Subscribe to RSS
DOI: 10.1055/s-0030-1267170
© Georg Thieme Verlag KG Stuttgart · New York
In Vivo Activity of 11β-Hydroxysteroid Dehydrogenase Type 1 in Man: Effects of Prednisolone and Chenodesoxycholic Acid
Publication History
received 25.06.2010
accepted 31.08.2010
Publication Date:
05 October 2010 (online)

Abstract
The 11β-hydroxysteroid dehydrogenases (11β-HSDs) play a pivotal role in glucocorticoid (GC) action. 11β-HSD1 is a predominant reductase, activating GCs from inert metabolites, whereas 11β-HSD2 is a potent dehydrogenase inactivating GCs. Knowing the metabolic effects of GCs, a selective inhibition of 11β-HSD1 represents a potential target for therapy of impaired glucose tolerance, insulin insensitivity and central obesity. In vitro, 11β-HSD1 is selectively inhibited by chenodesoxycholic acid (CDCA) and upregulated under GC exposure. Therefore, we aimed to investigate the effects of CDCA and prednisolone on hepatic 11β-HSD1 activity in vivo by measuring 11-reduction of orally given cortisone (E) acetate to cortisol (F). CDCA or placebo was given to 5 male healthy volunteers within a randomised cross-over trial before and after oral administration of 12.5 mg E acetate at 8:00 h. For measurement of in vivo effects of GCs on 11β-HSD1 activity, hepatic reduction of 25 mg E acetate before and after treatment with prednisolone (30 mg for 6 days) was determined in 7 healthy males. Serum GC levels were determined using a fully automated liquid chromatographic system. CDCA had no effect on the activity of 11β-HSD1 in vivo. Prednisolone therapy leads to a marked rise in serum F concentrations and an elevated F/E serum ratio. This proves GC-induced activation of hepatic 11β-HSD1, which could not be extinguished by a parallel increase of IGF-1 under prednisolone. CDCA does not affect in vivo activity of 11β-HSD1 when given in therapeutic dosages. During GC treatment, increased hepatic activation of E to F may aggravate metabolic side effects of GCs such as seen in the metabolic syndrome.
Key words
metabolism - selective inhibition - glucocorticoids - metabolic syndrome - IGF-1
References
- 1 Agarwal MK, Mirshahi M. General overview of mineralocorticoid hormone action. Pharmacol Ther. 1999; 84 273-326
- 2 Ballard PL, Carter JP, Graham BS, Baxter JD. A radioreceptor assay for evaluation of the plasma glucocorticoid activity of natural and synthetic steroids in man. J Clin Endocrinol Metab. 1975; 41 290-304
- 3 Stewart PM, Krozowski ZS. 11 beta-Hydroxysteroid dehydrogenase. Vitam Horm. 1999; 57 249-324
- 4 Edwards CR, Stewart PM, Burt D, Brett L, McIntyre MA, Sutanto WS, de Kloet ER, Monder C. Localisation of 11 beta-hydroxysteroid dehydrogenase – tissue specific protector of the mineralocorticoid receptor. Lancet. 1988; 2 (8618) 986-989
- 5 Ricketts ML, Verhaeg JM, Bujalska I, Howie AJ, Rainey WE, Stewart PM. Immunohistochemical localization of type 1 11beta-hydroxysteroid dehydrogenase in human tissues. J Clin Endocrinol Metab. 1998; 83 1325-1335
- 6 Seckl JR, Walker BR. Minireview: 11beta-hydroxysteroid dehydrogenase type 1 - a tissue-specific amplifier of glucocorticoid action. Endocrinology. 2001; 142 1371-1376
