Cortisol Synthesis Research Articles

A comprehensive evaluation of the endocrine-disrupting effects of emerging organophosphate esters

The ubiquitous presence of organophosphate esters (OPEs) in the environment has prompted growing concerns about their potential health risks, particularly their endocrine-disrupting effects. This study comprehensively evaluated the endocrine-disrupting properties of six emerging OPEs: five aryl-OPEs (2-ethylhexyl diphenyl phosphate (EHDPP), tris (2-biphenylyl) phosphate (TBPP), resorcinol bis (diphenyl phosphate) (RDP), 4-hydroxyphenyl diphenyl phosphate (para-OH-TPHP), and 3-hydroxyphenyl diphenyl phosphate (meta-OH-TPHP)) and one alkyl-OPE, triallyl phosphate (TAP). Our findings revealed that all tested aryl-OPEs exhibited antagonistic effects on one or more hormone receptors. Importantly, para-OH-TPHP demonstrated the most potent antagonistic activity, inhibiting estrogen receptor α (ERα), thyroid hormone receptor β (TRβ), glucocorticoid receptor (GR), and mineralocorticoid receptor (MR) with the concentration of test compounds showing 20 % relative inhibitory concentration (RIC20) value below 10−6 mol/L (M). RDP antagonized ERα and cortical receptors (GR and MR), TBPP affected TRβ and GR, while EHDPP and meta-OH-TPHP targeted MR. Regarding steroidogenesis, para-OH-TPHP significantly inhibited genes for estrogen (cyp19) and cortisol synthesis (cyp11b2), and along with meta-OH-TPHP, EHDPP, TAP, and RDP downregulated cyp11a1, a rate-limiting enzyme in hormone synthesis. All compounds caused malformations and swimming abnormalities in zebrafish embryos/larvae at concentrations of 10−7 M or higher, with para-OH-TPHP showing nearly 50 % peak induction. Furthermore, the six compounds tested influenced genes associated with the hypothalamic-pituitary–gonadal (HPG) axis in both zebrafish larvae and adult female zebrafish, in addition to affecting the reproductive behavior of zebrafish. A weighted scoring system was employed to rank the endocrine-disrupting potency of the OPEs, with para-OH-TPHP exhibiting the highest risk, followed by EHDPP, RDP, TBPP, meta-OH-TPHP, and TAP. Collectively, our results highlight the significant endocrine-disrupting effects of emerging OPEs, underscoring the urgent need for further research to assess their potential health implications.

Comparative Metabolomic Analysis Reveals the Impact of the Photoperiod on the Hepatopancreas of Chinese Grass Shrimp (Palaemonetes sinensis)

The photoperiod is a key environmental factor that in crustaceans influences development, feeding, and metabolism. In this study, liquid chromatography-tandem mass spectrometry was used to examine metabolic changes in Palaemonetes sinensis under different photoperiods. Our results showed that key metabolic pathways, such as linoleic acid metabolism, axon regeneration, pyrimidine metabolism, and cortisol synthesis, were significantly altered under both constant light (24L:0D) and constant darkness (0L:24D) compared with natural light conditions. The photoperiod notably affected the digestive and metabolic functions of P. sinensis. Most metabolic pathways were downregulated under full darkness and full light conditions, suggesting that inhibition of metabolism is a potential adaptive response. Furthermore, enzyme assays revealed significant variations in trypsin, lipase, and amylase activity across different photoperiods, highlighting the profound impact of light conditions on digestive functions. These findings suggest that extreme light conditions may negatively impact the metabolic and digestive functions of P. sinensis. This study provides new insights into the adaptive mechanisms of P. sinensis in response to photoperiod changes and offers valuable information for optimizing aquaculture practices to enhance the health and growth performance of this crustacean.

Environmental Heat Stress Decreases Sperm Motility by Disrupting the Diurnal Rhythms of Rumen Microbes and Metabolites in Hu Rams.

Heat stress (HS) has become a common stressor, owing to the increasing frequency of extreme high-temperature weather triggered by global warming, which has seriously affected the reproductive capacity of important livestock such as sheep. However, little is known about whether HS reduces sperm motility by inducing circadian rhythm disorders in rumen microorganisms and metabolites in sheep. In this study, the year-round reproduction of two-year-old Hu rams was selected, and the samples were collected in May and July 2022 at average environmental temperatures between 18.71 °C and 33.58 °C, respectively. The experiment revealed that the mean temperature-humidity index was 86.34 in July, indicating that Hu rams suffered from HS. Our research revealed that HS significantly decreased sperm motility in Hu rams. Microbiome analysis further revealed that HS reshaped the composition and circadian rhythm of rumen microorganisms, leading to the circadian disruption of microorganisms that drive cortisol and testosterone synthesis. Serum indicators further confirmed that HS significantly increased the concentrations of cortisol during the daytime and decreased the testosterone concentration at the highest body temperature. Untargeted metabolomics analysis revealed that the circadian rhythm of rumen fluid metabolites in the HS group was enriched by the cortisol and steroid synthesis pathways. Moreover, HS downregulated metabolites, such as kaempferol and L-tryptophan in rumen fluid and seminal plasma, which are associated with promotion of spermatogenesis and sperm motility; furthermore, these metabolites were found to be strongly positively correlated with Veillonellaceae_UCG_001. Overall, this study revealed the relationship between the HS-induced circadian rhythm disruption of rumen microorganisms and metabolites and sperm motility decline. Our findings provide a new perspective for further interventions in enhancing sheep sperm motility with regard to the circadian time scale.

