steroid

/stear"oyd, ster"-/, Biochem.

n.

1. any of a large group of fat-soluble organic compounds, as the sterols, bile acids, and sex hormones, most of which have specific physiological action.

adj.

2. Also, steroidal /sti royd"l, ste-/. pertaining to or characteristic of a steroid.

[1925-30; STER(OL) + -OID]

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Any of a class of natural or synthetic organic compounds with a molecular core, or nucleus, of 17 carbon atoms in a characteristic three-dimensional arrangement of four rings.

The configuration of the nucleus, the nature of the groups attached to it, and their positions distinguish different steroids. Hundreds have been found in plants and animals and thousands more synthesized or made by modifying natural steroids. Steroids are important in biology, chemistry, and medicine. Examples include many hormones (including the sex hormones), bile acids, sterols (including cholesterol), and oral contraceptives (see contraception). Digitalis was the first steroid widely used in Western medicine. Corticosteroids (see cortisone) and their synthetic analogs are used to treat rheumatism and other inflammatory ailments. See also anabolic steroid.

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▪ chemical compound

Introduction

 any of a class of natural or synthetic organic compounds (organic compound) characterized by a molecular structure of 17 carbon atoms arranged in four rings. Steroids are important in biology, chemistry, and medicine. The steroid group includes all the sex hormones (sex hormone), adrenal (adrenal gland) cortical hormones, bile acids, and sterols of vertebrates, as well as the molting (molt) hormones of insects (insect) and many other physiologically active substances of animals (animal) and plants (plant). Among the synthetic steroids of therapeutic value are a large number of anti-inflammatory agents, anabolic (growth-stimulating) agents, and oral contraceptives.

      Different categories of steroids are frequently distinguished from each other by names that relate to their biological source—e.g., phytosterols (found in plants), adrenal steroids, and bile acids—or to some important physiological function—e.g., progesterones (progesterone) (promoting gestation), androgens (androgen) (favouring development of masculine characteristics), and cardiotonic steroids (facilitating proper heart function).

      Steroids vary from one another in the nature of attached groups, the position of the groups, and the configuration of the steroid nucleus (or gonane). Small modifications in the molecular structures of steroids can produce remarkable differences in their biological activities.

      This article covers the history, chemistry, biological significance, and basic pharmacology of steroids. For more information about the physiological relevance and the pharmacological applications of steroids, see human endocrine system (endocrine system, human), endocrine system, and drug.

History of steroids

 The first therapeutic use of steroids occurred in the 18th century when English physician William Withering used digitalis, a compound extracted from the leaves of the common foxglove (Digitalis purpurea), to treat edema. Studies of steroids commenced in the early 19th century with investigations of the unsaponifiable (i.e., remaining undissolved after heating with excess of alkali) material, largely cholesterol, of animal fat and gallstones (gallstone) and of acids obtainable from bile. This early work, with which many of the noted chemists of the time were associated, led to the isolation of cholesterol and some bile acids in reasonable purity and established some significant features of their chemistry.

      Insight into the complex polycyclic steroid structure, however, came only after the beginning of the 20th century, following the consolidation of chemical theory and the development of chemical techniques by which such molecules could be broken down step by step. Arduous studies, notably by the research groups of the German chemists Adolf Windaus (Windaus, Adolf) and Heinrich Wieland (Wieland, Heinrich Otto), ultimately established the structures of cholesterol; of the related sterols, stigmasterol and ergosterol; and of the bile acids. Investigation of ergosterol was stimulated by the realization that it can be converted into vitamin D. Only in the final stages of this work (1932) was the arrangement of the component rings of the nucleus clarified by results obtained by pyrolytic (heat-induced bond-breaking) dehydrogenation and X-ray crystallography.

      With the foundations of steroid chemistry firmly laid, the next decade saw the elucidation of the structures of most of the physiologically potent steroid hormones of the gonads (gonad) and the adrenal cortex. Added impetus was given to steroid research when American physician Philip S. Hench (Hench, Philip Showalter) and American chemist Edward C. Kendall (Kendall, Edward Calvin) announced in 1949 that the hitherto intractable symptoms of rheumatoid arthritis were dramatically alleviated by the adrenal hormone cortisone. New routes of synthesis of steroids were developed, and many novel analogs were therapeutically tested in a variety of disease states. From these beginnings has developed a flourishing steroid pharmaceutical industry—and with it a vastly expanded fundamental knowledge of steroid reactions that has influenced many other areas of chemistry.

      Knowledge of the biochemistry of steroids has grown at a comparable rate, assisted by the use of radioisotopes (radioactive isotope) and new analytical techniques. The metabolic pathways (sequences of chemical transformations in the body), both of synthesis and of decomposition, have become known in considerable detail for most steroids present in mammals (mammal), and much research relates to control of these pathways and to the mechanisms by which steroid hormones exert their effects. The hormonal role of steroids in other organisms is also of growing interest.

Steroid numbering system and nomenclature

       Names of fundamental structures most often used in steroid nomenclature Names of fundamental structures most often used in steroid nomenclatureAll steroids are related to a characteristic molecular structure composed of 17 carbon atoms—arranged in four rings conventionally denoted by the letters A, B, C, and D—bonded to 28 hydrogen atoms.