- 7 Bahr V, Pfeiffer AF, Diederich S. The metabolic syndrome X and peripheral cortisol synthesis. Exp Clin Endocrinol Diabetes. 2002; 110 313-318
- 8 Staab CA, Maser E. 11 β-Hydroxysteroid dehydrogenase type 1 is an important regulator at the interface of obesity and inflammation. J Steroid Biochem Mol Biol. 2010; 119 56-72
- 9 Morton NM. Obesity and corticosteroids: 11β-Hydroxysteroid type 1 as a cause and therapeutic target in metabolic disease. Mol Cell Endocrinol. 2010; 316 154-164
- 10 Cooper MS, Stewart PM. 11β-Hydroxysteroiddehydrogenase type 1 and its role in the hypothalamus-pituitary-adrenal axis, metabolic syndrome and inflammation. J Clin Endocrinol Metab. 2009; 94 4645-4654
- 11 Veilleux A, Rheaume C, Daris M, Luu-The V, Tchernof A. Omental adipose tissue type 1 11β-hydroxysteroid dehydrogenase oxoreductase activity, body fat distribution and metabolic alterations in women. J Clin Endocrinol Metab. 2009; 94 3550-3557
- 12 Masuzaki H, Paterson J, Shinyama H, Morton NM, Mullins JJ, Seckl JR, Flier JS. A Transgenic Model of Visceral Obesity and the Metabolic Syndrome. Science. 2001; 294 2166-2170
- 13 Kotelevtsev Y, Holmes MC, Burchell A, Houston PM, Schmoll D, Jamieson P, Best R, Brown R, Edwards CR, Seckl JR, Mullins JJ. 11beta-hydroxysteroid dehydrogenase type 1 knockout mice show attenuated glucocorticoid-inducible responses and resist hyperglycemia on obesity or stress. Proc Natl Acad Sci USA. 1997; 94 14924-14929
- 14 Bujalska IJ, Kumar S, Hewison M, Stewart PM. Differentiation of adipose stromal cells: the roles of glucocorticoids and 11beta-hydroxysteroid dehydrogenase. Endocrinology. 1999; 140 3188-3196
- 15 Hammami MM, Siiteri PK. Regulation of 11 beta-hydroxysteroid dehydrogenase activity in human skin fibroblasts: enzymatic modulation of glucocorticoid action. J Clin Endocrinol Metab. 1991; 73 326-334
- 16 Voice MW, Seckl JR, Edwards CR, Chapman KE. 11 beta-hydroxysteroid dehydrogenase type 1 expression in 2S FAZA hepatoma cells is hormonally regulated: a model system for the study of hepatic glucocorticoid metabolism. Biochem J. 1996; 317 621-625
- 17 Quinkler M, Troeger H, Eigendorff E, Maser-Gluth C, Stiglic A, Oelkers W, Bähr V, Diederich S. Enhanced 11beta-hydroxysteroid dehydrogenase type 1 activity in stress adaptation in the guinea pig. J Endocrinol. 2003; 176 185-192
- 18 Sai S, Esteves CL, Kelly V, Michailidou Z, Anderson K, Coll AP, Nakagawa Y, Ohzeki T, Seckl JR, Chapman KE. Glucocorticoid regulation of the promoter of 11β-hydroxysteroid dehydrogenase is indirect and requires CCAAT/enhancer-binding protein-β. Mol Endocrinol. 2008; 22 2049-2060
- 19 Quinkler M, Oelkers W, Diederich S. Clinical implications of glucocorticoid metabolism by 11beta-hydroxysteroid dehydrogenases in target tissues. Eur J Endocrinol. 2001; 144 87-97
- 20 Walker BR, Connacher AA, Lindsay RM, Webb DJ, Edwards CR. Carbenoxolone increases hepatic insulin sensitivity in man: a novel role for 11-oxosteroid reductase in enhancing glucocorticoid receptor activation. J Clin Endocrinol Metab. 1995; 80 3155-3159
- 21 Alberts P, Engblom L, Edling N, Forsgren M, Klingstrom G, Larsson C, Rönquist-Nii Y, Ohman B, Abrahmsen L. Selective inhibition of 11β-hydroxysteroid dehydrogenase type 1 decreases blood glucose concentrations in hyperglycaemic mice. Diabetologia. 2002; 45 1528-1532