Computational approaches for identifications of altered ion channels in keratoconus.

Keratoconus is an etiologically complex, degenerative corneal disease that eventually leads to loss of corneal integrity. Cells in corneal epithelium and endothelium express various types of ion channels that play important roles in ocular pathology. This emphasizes the need of understanding alterations of ion channels in keratoconus. Differential gene expression analysis was performed to identify deregulated ion channels in keratoconus patients using transcriptomic data. Thereafter correlation analysis of ion channel expression was performed to obtain the changed correlation between ion channels' expression in keratoconus patients versus control samples. Moreover, Protein-protein interaction networks and a pathway map was constructed to identify cellular processes altered due to the deregulation of ion channels. Furthermore, drugs interacting with deregulated ion channels were identified. Total 75 ion channels were found to be deregulated in keratoconus, of which 12 were upregulated and 63 were downregulated. Correlations between ion channel expressions found to be different in control and keratoconus samples. Thereafter, protein-protein interactions network was generated to identify hub ion channels in network. Furthermore, the pathway map was constructed to depict calcium signalling, MAPK signalling, synthesis and secretion of cortisol, and cAMP signalling. The 19 FDA- approved drugs that interact with the 6 deregulated ion channels were identified. Down-regulation of voltage-gated calcium channels can be attributed to reduced cell proliferation and differentiation. Additionally, deregulated ion channels in 3',5'- cyclic adenosine monophosphate signalling may be responsible for elevated cortisol level in progressive keratoconus patients.

Integrated Transcriptomics and Metabolomics Studies Reveal Steroid Biosynthesis Pathway and BCL2 Inhibitory Diazo-Progesterone of Drimia indica for Conservation and Sustainable Utilization.

This study is the first report on the sequence of the transcriptome of Drimia indica, a non-model plant with medicinal properties found in a forest tribal belt, using the Illumina NovaSeq platform. The primary objectives of this study were to elucidate the gene expression profiles in different tissues, identify key regulatory genes and pathways involved in secondary metabolite biosynthesis, and explore the plant's potential pharmacological properties. The study generated 670087 unigenes from both leaves and roots and identified putative homologs of annotated sequences against UniProt/Swiss-Prot and KEGG databases. The functional annotation of the identified unigenes revealed the secondary metabolite biosynthetic process as the most prominent pathway, with gene enrichment analysis predominantly accounting for secondary metabolite pathways, such as terpenoid, steroid, flavonoid, alkaloid, selenocompound, and cortisol synthesis. The study also identified regulatory genes NAC, Bhlh, WRKY, and C2H2 on the transcriptome dataset. The functionally annotated unigenes suggested phytocompounds in Drimia indica to have multi-potent properties, such as anti-cancer, anti-inflammatory, and anti-diabetic activities, which has been further validated by GC-MS-based metabolite profiling. Notably, we have identified two novel molecules, di-azo progesterone and 4H-pyran-4-one 2,3-dihydro-3,5-dihydroxy- 6-methyl, with potential BCL2 inhibitory anticancer properties, supported by stable binding interactions observed in molecular docking and dynamics simulations. Additionally, an abundance of mono-nucleotide SSR markers has been identified, useful for genetic diversity studies. This study provides a foundational understanding of the molecular mechanisms in Drimia indica, highlighting its potential as a source for novel therapeutic agents and contributing valuable insights for future pharmacological and agricultural applications. However, further in vivo studies are warranted to confirm these findings and validate their pharmacological efficacy and therapeutic potential. The SSR markers identified also offer valuable tools for molecular genetics, plant breeding, and sustainable drug development.