      This parent structure (1), named gonane (also known as the steroid nucleus), may be modified in a practically unlimited number of ways by removal, replacement, or addition of a few atoms at a time; hundreds of steroids have been isolated from plants and animals, and thousands more have been prepared by chemical treatment of natural steroids or by synthesis from simpler compounds.

      The steroid nucleus is a three-dimensional structure, and atoms or groups are attached to it by spatially directed bonds. Although many stereoisomers of this nucleus are possible (and may be synthesized), the saturated nuclear structures of most classes of natural steroids are alike, except at the junction of rings A and B. Simplified three-dimensional diagrams may be used to illustrate stereochemical details. For example, androstane, common to a number of natural and synthetic steroids, exists in two forms (2 and 3), in which the A/B ring fusions are called cis and trans, respectively.

      In the cis isomer, bonds to the methyl group, CH₃, and to the hydrogen atom, H, both project upward from the general plane defined by the rest of the molecule, whereas in the trans isomer, the methyl group projects up and the hydrogen projects down. Usually, however, steroid structures are represented as plane projection diagrams such as 4 and 5, which correspond to 2 and 3, respectively.

      The stereochemistry of rings A and B must be specified by showing the orientation of the hydrogen atom attached at C5 (that is, carbon atom number 5; steroid numbering is explained below) as either above the plane of the diagram (designated β) or below it (α). The α-, β- symbolism is used in a similar manner to indicate the orientation of any substituent group that is attached to a saturated (fully substituted) carbon within the steroid ring system. Groups attached to unsaturated carbons lie in the same plane as the adjacent carbons of the ring system (as in ethylene), and no orientation need be specified. When the orientation of a substituent is unknown, it is assigned the symbol ξ. Bonding of β-attached substituents is shown diagrammatically as in 4 by a full line, that of α-substituents by a broken line, as in 5, and that of ξ-substituents by a wavy line.

      Each carbon atom of a steroid molecule is numbered, and the number is reserved to a particular position in the hypothetical parent skeletal structure (6) whether this position is occupied by a carbon atom or not.

      Steroids are named by modification of the names of skeletal root structures according to systematic rules agreed upon by the International Union of Pure and Applied Chemistry. By attaching prefixes and suffixes to the name of the appropriate root structure, the character of substituent groups or other structural modification is indicated. The prefixes and suffixes include numbers, called locants, indicative of the position in the carbon skeleton at which the modification occurs, and, where necessary, the orientation of a substituent is shown as α- or β-. The carbon atom at position 3, for example, is referred to as C3; a hydroxyl group attached to C3 is referred to as a 3-OH group or, more specifically, as a 3α-OH or 3β-OH group. In addition to differences in details of the steroid nucleus, the various classes of steroids are distinguished by variations in the size and structure of an atomic group (the side chain) attached at position 17. For unambiguous use of the names of the fundamental structures of steroids, the orientation (α or β) of hydrogen at C5 must be specified. If no other modification is indicated, the nucleus is assumed to be as shown in 2 and 3, except in the cardanolides and bufanolides; compounds of these types characteristically possess the 5β,14β configurations, which, however, are specified.

      For brevity in discussion and in trivial nomenclature, a number of prefixes are often attached, with locants, to the names of steroids to indicate specific modifications of the structure. In addition to the usual chemical notations for substituent groups replacing hydrogen atoms (e.g., methyl-, chloro-, hydroxy-, oxo-), the following prefixes are commonly used: dehydro- (lacking two hydrogen atoms from adjacent positions); dihydro- (possessing two additional hydrogen atoms in adjacent positions); deoxy- (hydroxyl group replaced by a hydrogen atom); epi- (differing in configuration of a carbon atom bonded to two other carbon atoms); iso- (differing in configuration of a carbon atom bonded to three other carbon atoms); nor- (lacking one carbon atom); homo- (possessing one additional carbon atom); cyclo- (with a bond between two carbons that are normally not united); and seco- (with a carbon-carbon bond of the nucleus broken).

      Depending on the number and character of their functional groups, steroid molecules may show diverse reactivities. Moreover, the reactivity of a functional group varies according to its location within the molecule (for example, esters (ester) are formed readily by 3-OH groups but only with difficulty by the 11β-OH group). An important property of steroids is polarity—i.e., their solubility in oxygen-containing solvents (e.g., water and alcohols (alcohol)) rather than hydrocarbon solvents (e.g., hexane and benzene). Hydroxyl, ketonic, or ionizable (capable of dissociating to form electrically charged particles) groups in a steroid molecule increase its polarity to an extent that is strongly influenced by the spatial arrangement of the atoms within the molecule.

Methods of isolation (separation and purification)

      Procedures for isolation of steroids differ according to the chemical nature of the steroids and the scale and purpose of the isolation. Steroids are isolated from natural sources by extraction with organic solvents, in which they usually dissolve more readily than in the aqueous fluids of tissues. The source material often is treated initially with an alcoholic solvent, which dehydrates it, denatures (denaturation) (renders insoluble) proteins (protein) associated with the steroids, and dissolves many steroids. Saponification either of whole tissues or of substances extracted from them by alcohol splits the molecules of sterol esters (ester), triglycerides (triglyceride), and other fatty esters and permits the extraction of the sterols by means of water-immiscible solvents, such as hexane or ether, with considerable purification. Intact sterol esters or hormonal steroids and their metabolites (compounds produced by biological transformation) that are sensitive to strong acids (acid) or alkalies (alkali), however, require essentially neutral conditions for isolation, and, although some procedures for analysis of urinary steroids employ acid treatment, milder hydrolysis, as by enzymes (enzyme), is preferred. The acidity of some steroids allows them to be held in alkaline solution, while nonacidic impurities are extracted with organic solvents.

