown but may be due to an effect on major metabolically active tissues such as liver and muscle. This study investigates the expression of key regulatory targets ...

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ea0034p367 | Steroids | SFEBES2014

The endocrine response to severe trauma: the Steroids and Immunity from injury to Rehabilitation (SIR) study

Foster Mark , Taylor Angela , Hill Neil , Staruch Rob , O'Neil Donna , Bion Julian , Young Stephen , Midwinter Mark , Lord Janet , Arlt Wiebka

There are 1.21 million deaths from road traffic accidents worldwide. In Afghanistan, there have been 2005 battle injuries over 10 years. Advances in military trauma care have improved survival, resulting in more severely injured individuals entering the trauma care pathway. Improved understanding of endocrine-immune changes after severe trauma may facilitate novel interventions to improve outcomes. We prospectively recruited 102 severely injured patients at the Queen Elizabeth...

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ea0034p368 | Steroids | SFEBES2014

Glucocorticoid activation in muscle by 11β-hydroxysteroid dehydrogenase type 1: contributions to inflammatory muscle wasting

Hardy Rowan , Lavery Gareth , Pierson Mark , Doug Craig , Filer Andrew , Buckley Christopher , Lord Janet , Stewart Paul , Cooper Mark , Raza Karim

Muscle wasting remains a significant complication in patients with inflammatory disease where it contributes to disability, risk of falls and early mortality. Interestingly, muscle wasting in patients with glucocorticoid excess mirrors that observed in patients with inflammatory disease. We have previously reported that the glucocorticoid activating enzyme 11β-hydroxysteroid dehydrogenase type 1 (11β-HSD1) is potently up-regulated within mesenchymal derived cell popu...

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ea0034p369 | Steroids | SFEBES2014

Abstract Withdrawn....

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ea0034p370 | Steroids | SFEBES2014

A very late and unusual presentation of congenital adrenal hyperplasia

Abou-Saleh Ahmad , Barnes Dennis , Haq Masud

A 71-year-old gentleman was referred for investigation of bilateral enlarged adrenals first discovered after presenting with subacute bowel obstruction. A CT scan of his abdomen revealed the left adrenal was 8×5 cm, the right 3 cm. No other abnormalities were detected.The patient was otherwise well. No other medical history was volunteered. On examination, he was of short stature (height 1.47 m) with a normal pattern of pubic and axillary hair. Bloo...

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ea0034p371 | Steroids | SFEBES2014

Enhanced expression of hepatic inflammatory markers in 11β-hydroxysteroid dehydrogenase type 1 knockout mice fed a steatogenic diet

Larner Dean , Morgan Stuart , Gathercole Laura , Nasiri Maryam , Guest Philip , Chapman Matthew , Tomlinson Jeremy , Stewart Paul , Lavery Gareth

Non-alcoholic fatty liver disease (NAFLD) is characterised by intra-hepatocyte lipid accumulation. Simple steatosis, which is a reversible condition, can progress to non-alcoholic steatohepatitis (NASH), cirrhosis and eventually hepatocellular carcinoma. The aetiology of NAFLD is not fully understood and it is suggested that glucocorticoid reactivation through the activity of the 11β-hydroxysteroid dehydrogenase type 1 (11β-HSD1) enzyme may promote hepatic lipid accu...

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ea0034p372 | Steroids | SFEBES2014

Cushing's syndrome, missed in pregnancy

Jacob Koshy , Jinadev Pushpa

Mrs XY, 28 years. primigravida was seen for PV bleed. Ultrasonogram confirmed live intrauterine foetus of 8 weeks gestation with no obvious cause for PV bleeding. An OGTT at 21 weeks suggested gestational diabetes. She was referred to Diabetes Nurse led clinic and treated with metformin. Hypertension was recorded and controlled with labetalol and amlodipine. Mrs XY had recurrent admissions for PV bleeds and some polycythaemia. She was seen by the haematologist and a diagnosis ...

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ea0034p373 | Steroids | SFEBES2014

Dutasteride and 5α-reductase type 1 activity: for androgens only?