7203 A case of undifferentiated shock found to be due to voriconazole-related primary adrenal insufficiency

Abstract Disclosure: K.X. Zhang: None. C. Bergwitz: None. Primary adrenal insufficiency can be a rare effect observed with azole antifungal therapy, classically ketoconazole, via inhibition of cortisol and aldosterone synthesis. Whether primary AI can be observed with newer triazole drugs used for neutropenic prophylaxis and treating invasive fungal infections is far less understood. We describe a case of a 65-year-old man with medical history notable for COPD and gout, who was on voriconazole for Aspergillus pneumonia, and admitted to the medical ICU with confusion and undifferentiated shock. His potassium was 6.5 mmol/L, sodium 133 mmol/L, bicarbonate 18 mmol/L, and blood pressure 72/63 requiring pressor support. Voriconazole was withdrawn. He also had a fever to 101.7F that was attributed to a gout flare, and he received a course of high dose prednisone. His shock and electrolyte abnormalities quickly resolved, and he was discharged on isavuconazole. At the 1 week mark, he was found to have a morning cortisol 2.3 ug/dL, potassium 5.4 mmol/L, and sodium 134 mmol/L, along with fatigue, nausea, and hypotension, which prompted resumption of steroid and mineralocorticoid replacement. One month after completing his course of isavuconazole, morning cortisol normalized to 11.0 ug/dL and ACTH 22.3 pg/mL. We present a convincing clinical story supporting the etiology of this patient’s initial shock as primary adrenal insufficiency related to a voriconazole effect. This case illustrates how iatrogenic AI can be a missed diagnosis in the emergency room setting. Primary AI has classically been reported following ketoconazole therapy, but there are only 4 reports of primary AI involving the newer triazole posaconazole, and none for voriconazole or isavuconazole. Due to the rarity of this effect, AI due to voriconazole was not on the initial shock differential and timely endocrine labs to seal the diagnosis (morning cortisol, ACTH, and renin/aldosterone levels) were not obtained. If our patient had not received steroids serendipitously for gout, he may have been at risk for adrenal crisis. Whereas central AI is more common and induced by chronic use of systemic steroids, it is important to also think about AI caused by antifungal therapy with newer azoles. Presentation: 6/3/2024

7003 Comparative Study Of The Properties And Differences Of Steroidogenesis Inhibitors In Vitro

Abstract Disclosure: Y. Taki: None. T. Kono: None. S. Kono: None. N. Hashimoto: None. H. Nagano: None. T. Tanaka: None. Objective: Osilodrostat (Osi) is utilized as an inhibitor of cortisol (F) synthesis and is a potent inhibitor of CYP11B2, in addition to CYP11B1. Therefore, we investigated the aldosterone (Ald) and cortisol concentration-dependent inhibitory effects of Osi in vitro, using tissues from 9 cases [5 Aldosterone-producing adenoma (APA) and 4 Cortisol-producing adenoma (CPA)] operated at our institution. Methods: Adrenal tumor surgery specimens were treated with collagenase and cultured on plates. After 3 days, the medium was changed and incubated with osilodrostat or metyrapone (0.0001 to 10 µM). After another 3 days, the medium was collected, and Ald/F concentrations were measured. The IC50 of both drugs for Ald/F were then compared. Results: In APA cases, Osi inhibited at significantly lower concentrations (IC50: 0.003 µM) than Met (0.782 µM; p=0.0159) for Ald; in CPA cases, Osi inhibited with similar potency to Met (IC50: 0.061 µM vs 0.466 µM, p=0.2286) for F. In all cases, Osi inhibited at significantly lower concentrations for Ald than F (IC50: 0.003 µM vs 0.028 µM, p=0.0008). Discussion: Osi is a potent inhibitor of Ald and F production, and its use for PA alone is challenging because clinical trials of Osi for PA were terminated due to concerns about adrenal insufficiency. Therefore, we suggest that Osi may be useful in PA-associated CPA patients for whom surgery is not indicated or as a preoperative drug therapy. Presentation: 6/1/2024