      Commercially, abundant steroids usually are purified by repeated crystallization from solvents. Small-scale laboratory isolations for investigative or assay purposes usually exploit differing polarities of the steroid and of its impurities, which may be separated by partitioning between solvents differing in polarity or by chromatography (see below Determination of structure and methods of analysis (steroid)). Occasionally, special reagents may selectively precipitate or otherwise sequester the desired steroid. A classical example is the precipitation of 3β-hydroxy sterols such as cholesterol by the natural steroid derivative digitonin. New steroids of great physiological interest often are isolated from tissue only with extreme difficulty, because they are usually trace constituents. In one example, 500 kg (1,100 pounds) of silkworm (silkworm moth) pupae yielded 25 mg (0.0008 ounce) of pure molting hormone, the steroid ecdysone (i.e., 20 × 10⁶-fold purification). In such cases each isolation step is followed by an assay for the relevant physiological activity to ensure that the desired material is being purified. The percentage recovery of known steroid hormones during their assay in small biological samples usually is assessed by adding a trace of the same steroid in radioactive form to the initial sample, followed by radioassay (analysis based on radioactivity) after purification is complete. The efficiency of recovery of the radioactive steroid is assumed to be the same as that of the natural substance.

Determination of structure and methods of analysis

      The systematic, stepwise breakdown by chemical methods of the steroid ring systems, used in early investigations of structure, is mainly of historical interest. The small number of different nuclear structures found in steroids often has permitted establishment of the structure of a new steroid by conversion to related compounds of known structure. Structure elucidation in the steroid field, as in all areas of organic chemistry, depends heavily on physical methods, particularly nuclear magnetic resonance, infrared spectroscopy, mass spectrometry, and X-ray crystallography. Data obtained by these methods reinforce and often replace the classical criteria of characterization of steroids: melting point, optical rotation, elemental analysis, and ultraviolet absorption at a fixed wavelength.

       chromatography is a crucial technique in steroid chemistry. The behaviour of a steroid in selected chromatographic systems often identifies it with a high degree of probability. The identification may be made virtually certain by the conversion of the material to derivatives that in turn are examined chromatographically. Abundant data for the behaviour of steroids in paper chromatography, thin-layer chromatography, liquid chromatography, and gas-liquid chromatography show that individual features of molecular structure determine the chromatographic properties of steroids in a predictable manner. The gas-liquid chromatograph or liquid chromatograph linked directly to the mass spectrometer permits characteristic mass-spectral fragmentation patterns and critical gas-liquid chromatographic data to be obtained simultaneously, using a sample containing less than a microgram of a steroid. This powerful technique is of growing importance in the structural analysis of steroids in extracts of such body fluids as blood and urine.

Total synthesis of steroids

      In most total syntheses of steroids, a monocyclic starting material such as a quinone provides one ring upon which the other rings of the nucleus are elaborated step-by-step by condensation reactions (condensation reaction) with smaller molecules to give the desired stereochemistry in successive ring fusions. Each new ring closure must also provide functional groups that can be used in building up the next ring. In a quite different approach, stereochemical control of ring fusions is achieved by using the fact that under acidic conditions open-chain molecules containing suitably located double bonds cyclize to multiring structures that have the necessary stereochemistry and that can be relatively easily converted to steroids. From its analogy with the cyclization of squalene 2,3-oxide to lanosterol in the biosynthesis of cholesterol (see below Biosynthesis and metabolism of steroids: Cholesterol (steroid)), this method is said to involve biogenetic-type cyclization.

Partial synthesis of steroids

      Although total synthesis of steroids has proved commercially feasible, it is often more practical to prepare them by partial synthesis—that is, by modification of other naturally abundant steroids. To be useful as a starting material for partial synthesis, the naturally occurring steroid must possess a molecular structure that can be easily converted to that of the desired product. For the synthesis of cortisol, cortisone, and their analogs, which carry an oxygen function at C11, a preexisting oxygen function at this position or at the adjacent C12 is highly desirable. Indeed, prior to the advent of methods for microbiological oxidation, this was a crucial requirement, since the introduction of any functional group at C11 of most steroids was extremely difficult.

      In the early commercial synthesis of androgenic steroids, cholesterol was the main starting material. Cholic acid and deoxycholic acid, inexpensive by-products from slaughterhouses, were starting materials for production of cortisone. Today most steroid drugs are manufactured from the abundant steroids of plant origin, notably the sapogenins (sapogenin). Diosgenin, obtainable from several varieties of yams (yam) in the genus Dioscorea, is used in the commercial manufacture of progesterone. Progesterone can be converted to androgenic and estrogenic hormones and to the more complex adrenal steroid hormones (steroid hormone), such as cortisone and cortisol. A most important advance in this field was the discovery that microorganisms such as Rhizopus nigricans introduce hydroxyl groups into a variety of steroids at C11 and elsewhere: they are used in the commercial synthesis of a large number of steroid hormone analogs. A sapogenin, hecogenin, obtainable in quantity from the waste of sisal plants, is used for synthesis of cortisol. Stigmasterol, which is readily obtainable from soybean oil, can be transformed easily to progesterone and to other hormones, and commercial processes based on this sterol have been developed.