West Charles , Vincent Royce , Taylor Norman

Background: Three 5α-reductase (5α-R1-3) isoenzymes are described. In humans, 5α-R2 deficiency (5α-R2D) causes pseudohermaphroditism and 5α-R3 neurological defects. The role of 5α-R1 is not clear. Urine steroid profiling (USP) by GCMS can compare 5α-reduction activity based on excretion of 5α- and 5β-reduced metabolite ratios. Finasteride predominantly inhibits 5α-R2. USP in these patients shows concordance with 5α-R...

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ea0034p374 | Steroids | SFEBES2014

Differential impact of PAPS synthases on human sulfation pathways

Mueller Jonathan W , Idkowiak Jan , House Philip J , McNelis Joane , Rose Ian I , van den Boom Johannes , Schlereth Florian , Dhir Vivek , Arlt Wiebke

Mutations in the gene for 3′-phospho-adenosine-5′-phosphosulfate synthase 2 (PAPSS2) are linked to bone and cartilage mal-formation. More recently, we could identify PAPSS2-mutations as mono-genetic cause for androgen excess in women due to apparent SULT2A1 deficiency, the enzyme responsible for sulfation of the testosterone precursor DHEA that relies on PAPS provision by PAPS synthases. The only human orthologue, PAPSS1, is expressed in the affected tissu...

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ea0034p375 | Steroids | SFEBES2014

Increased lipopolysaccharide-induced neutrophilia in mice lacking the glucocorticoid receptor in bronchial epithelial (Clara) cells

Kearney Louise , Gibbs Julie , Farrow Stuart , Ray David , Loudon Andrew

One in five people in the UK is affected by lung disease, along with millions more worldwide. Glucocorticoids represent the most utilized anti-inflammatory therapy for the treatment of pulmonary inflammation, however a subset of patients exist which do not respond to therapeutically relevant doses.The non-ciliated bronchial epithelial (Clara) cells have been identified as key mediators of the pulmonary inflammatory response. The glucocorticoid receptor (...

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ea0034p376 | Steroids | SFEBES2014

Blocking local glucocorticoid activation improves skin thinning and impaired healing in Cushingoid mice

Tiganescu Ana , Uchida Yoshikazu , Elias Peter , Holleran Walter

Cushings disease presents with multiple symptoms of systemic glucocorticoid (GC) excess including increased skin thinning and poor wound healing (WH). Local GC concentrations are regulated by 11β-hydroxysteroid dehydrogenase (11β-HSD) isozymes converting inactive cortisone/11-dehydrocorticosterone to cortisol/corticosterone (11β-HSD1) or vice versa (11β-HSD2). We previously demonstrated elevated 11β-HSD1 activity during early WH, hypothe...

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ea0034p377 | Steroids | SFEBES2014

Increased 11β-hydroxysteroid dehydrogenase type 1 activity in UVB-irradiated mice

Tiganescu Ana , Uchida Yoshikazu , Elias Peter , Holleran Walter

UVB exposure induces skin damage including dermal atrophy, telangiectasia, fragility and poor wound healing; symptoms also attributable to glucocorticoid (GC) excess (e.g. Cushings syndrome). In peripheral tissues including skin, GC availability is regulated by 11β-hydroxysteroid dehydrogenase (11β-HSD) types 1/2 which respectively activate/deactivate cortisol (and rodent corticosterone) from/to cortisone (and rodent 11-dehydrocorticosterone). Although we previ...

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ea0034p378 | Steroids | SFEBES2014

The Prevention of Adrenal Crisis in Stress (PACS) study: serum cortisol during elective surgery and acute trauma in comparison to stress dose hydrocortisone in adrenal insufficiency

Taylor Angela , Karavitaki Niki , Foster Mark , Meier Sibylle , O'Neil Donna , Komninos John , Vassiliadi Dimitra , Mowatt Christopher , Lord Janet , Wass John , Arlt Wiebke

Patients with adrenal insufficiency (AI) require adjustment of hydrocortisone (HC) dose to avoid life-threatening adrenal crisis during illness, surgery and trauma. However, current dose recommendations are based on empirical grounds only and choice of dose and administration modes vary considerably. We designed the PACS study to compare cortisol levels achieved by currently recommended HC stress doses to those in i) healthy controls (n=85, 2170 years), ii) mili...

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ea0034p379 | Steroids | SFEBES2014

Abstract withdrawn....

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Society for Endocrinology BES 2014

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