7029 Changes In Adrenal Gland Size Seen By Linear Assessment On Routine Abdominal CT During Critical Illness

Abstract Disclosure: D.R. Vangipuram: None. N. Bhagat: None. R. Borkar: None. N.T. Mazengia: None. S. Williams, MD: None. S.K. Majumdar: None. Introduction: During acute stress, the hypothalamus-pituitary-adrenal (HPA) axis is activated, ultimately releasing adrenocorticotropic hormone (ACTH) from the pituitary gland, which stimulates cortisol synthesis and release from the adrenal gland. During this process, ACTH also increases adrenal blood flow which may result in noticeable changes in adrenal gland size on imaging. A previous study compared adrenal gland volume in patients with and without sepsis and concluded that adrenal gland volume was found to be nearly double in sepsis compared with patients without sepsis(1). Another study that evaluated adrenal gland size on MDCT, to provide normal values for volumetry and linear dimensions, found a concordance between volumetric and linear assessment (by cumulative width), though volumetry was more reproducible(2). Method: This is a retrospective study that included 50 adult patients (age 18 and over) who underwent a non-contrast or contrast CT scan of the abdomen within 5 years prior to admission to the Intensive Care Unit (ICU) with any critical illness, and then had another CT of the abdomen during the admission to the ICU. We measured the maximum width of the body (corpus) and that of the medial and lateral limbs of both the adrenal glands, perpendicular to the long axis, as seen on CT. The total (cumulative) width was calculated by adding the width of the corpus and both the limbs of each adrenal gland. The measurements were made by two different radiologists, who were blinded both to the before/after ICU admission CTs, and to each other’s measurements. Results: There was concordance in the measurements made by both the radiologists. We used the averages of both their measurements for analysis. The mean cumulative width of each adrenal gland, i.e., corpus+medial limb+lateral limb (in mm), was: Right adrenal before ICU admission 13.52 (± 3.20); during ICU admission 13.24 (± 3.13); p 0.444. Left adrenal before ICU admission 16.03 (± 3.18); during ICU admission 15.12 (± 3.47); p 0.021. Conclusion: There was a statistically significant decrease in the size of the left adrenal gland during critical illness, but no significant change in the right. Our findings do not suggest an increase in adrenal gland size during ICU admission.

7963 Analysis of the inhibition of adrenal synthesis and peripheral metabolism of corticosteroids by oteseconazole and two preclinical tetrazole antifungals

Abstract Disclosure: M. Jäger: None. V. González-Ruiz: None. F.L. Joos: None. D.V. Winter: None. J. Boccard: None. T. Degenhardt: Employee; Self; Mycovia Inc. S. Brand: Employee; Self; Mycovia Inc.. S. Rudaz: None. G.R. Thompson: None. A. Odermatt: None. The triazole antifungals posaconazole and itraconazole can cause pseudohyperaldosteronism with hypertension and hypokalemia by blocking adrenal cortisol synthesis and its peripheral inactivation [1]. Mechanisms of pseudohyperaldosteronism include inhibition of adrenal cytochrome P450 enzymes CYP11B1 and CYP17A1, as well as peripherally expressed 11β-hydroxysteroid dehydrogenase type 2 (11β-HSD2). To enhance specificity for fungal CYP51, tetrazole compounds have been developed [2]. Here, we used adrenal H295R cells and enzyme activity assays to assess the inhibition of steroidogenesis by the tetrazoles oteseconazole, VT-1129 and VT-1598. In addition, the three tetrazoles were tested for inhibition of 11β-HSD2. Steroidomic footprint analyses of H295R cell supernatants using untargeted LC-HRMS with steroid annotation indicated common features of the oteseconazole and VT-1129 patterns with that of the triazole itraconazole, and similarities between VT-1598 and the triazole isavuconazole. Targeted quantification of nine adrenal steroids by UHPLC-MS/MS in supernatants of treated H295R cells showed an overall inhibition of steroidogenesis by the tetrazoles and the triazoles itraconazole and isavuconazole. Experiments using recombinant human enzymes suggested that this effect is not caused by direct inhibition of steroidogenic enzymes because no or very weak inhibition could be observed. Furthermore, oteseconazole, VT-1129 and VT-1598 did not inhibit 11β-HSD2, suggesting that they unlikely cause pseudohyperaldosteronism. Further research needs to uncover the exact mechanism for the observed overall inhibition of steroidogenesis by the tetrazoles as well as itraconazole and isavuconazole, and whether concentrations reached in patients are high enough to cause adrenal insufficiency and hyperplasia.

Early metabolic and transcriptomic regulation in rainbow trout (Oncorhynchus mykiss) liver by 11-deoxycorticosterone through two corticosteroid receptors pathways

Cortisol hormone is considered the main corticosteroid in fish stress, acting through glucocorticoid (GR) or mineralocorticoid (MR) receptor. The 11-deoxycorticosterone (DOC) corticosteroid is also secreted during stress and could complement the cortisol effects, but this still not fully understood. Hence, we evaluated the early transcriptomic response of rainbow trout (Oncorhynchus mykiss) liver by DOC through GR or MR. Thirty juvenile trout were pretreated with an inhibitor of endogenous cortisol synthesis (metyrapone) by intraperitoneal injection in presence or absence of GR (mifepristone) and MR (eplerenone) pharmacological antagonists for one hour. Then, fish were treated with a physiological DOC dose or vehicle (DMSO-PBS1X as control) for three hours (n = 5 per group). We measured several metabolic parameters in plasma, together with the liver glycogen content. Additionally, we constructed cDNA libraries from liver of each group, sequenced by HiseqX Illumina technology and then analyzed by RNA-seq. Plasma pyruvate and cholesterol levels decreased in DOC-administered fish and only reversed by eplerenone. Meanwhile, DOC increased liver glycogen contents depending on both corticosteroid receptor pathways. RNA-seq analysis revealed differential expressed transcripts induced by DOC through GR (448) and MR (1901). The enriched biological processes to both were mainly related to stress response, protein metabolism, innate immune response and carbohydrates metabolism. Finally, we selected sixteen genes from enriched biological process for qPCR validation, presenting a high Pearson correlation (0.8734 average). These results describe novel physiological effects of DOC related to early metabolic and transcriptomic responses in fish liver and differentially modulated by MR and GR.