Biological significance of steroids

      That such diverse physiological functions and effects should be exhibited by steroids, all of which are synthesized by essentially the same central biosynthetic pathway, is a remarkable example of biological economy. Most of these functions, especially those of a hormonal type, involve the transmission of biologically essential information. The specific information content of the steroid resides in the character and arrangement of its substituent groups and in other subtle structural modifications.

Sterols and bile acids

       Some important sterols and their sources Some important sterols and their sourcesThe most generally abundant steroids are sterols, which occur in all tissues of animals (animal), green plants (plant), and fungi (fungus) such as yeasts (yeast). Evidence for the presence of steroids in bacteria and in primitive blue-green algae is conflicting. The major sterols of most tissues are accompanied by traces of their precursors—lanosterol in animals and cycloartenol in plants—and of intermediates between these compounds and their major sterol products. In mammalian skin one precursor of cholesterol, 7-dehydrocholesterol, is converted by solar ultraviolet light (ultraviolet radiation) to cholecalciferol, vitamin D₃, which controls calcification of bone by regulating intestinal absorption of calcium. The disease rickets, which results from lack of exposure to sunlight or lack of intake of vitamin D, can be treated by administration of the vitamin or of the corresponding derivative of ergosterol, ergocalciferol (vitamin D₂).

      Sterols are present in tissues both in the nonesterified (free) form and as esters (ester) of aliphatic fatty acids (fatty acid). In the disease atherosclerosis, fatty materials containing cholesterol form deposits (plaques), especially in the walls of the major blood vessels (blood vessel), and vascular function may be fatally impaired. The disease has many contributory factors but typically is associated with elevated concentrations of cholesterol in the blood plasma. One aim of medical treatment is to lower the plasma cholesterol level.

       Evolutionary relationships of bile alcohols and bile acids Evolutionary relationships of bile alcohols and bile acidsFree sterols appear to stabilize the structures of cellular and intracellular membranes (cell). Because the sheath of fibres is a deposit of many layers of the membranes of neighbouring cells, mature mammalian nerve tissue (e.g., beef brain) is the richest source of cholesterol. Cholesterol also is converted in animals to steroids that have a variety of essential functions and in plants to steroids whose functions are less clearly understood. The bile acids (cholanoic acids, also called cholanic acids) of higher vertebrates form conjugates with the amino acids (amino acid) taurine and glycine, and the bile alcohols (cholane derivatives) of lower animals form esters with sulfuric acid (sulfates). These conjugates and sulfates enter the intestine as sodium salts and assist in the emulsification and absorption of dietary fat, processes that may be impaired when bile acid secretion is reduced, as in some liver diseases and in obstructive jaundice. The mixture of bile acids found in feces reflects the actions of intestinal microorganisms on the primary bile-acid secretory products (e.g., deoxycholic acid arises by bacterial transformation of cholic acid).

Sex hormones (sex hormone)

      Steroids that have a phenolic ring A (i.e., those in which ring A is aromatic and bears a hydroxyl group) are ubiquitous products of the ovary of vertebrate animals. These are the estrogens (estrogen), of which estradiol is the most potent. They maintain the female reproductive tissues in a fully functional condition, promote the estrous state of preparedness for mating, and stimulate development of the mammary glands (mammary gland) and of other feminine characteristics. Estrogenic steroids have been isolated from urines (urine) of pregnant female mammals of many species, including humans, from placental (placenta) and adrenal (adrenal gland) tissues, and, unexpectedly, from the testes (testis) and urines of stallions.

      The corpus luteum, a modification of vertebrate ovarian tissue that forms following ovulation (release of the mature egg cell from the ovary), produces progesterone and its derivatives. Progesterone is also secreted by the adrenals and placenta. Progesterone, in combination with estrogen, regulates the metabolism of the uterus to permit implantation and subsequent development of the fertilized ovum in mammals. In birds (bird), estrogen and progesterone stimulate the development of the oviduct and its secretion of albumin. Estrogen and progesterone suppress ovulation; this fact is the basis of action of steroid antifertility drugs (see below Pharmacological actions of steroids: Steroid contraceptives (steroid)). Estrogen and progesterone occur in primitive invertebrates (invertebrate), but their functions in those animals are obscure.

      In male vertebrates the androgens (androgen)—steroids secreted by the testes—maintain spermatogenesis and the tissues of the reproductive tract.

      Androgens promote male sexual behaviour and aggressiveness, muscular development, and, in humans, the growth of facial and body hair and deepening of the voice. testosterone and androstenedione are the principal androgens of the testes. Testosterone is more potent than androstenedione, but in the sexual tissues it appears to be converted to 5α-dihydrotestosterone, an even more potent androgen.