- 22 Barf T, Vallgarda J, Emond R, Haggstrom C, Kurz G, Nygren A, Larwood V, Mosialou E, Axellson K, Olsson R, Engblom L, Edling N, Rönquist-Nii Y, Ohman B, Alberts P, Abrahmsen L. Arylsulfonamidothiazoles as a new class of potential antidiabetic drugs. Discovery of potent and selective inhibitors of the 11beta-hydroxysteroid dehydrogenase type 1. J Med Chem. 2002; 45 3813-3815
- 23 Su X, Vicker N, Truselle M, Halem H, Culler MD, Potter BV. Discovery of novel inhibitors of human 11β-hydroxysteroid dehydrogenase type 1. Mol Cell Endocrinol. 2009; 301 169-173
- 24 Hadoke PWF, Iqbal J, Walker BR. Therapeutic manipulation of glucocorticoid metabolism in cardiovascular disease. Br J Pharmacol. 2009; 156 689-712
- 25 Maeda Y, Naganuma S, Niina I, Shinohara A, Koshimoto C, Kondo K, Chijiiwa K. Effects of bile acids on rat hepatic microsomal type I 11β-hydroxysteroid dehydrogenase. Steroids. 2010; 75 164-168
- 26 Diederich S, Grossmann C, Hanke B, Quinkler M, Herrmann M, Bahr V, Oelkers W. In the search for specific inhibitors of human 11beta-hydroxysteroid-dehydrogenases (11beta-HSDs): chenodeoxycholic acid selectively inhibits 11beta-HSD-I. Eur J Endocrinol. 2000; 142 200-207
- 27 Ponz de Leon M, Loria P, Carulli N, Murphy G, Dowling R. Intestinal solubilization, absorption, pharmacokinetics and bioavailability of chenodesoxycholic acid. Eur J Clin Invest. 1980; 10 261-271
- 28 Stewart PM, Wallace AM, Atherden SM, Shearing CH, Edwards CR. Mineralocorticoid activity of carbenoxolone: contrasting effects of carbenoxolone and liquorice on 11 beta-hydroxysteroid dehydrogenase activity in man. Clin Sci. 1990; 78 49-54
- 29 Mai K, Kullmann V, Bobbert T, Maser-Gluth C, Möhlig M, Bähr V, Pfeiffer AFH, Spranger J, Diederich S. In vivo activity of 11beta-hydroxysteroid- dehydrogenase type 1 and free fatty acids induced insulin resistance. Clin Endocrinol. 2005; 63 442-449
- 30 Mai K, Andres J, Bobbert T, Maser-Gluth C, Möhlig M, Bähr V, Pfeiffer AFH, Spranger J, Diederich S. Rosiglitazone decreases 11beta-hydroxysteroid- dehydrogenase type 1 in subcutaneous adipose tissue. Clin Endocrinol. 2007; 67 419-425
- 31 Otto B, Tschoep M, Heldwein W, Pfeiffer AFH, Diederich S. Endogenous and exogenous glucocorticoids decrease plasma ghrelin in humans. Eur J Endocrinol. 2004; 151 113-117
- 32 Diederich S, Hanke B, Burkhardt P, Müller M, Schöneshöfer M, Bähr V, Oelkers W. Metabolism of synthetic corticosteroids by 11β-hydroxysteroid-dehydrogenases in man. Steroids. 1998; 63 271-277
- 33 Diederich S, Eigendorff E, Burkhard P, Quinkler M, Bumke-Vogt C, Rochel M, Seidelmann D, Esperling P, Oelkers W, Bähr V. 11β-hydroxysteroid dehydrogenase type 1 and 2: An important pharmacokinetic determinant for the activity of synthetic mineralo- and glucocorticoids. J Clin Endocrinol Metab. 2002; 87 5695-5701
- 34 Schoneshofer M, Fenner A. A convenient and efficient method for the extraction and fractionation of steroid hormones from serum or urine. J Clin Chem Clin Biochem. 1981; 19 71-74
- 35 Ricketts ML, Shoesmith KJ, Hewison M, Strain A, Eggo MC, Stewart PM. Regulation of 11 beta-hydroxysteroid dehydrogenase type 1 in primary cultures of rat and human hepatocytes. J Endocrinol. 1998; 156 159-168