Congenital Adrenal Hyperplasia: A Review of Current Knowledge and Future Directions

Introduction: Congenital adrenal hyperplasia (CAH) is a group of diseases in which genetic defects occur that disturb the synthesis of cortisol. The most common variant of CAH (95%-99%) is caused by 21-hydroxylase deficiency as a result of mutations in the CYP21A2 gene and is one of the most common monogenic diseases. CAH is characterized by androgen overproduction along with variable degrees of cortisol and aldosterone deficiency. Age at diagnosis can provide some information about the underlying mutations, with those diagnosed at birth/early infancy being at greater risk of developing serious enzyme defects. Classic and non-classical forms of this disorder have been described in the literature. CAH diagnosis is based on the clinical presentation, hormonal panel, Adrenocorticotropic Hormone (ACTH) stimulation test, and genetic testing. The main goals of treatment for congenital adrenal hyperplasia are glucocorticoid/mineralcorticoid supplementation, control of high adrenal androgen levels, fertility control, genetic counseling, and optimization of patients’ quality of life. Purpose of the work: This study aims to review and characterize the clinical and pathophysiological aspects of congenital adrenal hyperplasia. Materials and methods: A comprehensive analysis of research papers available on PubMed, Google Scholar, Web of Science, Embase and Scopus was undertaken using the searchterms encompassing the following keywords: congenital adrenal hyperplasia, 21-hydroxylase deficiency, CYP21A2 Results: Congenital adrenal hyperplasia is a heterogeneous group of genetic disorders that can lead to serious and even fatal complications in the form of adrenal crisis. Therefore, screening tests and early diagnosis are crucial and can save the lives of newborns. Treatment should be individualized and allow patients to achieve normal growth, sexual development, fertility and a better quality of life.

From the First Case Reports to KDM1A Identification: 35 Years of Food (GIP)-Dependent Cushing's Syndrome.

Food-dependent Cushing's syndrome (FDCS) is a rare presentation of hypercortisolism from adrenal origin, mostly observed in primary bilateral macronodular adrenal hyperplasia (PBMAH) but also in some cases of unilateral adrenocortical adenoma. FDCS is mediated by the aberrant expression of glucose-dependent insulinotropic peptide (GIP) receptor (GIPR) in adrenocortical cells. GIP, secreted by duodenal K cells after food intake, binds to its ectopic adrenal receptor, and stimulates cortisol synthesis following meals. FDCS was first described more than 35 years ago, and its genetic cause in PBMAH has been recently elucidated: KDM1A inactivation by germline heterozygous pathogenic variants is constantly associated with a loss-of-heterozygosity of the short arm of chromosome 1, containing the KDM1A locus. This causes biallelic inactivation of KDM1A, resulting in the GIPR overexpression in the adrenal cortex. These new insights allow us to propose the KDM1A genetic screening to all PBMAH patients with signs of FDCS (low fasting cortisol that increases after a mixed meal or oral glucose load) and to all first-degree relatives of KDM1A variant carriers. Given that KDM1A is a tumor suppressor gene that has also been associated with monoclonal gammopathy of uncertain significance and multiple myeloma, the investigation of FDCS in the diagnostic management of patients with PBMAH and further genetic testing and screening for malignancies should be encouraged.

Metformin modulates corticosteroids hormones in adrenals cells promoting Mycobacterium tuberculosis elimination in human macrophages

Research suggests that both tuberculosis (TB) and type 2 diabetes mellitus (T2DM) have an immuno-endocrine imbalance characterized by dysregulated proinflammatory molecules and hormone levels (high cortisol/DHEA ratio), impeding an effective immune response against Mycobacterium tuberculosis (Mtb) driven by cytokines, antimicrobial peptides (AMPs), and androgens like DHEA. Insulin, sulfonylurea derivatives, and metformin are commonly used glucose-lowering drugs in patients suffering from TB and T2DM. For this comorbidity, metformin is an attractive target to restore the immunoendocrine mechanisms dysregulated against Mtb. This study aimed to assess whether metformin influences cortisol and DHEA synthesis in adrenal cells and if these hormones influence the expression of proinflammatory cytokines and AMPs in Mtb-infected macrophages. Our results suggest that metformin may enhance DHEA synthesis while maintaining cortisol homeostasis. In addition, supernatants from metformin-treated adrenal cells decreased mycobacterial loads in macrophages, which related to rising proinflammatory cytokines and AMP expression (HBD-2 and 3). Intriguingly, we find that HBD-3 and LL-37 can modulate steroid synthesis in adrenal cells with diminished levels of cortisol and DHEA, highlighting the importance of crosstalk communication between adrenal hormones and these effectors of innate immunity. We suggest that metformin's effects can promote innate immunity against Mtb straight or through modulation of corticosteroid hormones.