Adrenal hormones

      The adrenal cortex of vertebrates synthesizes oxygenated progesterone derivatives. These compounds are hormones that are vital to survival and are classified according to their biological activity. The glucocorticoids promote the deposition of glycogen in the liver and the breakdown of body proteins (protein). Mineralocorticoids stimulate retention of sodium in the extracellular body fluids. cortisol is the principal glucocorticoid in many species, including humans; in most rodents (rodent) this role is filled by corticosterone. The most potent mineralocorticoid of all species is aldosterone. Aldosterone has about 20 percent of the glucocorticoid activity of cortisol, which, conversely, has about 0.1 percent of the mineralocorticoid activity of aldosterone. Either steroid can maintain life in an animal from which the adrenal glands (adrenal gland) have been removed. The secretion of glucocorticoids is exquisitely responsive to injury and fear in animals and is primarily responsible for metabolic adaptation to stressful conditions. Failure of the adrenal cortex in humans gives rise to Addison disease, a formerly fatal condition that can now be successfully treated with synthetic adrenal steroids.

Steroids of insects, fungi, and other organisms

       Representative ecdysones of arthropods and plants Representative ecdysones of arthropods and plantsAn area of increasing interest is the role of steroids in the reproduction, development, and self-defense of organisms such as insects. Insects (insect) and crustaceans (crustacean) produce the ecdysones, steroid hormones that promote molting (molt) and the development of adult characteristics.

      Steroids also occur in fungi (fungus). For example, in the aquatic fungus Achlya bisexualis, the steroid antheridiol (12) of the female stimulates male gamete formation.

      Many plants, especially ferns (fern) and conifers (conifer), contain steroids that may protect them against some predatory insects, although this function is not established. Progesterone, 11-deoxycorticosterone, and related steroids with no known endocrine (endocrine system) function in insects are released into the water by several species of water beetles (water beetle) to repel predatory fish, and the sea cucumbers (sea cucumber) (Holothuroideae) produce the holothurinogenins, a group of lanosterol derivatives toxic to nerve tissue. An example of a holothurinogenin (13) is shown here.

      Cardanolide and bufanolide derivatives, found in many plants and in the skin of toads (toad), cause vomiting, visual disturbances, and slowing of the heart in vertebrates and are strong deterrents to predators. Birds and other predators instinctively avoid certain grasshoppers (grasshopper) and butterflies (butterfly) that store cardenolides of the plants upon which they feed. The skin of the poison frog, Phyllobates aurotaenia, produces a deadly alkaloid, batrachotoxin (14), which is used by tribal peoples as an arrow poison. The skin of salamanders (salamander) secretes a comparably poisonous alkaloid—samandarin (15).

      Many steroid alkaloids (alkaloid) occur in plants, but their functions, like those of the steroid saponins (saponin), are unknown. It is possible that the taste of many of these compounds deters grazing animals or attracts certain insect species to the plant.

Pharmacological actions of steroids

      Aside from their principal physiological effects, all steroid hormones have generalized influences on metabolic systems throughout the body. These are sometimes seen as powerful pharmacological side effects when, either during hormone therapy or through some endocrine abnormality, the body is exposed to excessive amounts of a naturally occurring steroid hormone. In some synthetic analogs of the natural hormones, a desired activity is accentuated, whereas others are minimized. Furthermore, just as naturally occurring steroid hormones of differing biological activity (estrogens (estrogen), androgens (androgen), glucocorticoids, and mineralocorticoids) often act antagonistically, the many steroid analogs include a number of inhibitors of the natural hormones.

Androgens (androgen) and anabolic steroids (anabolic steroid)

      A growing number of amateur and professional athletes have made use of synthetic analogs of testosterone to accelerate muscular development and to improve strength. Medical researchers have determined that the use of anabolic steroids may lead to heart disease, sexual and reproductive disorders, immune deficiencies, liver damage, stunted growth (in teenagers and young adults), and aggressive, violent behaviour.

      Androgens secreted or administered in abnormally large amounts can cause development of male characteristics in the female and precocious sexual development in the male. Conversely, hypogonadism of the male (inadequate testicular function) leads to retarded sexual development and retention of feminine bodily characteristics (eunuchoidism), which can sometimes be remedied by administration of androgenic steroids. Several esters (ester) of testosterone are commonly used by injection for this purpose. Many orally active analogs of testosterone are also available in which activity is greatly enhanced, and often the ratio of androgenic activity to anabolic activity is shifted markedly in favour of the latter. This ratio primarily determines the therapeutic value of these compounds as anabolic agents. They are used together with growth hormone to promote growth in children in whom physical development is retarded. They are also used to promote physical recovery from debilitating diseases.

Steroid contraceptives

      The most effective method of contraception uses combinations of synthetic estrogen and progesterone that prevent ovulation and render the uterine environment unfavourable to conception and to the development of the ovum. Unlike the natural hormones, these synthetic steroids are highly active when taken orally as tablets.

      Estrogens that have been used in oral contraceptives include estranol, which has about the same potency as estradiol, and mestranol, which is less potent. The main differences between preparations are the character of the progesterones and the quantities and ratios of the steroids. Synthetic progesterone is also used to correct irregularities of the menstrual cycle and to maintain pregnancy in cases of threatened abortion.

      Contraceptive steroid preparations are also used for control of breeding cycles and synchronization of estrus in farm animals. Synthetic estrogens can be used to alleviate the unpleasant physical and psychic symptoms of menopause in women and for the treatment of prostate cancer in men and breast cancer in women. They are also used in some cases to suppress the plasma cholesterol concentrations in people with advanced atherosclerosis, a disease that is prevalent in men and postmenopausal women. (For more information about oral contraceptives, see birth control and contraception.)