- 36 Jamieson PM, Chapman KE, Edwards CR, Seckl JR. 11 beta-hydroxysteroid dehydrogenase is an exclusive 11β-reductase in primary cultures of rat hepatocytes: Effect of physiochemical and hormonal manipulations. Endocrinology. 1995; 136 4754-4761
- 37 Whorwood CB, Sheppard MC, Stewart PM. Licorice inhibits 11 beta-hydroxysteroid dehydrogenase messenger ribonucleic acid levels and potentiates glucocorticoid hormone action. Endocrinology. 1993; 132 2287-2292
- 38 Renner E, Horber F, Jost G, Frey BM, Frey FJ. Effect of liver function on the metabolism of prednisone and prednisolone in humans. Gastroenterology. 1986; 90 819-828
- 39 Rask E, Olsson T, Soderberg S, Andrew R, Livingstone DE, Johnson O, Walker B. Tissue-specific dysregulation of cortisol metabolism in human obesity. J Clin Endocrinol Metab. 2001; 86 1418-1421
- 40 Moore JS, Monson JP, Kaltsas G, Putignano P, Wood PJ, Sheppard MC, Besser GM, Taylor NF, Stewart PM. Modulation of 11β-hydroxysteroid dehydrogenase isoenzymes by growth hormone and insulin-like growth factor: in vivo and in vitro studies. J Clin Endocrinol Metab. 1999; 84 4172-4177
- 41 Mauras N. Can growth hormone counteract the catabolic effects of steroids?. Horm Res. 2009; 72 (S 01) 48-54
- 42 Pralong FP, Miell JP, Corder R, Gaillard RC. Dexamethasone treatment in man induces changes in 24-hour growth hormone (GH) secretion profile without altering total GH released. J Clin Endocrinol Metab. 1991; 73 1191-1196
- 43 van Raalte DH, Ouwens DM, Diamant M. Novel insights into glucocorticoid-mediated diabetogenic effects: towards expansion of therapeutic options?. Eur J Clin Invest. 2009; 39 81-93
- 44 Paterson JM, Morton NM, Fievet C, Kenyon CJ, Holmes MC, Staels B, Seckl JR, Mullins JJ. Metabolic syndrome without obesity: Hepatic overexpression of 11beta-hydroxysteroid dehydrogenase type 1 in transgenic mice. Proc Natl Acad Sci USA. 2004; 101 7088-7093
- 45 Dötsch J, Rascher W. The role of 11β-hydroxysteroid dehydrogenase activity in the etabolic syndrome: lessons learned from the animal model. Eur J Endocrinol. 2002; 146 603-605
- 46 Mezuk B, Eaton WW, Albrecht S, Golden SH. Depression and type 2 diabetes over the lifespan: a meta-analysis. Diabetes care. 2008; 31 2383-2390
- 47 Gambertoglio JG, Vincenti F, Feduska NJ, Birnbaum J, Salvatierra Jr O, Amend WJ. Prednisolone disposition in cushingoid and non cushingoid kidney transplant patients. J Clin Endocrinol Metab. 1980; 51 561-565
- 48 Stewart PM, Boulton A, Kumar S, Clark PMS, Shackleton CHL. Cortisol metabolism in human obesity: impaired cortisone to cortisol conversion in subjects with central obesity. J Clin Endocrinol Metab. 1999; 84 1022-1027
- 49 Andrews RC, Herlihy O, Livingstone DE, Andrew R, Walker BR. Abnormal cortisol metabolism and tissue sensitivity to cortisol in patients with glucose intolerance. J Clin Endocrinol Metab. 2002; 87 5587-5593
Correspondence
S. Diederich
Endokrinologikum Berlin am
Gendarmenmarkt
Centre for Endocrine and
Metabolism Diseases
Friedrichstraße 76 (Q207)
10117 Berlin
Phone: +49/30/2091 562 290
Fax: +49/30/2091 562 291
Email: sven.diederich@endokrinologikum.com