P-400 Pregnancy-specific glycoproteins - potential markers for risk associated with preeclampsia during gestational SARS-CoV-2 Infection

Abstract Study question Could pregnancy-specific glycoproteins serve as potential markers for the risk of developing preeclampsia during gestational SARS-CoV-2 Infection? Summary answer Pregnancy-specific glycoproteins (PSGs) are significantly down-regulated in women with gestational SARS-CoV-2 infection, which could be used to diagnose high-risk pregnancies in assisted reproductive treatment (ART). What is known already In vitro fertilization (IVF) pregnancies are precious and face increased risks of preeclampsia. Similarly, SARS-CoV-2 infection during pregnancy increases the risk for preeclampsia. Precious pregnancies with ART along with SARS-CoV-2 infection can further exacerbate the risk for preeclampsia, affecting both maternal and fetal health. Thus, identifying molecular markers associated with preeclampsia risk in the context of SARS-CoV-2 infection is crucial for maternal and fetal health management, specifically in pregnancies with IVF. Study design, size, duration Placental samples (n = 16) were collected at term delivery from SARS-CoV-2 positive women (n = 7) and negative healthy women (n = 9). We studied separately, the gene expression pattern in maternal and fetal placental compartments. Interesting genes from RNA sequencing results were validated using real-time PCR. Participants/materials, setting, methods All pregnant women at their term delivery were clinically tested for SARS-CoV-2 infection by PCR. Maternal and fetal sides of placenta were collected in total RNA was extracted from the snap-frozen tissues. cDNA libraries were constructed using Smart-seq2 method and sequenced using Illumina NovaSeq 6000 sequencing platform. Bioinformatic analysis was using Partek® Flow® software, v9.0, DEGs were identified by applying FDR ≤ 0.05. qPCR was for validating the interesting genes. Main results and the role of chance Our analysis revealed 635 DEGs in the maternal placental tissue, with 518 upregulated and 117 downregulated genes in SARS-CoV-2-positive women compared with the healthy SARS-CoV-2-negative women. In contrast, the fetal compartment did not exhibit any significant changes in gene expression with SARS-CoV-2 infection. In the maternal compartment, we observed significant downregulation of nine genes belonging to the pregnancy-specific glycoprotein related to the immunoglobulin superfamily with active SARS-CoV-2 infection (fold change range from −13.70 to − 5.28; FDR ≤ 0.01). Additionally, comparing symptomatic women with healthy women, we identified 1788 DEGs. Furthermore, pathway enrichment analysis revealed that pathways related to oxidative phosphorylation, insulin secretion, cortisol synthesis, estrogen signaling, oxytocin signaling, and antigen processing were altered significantly in symptomatic women. Limitations, reasons for caution We have a limited sample size in this study, though we collected placental samples from all the women who were positive for SARS-CoV-2, at admission for delivery. Studies with larger sample sizes are warranted to further reconfirm the results. In vitro studies may help us to deepen our understanding. Wider implications of the findings This study sheds light on PSGs as potential biomarkers for risk for preeclampsia during gestational SARS-CoV-2 and reveals molecular pathways associated with an increased clinical risk of preeclampsia with COVID-19 during pregnancy. The findings offer valuable insights that could be further explored clinically in managing pregnant women with COVID-19. Trial registration number not applicable

Human Gonads Do Not Contribute to the Circulating Pool of 11-Oxygenated Androgens.