Cardiotonic steroids

      Preparations in which cardiotonic steroids of both vegetable and animal origin are the active principles have been used as emetics, diuretics (diuretic), and arrow poisons for centuries. The use of digitalis, ouabain, and strophanthin glycosides (glycoside) to slow the rate and strengthen the contractility of the failing heart is one of the most important methods of treatment of this condition. Of these agents, the digitalis glycosides are the most widely used. The therapeutic effects of these agents are related to their influence on muscle cells of the heart.

Biosynthesis (anabolism) and metabolism of steroids

 In plants and animals, steroids appear to be biosynthesized by similar reactions, beginning with acetic acid, assisted by a type of enzyme. The isoprenoid hydrocarbon called squalene, which occurs widely in nature, is thought to be the starting material from which all steroids are made. Enzymatic transformation of squalene produces lanosterol in animals and cycloartenol in plants, which yield cholesterol in both animals and plants. Cholesterol is then converted to bile acids and steroid hormones (steroid hormone) in animals and to steroids such as alkaloids (alkaloid) in plants.

Cholesterol

 Steroids are probably synthesized in all vertebrates and in many invertebrates by the same pathway, which includes cholesterol. Biosynthesis of cholesterol is especially vigorous in the liver of vertebrates but also occurs in the intestine, gonads (gonad), skin, and immature brain. Cholesterol is barely detectable in the adult brain. The insects, certain mollusks (mollusk), annelids (annelid), and some protozoa (protozoan) do not synthesize cholesterol but must obtain it, or a related sterol, in their diets.

      Cholesterol and other steroids are biosynthesized by extension of the enzyme pathway by which terpenoids are synthesized. Acetate fragments derived from common nutrient materials are converted into mevalonic acid, from which the terpenoid hydrocarbon squalene (16a) is formed. One end of the squalene molecule is then oxidized, giving squalene 2,3-oxide (16b), which, by an intramolecular reaction (cyclization) and structural rearrangement, yields the steroid lanosterol (16c). This enzyme-controlled reaction may be initiated by introduction of a positive charge into the oxide ring, because it is remarkably similar to the nonenzymic, acid-catalyzed cyclizations of certain unsaturated hydrocarbons (hydrocarbon) similar in structure to squalene. Cholesterol (16d) is formed from lanosterol by further structural changes.

      The principal forms in which cholesterol is excreted by vertebrates are the bile acids, which are synthesized in the liver. Their formation involves specific modifications of the steroid nucleus and formation of a carboxylic acid group that is linked to the amino acids (amino acid) taurine or glycine to give the forms in which the bile acids are secreted into the bile. The biosynthesis of cholesterol is influenced by feedback mechanisms that suppress the formation of mevalonic acid and, consequently, of cholesterol when levels of cholesterol and bile acids in the tissues are elevated.

Steroid hormones (steroid hormone)

      In vertebrates, cholesterol is the central precursor of all steroid hormones secreted by the testes (testis) of the male, the ovaries (ovary) of the female, and the adrenals (adrenal gland) of both sexes. These tissues share an embryonic tissue of origin and, in consequence, many enzymes for the transformation of cholesterol. A major (though not exclusive) common pathway involves conversion to progesterone (17a). Progesterone is secreted by the corpus luteum of the ovary, but in the adrenal cortex it is further metabolized to steroid hormones (corticosteroids) such as cortisol (17b) and aldosterone (17d). In both ovary and testis, progesterone is transformed further to the androgenic steroid androstenedione (17c), which, together with its derivative testosterone (17e), is secreted by the testis. In the ovary, androstenedione is modified to the estrogen estradiol (17f). Normally, each organ secretes its own characteristic pattern of hormones, but in some disease states (e.g., genetic defects (genetic disease, human) and some tumours (tumour) of these endocrine glands), these patterns may be profoundly distorted.

      Many tissues, but mainly the liver, metabolize the steroid hormones to physiologically inactive products that are voided mainly in the urine, though some are also eliminated via the bile and, ultimately, the feces. Diagnosis of endocrine abnormalities may be assisted by analysis of urinary steroids. Urinary 17-ketosteroids (androstane derivatives with a C=O function at C17) arise principally through oxidation of adrenal steroid hormones in the liver and thus are used to gauge secretion by the adrenal gland rather than by the testis. In pregnancy the urinary excretion of pregnanediol, the principal metabolite of progesterone, measures placental (placenta) progesterone output. Its decline before term may forewarn of abortion, which may be averted by administration of progestational hormones.

Steroid metabolism in plants (plant)

      The early steps in the biosynthesis of steroids of both plants and animals are the same, except that in plants lanosterol is replaced by the related compound cycloartenol, which contains a three-membered ring (C9, C10, C19) in lieu of the nuclear double bond of lanosterol. The side chains of the phytosterols, such as stigmasterol, and of the sterol ergosterol of yeasts (yeast) and other fungi contain extra carbon atoms that are incorporated in reactions involving S-adenosylmethionine, which donates methyl groups (methyl group) in numerous biological processes. Although most plant tissues contain only traces of cholesterol, this sterol is the biogenetic precursor of such important plant steroids as the sapogenins (sapogenin), glycosides (glycoside), and alkaloids (alkaloid). Because pregnane derivatives are intermediates in some of these transformations, plants and animals appear to have important features of steroid metabolism in common.

Structural relationships of the principal categories of steroids

Sterols

      A large group, the sterols, is composed of the common 3-monohydroxy steroids of the cholestane, ergostane, and stigmastane series and their methyl sterol biogenetic precursors: lanosterol, cycloartenol, and certain derivatives of these sterols, such as lophenol. Most sterols have a 3β-hydroxyl group, and many (though not the 4-methyl sterols) have a double bond between carbon atoms 5 and 6. Various sterols have double bonds at other positions in the nucleus corresponding to stages in the biosynthesis of cholesterol and other steroids that resemble it in the structure of ring A. Animal sterols, especially in embryonic tissues and skin, and phytosterols (e.g., stigmasterol) also may have a double bond in the side chain. Sterols of feces (e.g., coprostanol) have a 3α-hydroxyl group and cis- (5β-) linked rings A and B; they are formed by metabolism of other sterols by intestinal bacteria. Certain sterols are transformed to calciferols (D vitamins (vitamin D)) by ultraviolet light (ultraviolet radiation); this process occurs naturally in the skin and is used commercially in the manufacture of vitamin D₂ (ergocalciferol) from ergosterol and of vitamin D₃ (cholecalciferol) from synthetic 7-dehydrocholesterol.

Bile acids and alcohols (alcohol)

      The molecular structures of metabolites of cholesterol form an evolutionary series from the bile alcohols (alcohol), such as myxinol and scymnol of the elasmobranch fishes (e.g., sharks (shark) and rays (ray)) and the related alcohols of some bony fishes (bony fish) and frogs (frog), through the 5β-cholestanoic acids of crocodiles (crocodile) and alligators (alligator), to the 5β-cholanoic acids of the birds (bird) and mammals (mammal). They are not exclusively confined to the species indicated; for example, chenodeoxycholic acid is a major bile acid in humans and many other mammals, and cholic acid is found in many nonmammalian species, together with primitive bile acids or alcohols that are not found in mammals.

Estrogens (estrogen)

      The estrogens (estrogen) of the ovary of vertebrates are steroids that are abundant in the urines (urine) of pregnant mares and of stallions. The most potent natural estrogen is estradiol; the less-potent estrogens—estrone, estriol, and other oxygenated phenolic steroids—are metabolites of estradiol. Some species, notably the Equidae (horse), secrete the less-active estrogen equilenin. Estrone, synthesized from diosgenin, has been used as a starting material for synthesis of androgenic and progestational steroids lacking a C19 methyl group (19-nor steroids). Synthetic estrogens, such as estranol or mestranol (18), commonly used in oral contraceptives and for other therapeutic purposes, have acetylenic (containing triple bonds between carbon atoms) substituents. Nonsteroidal synthetic estrogens—e.g., diethylstilbestrol (19) and related compounds—are used clinically and also in animal husbandry to promote fattening of livestock and poultry and to improve the quality of their meat.

Progesterones (progesterone)

      Three naturally occurring steroids of the corpus luteum and placenta have progestational action; these are progesterone and two of its metabolites. All possess an unsaturated ketonic structure in ring A. Pregnanediol, the main metabolite of progesterone, lacks both this structural feature and progestational activity.

      Synthetic progestational steroids that are used in oral contraceptives and for other therapeutic purposes (see above Pharmacological actions of steroids: Steroid contraceptives (steroid)) are derivatives of progesterone or of 19-nortestosterone. Among the latter is norethandrolone (20).

Androgens (androgen)

       testosterone and androstenedione are the major testicular androgens (androgen). Several other less-active androgens occur naturally. Major metabolites of testosterone are androsterone and etiocholanolone. The latter compound is androgenically inactive, but it is a pyrogen (e.g., a fever-producing agent) that has been associated clinically with some febrile conditions.

Adrenal cortical hormones

      The steroids of the adrenal cortex are progesterone derivatives that bear hydroxyl groups at positions 11, 17α, or 21. The potent mineralocortoid aldosterone carries an aldehyde function in place of the more usual C18 methyl group. Glucocorticoid potency is higher in the trihydroxy derivative cortisol of humans, monkeys (monkey), and dogs (dog) than in the dihydroxy steroid corticosterone of rats (rat) and mice (mouse). Every adrenal steroid hormone has a ketone group at C3 and a double bond between C4 and C5. In the liver their physiological activities are lost when ring A is reduced, and they are partially inactivated when the 11β-hydroxyl is oxidized to a ketone group (as in cortisone and 11-dehydrocorticosterone). The adrenal corticoids are among the most chemically reactive of the steroid hormones; they are sensitive to strong acids (acid) and alkalies (alkali) and to elevated temperatures. In many synthetic analogs of cortisol and cortisone, physiological activity is modified.

Ecdysones

      The molting (molt) hormones (zooecdysones) of insects (insect) and crustaceans (crustacean) are generally derivatives of cholestane. All possess a ketone group at position 6, a double bond between positions 7 and 8, and 2β-, 3β-, and 14α-hydroxyl groups. The side chain is hydroxylated at C22 and variously at C20, C25, and C26. Some of these compounds occur in plants, many of which also contain potent ecdysone analogs (phytoecdysones) with ergostane and stigmastane side chains.

      The ecdysones show cross-species activity; that is, the ecdysone of one species induces molting in another species. The preponderance of ecdysones related to cholestane even in phytophagous insects probably reflects their capacity to convert dietary phytosterols to cholestane derivatives.