Androstenedione (A4) and testosterone (T) are produced by both the adrenal glands and the gonads. The adrenal enzyme 11β-hydroxylase (CYP11B1) executes the final step in cortisol synthesis; CYP11B1 also uses A4 and T as substrates, generating 11-hydroxyandrostenedione and 11-hydroxytestosterone, respectively. It has been suggested that CYP11B1 is expressed in the gonads, yet the circulating levels of all 11-oxygenated androgens (11-oxyandrogens) are similar in males and females of reproductive ages, despite enormous differences in T. To assess the gonadal contribution to the circulating pool of 11-oxyandrogens. We used liquid chromatography-tandem mass spectrometry to measure 13 steroids, including traditional and 11-oxyandrogens in: (I) paired gonadal and peripheral vein blood samples obtained during gonadal venograms from 11 patients (7 women), median age 37 (range 31-51 years); and (II) 17 women, median age 57 (range 41-81 years) before and after bilateral salpingo-oophorectomy (BSO). We also compared CYP11B1, 17α-hydroxylase/17,20-lyase (CYP17A1), and 3β-hydroxysteroid dehydrogenase type 2 (HSD3B2) mRNA expression in adrenal, ovarian, and testicular tissue. A4, T, estradiol, estrone, progesterone, 17α- and 16α-hydroxyprogesterone were all higher in gonadal veins vs. periphery (p < 0.05 for all), while four 11-oxyandrogens were similar between matched gonadal and peripheral vein samples. Equally, in women who underwent BSO, A4 (median [interquartile range]: 59.7 [47.7-67.6] ng/dL vs. 32.7 [27.4-47.8] ng/dL, p < 0.001) and T (24.1 [16.4-32.3] vs.15.5 [13.7-19.0] ng/dL, p < 0.001) declined, while 11-oxyandrogens remained stable. Gonadal tissue displayed negligible CYP11B1 mRNA. Despite producing substantial amounts of A4 and T, human gonads are not relevant sources of 11-oxyandrogens.

A Humanized and Viable Animal Model for Congenital Adrenal Hyperplasia-CYP21A2-R484Q Mutant Mouse.

Congenital Adrenal Hyperplasia (CAH) is an autosomal recessive disorder impairing cortisol synthesis due to reduced enzymatic activity. This leads to persistent adrenocortical overstimulation and the accumulation of precursors before the blocked enzymatic step. The predominant form of CAH arises from mutations in CYP21A2, causing 21-hydroxylase deficiency (21-OHD). Despite emerging treatment options for CAH, it is not always possible to physiologically replace cortisol levels and counteract hyperandrogenism. Moreover, there is a notable absence of an effective in vivo model for pre-clinical testing. In this work, we developed an animal model for CAH with the clinically relevant point mutation p.R484Q in the previously humanized CYP21A2 mouse strain. Mutant mice showed hyperplastic adrenals and exhibited reduced levels of corticosterone and 11-deoxycorticosterone and an increase in progesterone. Female mutants presented with higher aldosterone concentrations, but blood pressure remained similar between wildtype and mutant mice in both sexes. Male mutant mice have normal fertility with a typical testicular appearance, whereas female mutants are infertile, exhibit an abnormal ovarian structure, and remain in a consistent diestrus phase. Conclusively, we show that the animal model has the potential to contribute to testing new treatment options and to prevent comorbidities that result from hormone-related derangements and treatment-related side effects in CAH patients.

Psycho-neuroendocrine-immune Aspects of COVID-19 and its Relationship with Post-traumatic Stress Disorder

Abstract: A large body of literature indicates that the novel coronavirus disease (COVI D-19) was, and still is, a stressful and traumatic experience for different groups of people. Exposure to unexpected deaths or fear of death increases the risk of developing post-traumatic stress disorder (PTSD) anxiety disorder. Understanding the relationship between PTSD and SARS-CoV- 2 infection can help reduce the risk of developing psychiatric diseases, especially anxiety disorders. Here, we used the central mega databases of PubMed, Google Scholar, Scopus, Springer, and Science Direct. We explored the articles based on keywords and related articles. Social isolation stress during quarantine and hyperactivity of the hypothalamic-pituitary-adrenal (HPA) axis via increased cortisol synthesis and release seems to be key findings in current literature. Evidence shows that induced neuroendocrine changes in patients with COVID-19 can cause psychiatric diseases related to fear and anxiety. Studies suspect that angiotensinconverting enzyme 2 (ACE2) expressed in the hypothalamus and pituitary gland can be targeted by the infection and thereby could be a player in inducing psychiatric disorders. Here, we discuss the relationship between Covid-19 and post-traumatic stress disorder from psychoneuroendocrine- immune aspects and highlight the pro-inflammatory cytokines as mediators in the CNS-related processes, hoping to provide insights into the pathophysiology of PTSD.

In vitro pharmacokinetic behavior in lung of harringtonine, an antagonist of SARS-CoV-2 associated proteins: New insights of inhalation therapy for COVID-19

BackgroundRecent studies have shown that harringtonine (HT) could specifically bind with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) spike (S) protein and host cell transmembrane serine protease 2 (TMPRSS2) to block membrane fusion, which is an effective antagonist for SARS-CoV-2. PurposeOur study focused on in-depth exploration of in vitro pharmacokinetic characteristics of HT in lung. MethodsHPLC-fluorescence detection method was used to detect changes of HT content. Incubation systems of lung microsomes for phase I metabolism and UGT incubation systems for phase II metabolism were performed to elucidate metabolites and metabolic mechanisms of HT, and then the metabolic enzyme phenotypes for HT were clarified by chemical inhibition method and recombinant enzyme method. Through metabolomics, we comprehensively evaluated the physiological dynamic changes in SD rat and human lung microsomes, and revealed the relationship between metabolomics and pharmacological activity of HT. ResultsHPLC-fluorescence detection method showed strong specificity, high accuracy, and good stability for rapid quantification of HT. We confirmed that HT mainly underwent phase I metabolism, and the metabolites of HT in different species were all identified as 4′-demethyl HT, with metabolic pathway being hydrolysis reaction. CYP1A2 and CYP2E1 participated in HT metabolism, but as HT metabolism was not NADPH dependent, the esterase HCES1 in lung also played a role. The main KEGG pathways in SD rat and human lung microsomes were cortisol synthesis and secretion, steroid hormone biosynthesis and linoleic acid metabolism, respectively. The downregulated key biomarkers of 11-deoxycortisol, 21-deoxycortisol and 9(10)-EpOME suggested that HT could prevent immunosuppression and interfere with infection and replication of SARS-CoV-2. ConclusionHT was mainly metabolized into 4′-demethyl HT through phase I reactions, which was mediated by CYP1A2, CYP2E1, and HCES1. The downregulation of 11-deoxycortisol, 21-deoxycortisol and 9(10)-EpOME were key ways of HT against SARS-CoV-2. Our study was of great significance for development and clinical application of HT in the treatment of COVID-19.

Cortisol as a Target for Treating Mental Disorders: A Promising Avenue for Therapy.

Cortisol, commonly known as the "stress hormone," plays a critical role in the body's response to stress. Elevated cortisol levels have been associated with various mental disorders, including anxiety, depression, and post-traumatic stress disorder. Consequently, researchers have explored cortisol modulation as a promising avenue for treating these conditions. However, the availability of research on cortisol as a therapeutic option for mental disorders is limited, and existing studies employ diverse methodologies and outcome measures. This review article aimed to provide insights into different treatment approaches, both pharmacological and non-pharmacological, which can effectively modulate cortisol levels. Pharmacological interventions involve the use of substances, such as somatostatin analogs, dopamine agonists, corticotropin-releasing hormone antagonists, and cortisol synthesis inhibitors. Additionally, non-pharmacological techniques, including cognitivebehavioral therapy, herbs and supplements, transcranial magnetic stimulation, lifestyle changes, and surgery, have been investigated to reduce cortisol levels. The emerging evidence suggests that cortisol modulation could be a promising treatment option for mental disorders. However, more research is needed to fully understand the effectiveness and safety of these therapies.

Sedentary behavior, physical activity, sleep duration and obesity risk: Mendelian randomization study.

Observational studies have suggested associations between sedentary behaviors (SB), physical activity (PA), sleep duration (SD), and obesity, but the causal relationships remain unclear. We used Mendelian randomization (MR) with genetic variation as instrumental variables (IVs) to assess the causality between SB/PA/SD and obesity. Genetic variants associated with SB/PA/SD were obtained from Genome-wide association study (GWAS), and obesity data came from FinnGen. The primary MR analysis used the instrumental variable weighted (IVW) method, with sensitivity tests including Cochran Q, MR-Egger intercepts, and MR-Radial. Expression Quantitative Trait Loci (eQTL) analysis was applied to identify significant genetic associations and biological pathways in obesity-related tissues. The MR analysis revealed causal relationships between four SB-related lifestyle patterns and obesity. Specifically, increased genetic liability to television watching (IVW MR Odds ratio [OR] = 1.55, [95% CI]:[1.27, 1.90], p = 1.67×10-5), computer use ([OR] = 1.52, [95% CI]:[1.08, 2.13], p = 1.61×10-2), leisure screen time (LST) ([OR] = 1.62, [95% CI] = [1.43, 1.84], p = 6.49×10-14, and driving (MR [OR] = 2.79, [95% CI]:[1.25, 6.21], p = 1.23×10-2) was found to increase the risk of obesity. Our findings indicate that no causal relationships were observed between SB at work, sedentary commuting, PA, SD, and obesity. The eQTL analysis revealed strong associations between specific genes (RPS26, TTC12, CCDC92, NICN1) and SNPs (rs10876864, rs2734849, rs4765541, rs7615206) in both subcutaneous and visceral adipose tissues, which are associated with these SBs. Enrichment analysis further revealed that these genes are involved in crucial biological pathways, including cortisol synthesis, thyroid hormone synthesis, and insulin secretion. Our findings support a causal relationship between four specific SBs (LST, television watching, computer use, driving) and obesity. These results provide valuable insights into potential interventions to address obesity effectively, supported by genetic associations in the eQTL and enrichment analysis. Further research and public health initiatives focusing on reducing specific SBs may be warranted.