Cardiac glycosides and aglycones

      Many species of plants (plant) contain toxic (specifically, heart-arresting) steroids of the cardanolide type as glycosides (glycoside) (compounds that contain structural groups derived from sugars) of up to four sugar residues, which may include glucose, rhamnose, and 10 other sugars characteristic of this group of natural products. Typically, these compounds are 5β-steroids and have 3β- and 14β-hydroxyl groups, but hydroxyl groups may occur in many other positions. In all cases, the aglycone (the steroid that results when the sugar groups are removed) is less active than its glycosides, but generally activity declines with increasing numbers of sugar residues after the first. The structures of the sugars have important but not predictable effects on activity.

      The most important cardiac glycosides, medicinally, are those occurring in foxglove (Digitalis): digitoxin, gitoxin, and digoxin. Each of these contains a specific aglycone (e.g., digitoxigenin [23] is the aglycone of digitoxin) linked to three molecules of the sugar digitoxose and is derived from a more complex glycoside (digilanides A, B, and C, respectively) from which glucose and acetic acid are removed during the isolation procedures.

      The squill, or sea onion, Scilla maritima, a seashore plant, contains several toxic glycosides, the aglycones of which are bufadienolides more typical of the toad poisons than of plant products. (In a bufadienolide, two double bonds are present in the bufanolide side chain.)

      A white form of the squill produces the glycoside scillaren A, which contains the aglycone scillarenin, whereas a red form produces scilliroside, which is specifically toxic to rodents and has long been used as a rat poison. The contribution of the side chain to cardiac activity differs little between the bufanolides and the cardanolides.

toad poisons

      Defensive venoms (venom) secreted by skin glands (principally the parotid glands) of the toad owe their high toxicity to bufadienolides that occur both free (bufogenins) and combined (bufotoxins (bufotoxin)). These compounds have digitalis-like properties and have been used medicinally in a traditional Chinese preparation, Chan Su. The best characterized is bufotoxin (24), from the European toad Bufo vulgaris and the Asian toad Bufo gargarizans, the bufogenin of which is bufotalin, a close structural relative of gitoxin.

Sapogenins (sapogenin) and saponins (saponin)

      Sapogenins (sapogenin) are steroids of the spirostan type that occur widely and in great variety in plants. They are linked to sugars as glycosides, usually through a 3β-hydroxyl group. The glycosides are saponins (saponin), so called because they form soapy solutions and have other surface active (e.g., hemolytic) properties. Since saponins are difficult to purify, the complete structures of only a few are known. Among these is dioscin (25)—from certain yams (yam), genus Dioscorea; the steroid portion of this saponin is diosgenin.

      The nature and number of sugar residues per molecule are known for many saponins.

      These include the common sugars glucose, xylose, galactose, rhamnose, and arabinose. In most cases, however, the structure of only the sapogenin, which can be released from the saponin by acid hydrolysis, is known with certainty. Linkage of rings A and B may be cis (5β) or trans (5α) or may involve unsaturation at C5. A hydroxyl group is nearly always present at position 3, and hydroxyl or ketonic groups may be present at positions 1, 2, 4, 5, 6, 11, 12, or 15. Many pairs of natural sapogenins differ only in configuration at C25. Their structural features and abundance make diosgenin and hecogenin useful as starting materials for steroid hormone manufacture.

Antiandrogens and antiestrogens

      The estrogens and synthetic progesterones, such as medroxyprogesterone acetate and chlormadinone acetate (26), have antiandrogenic properties that are the basis for their use against benign or malignant hyperplasia of androgen-dependent tissues such as the prostate (prostate gland). Other antiandrogens are cyproterone (27) and A-nortestosterone and A-norprogesterone and their derivatives.

      Synthetic antiestrogens include methyltestosterone, fluoxymesterone, norethindrone (norethisterone), and norgestrel. Since estrogens block the release of the pituitary hormone responsible for ovulation, a potent antiestrogen can stimulate ovulation by inhibiting this action of estrogens.

Glucocorticoids and cortisol

       Some cardiac glycosides and their cardenolide aglycones Some cardiac glycosides and their cardenolide aglyconesThe anti-inflammatory and glucocorticoid activities of cortisol are enhanced, in some cases with relative reduction of its mineralocorticoid activity, by various structural modifications. For example, a 9α- fluorine atom enhances the glucocorticoid activity of cortisol about 10-fold but its salt-retaining activity about 50-fold. On the other hand, unsaturation at C1 increases glucocorticoid, but not mineralocorticoid, activity, and 6α-fluorine or methyl (methyl group), and 16-methyl or hydroxyl, groups (and especially 16α,17α-acetonides—i.e., compounds formed from 16α,17α-dihydroxy compounds and acetone) enhance anti-inflammatory activity while reducing salt activity. These groupings, therefore, appear in various combinations in anti-inflammatory steroids, many of which, however, lack the salt-retaining activity necessary for total adrenal-replacement therapy. Cortisol analogs, such as dexamethasone, are used to treat many inflammatory (inflammation) and rheumatic (rheumatism) diseases, to suppress the immune response in allergies (allergy) and in organ transplantation (transplant), and to delay the progress of leukemia. They are also widely used for treating local inflammatory reactions. A synthetic steroid of a quite different type, spironolactone (Aldactone A), is used as an antagonist to the action of aldosterone in certain cases of hypertension.

Raymond Brazenor Clayton Ronald H. Kluger

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