The adrenal gland produces a class of steroids called corticosteroids. Corticosteroids have an effect on a wide range of physiological processes in the body. These include regulating blood pressure and metabolism and helping the body deal with physical stress. A shortage of corticosteroids causes congenital adrenal hyperplasia and Addison’s disease.
Treatment consists of replacing one of the steroids that patients are unable to produce with a steroid called cortisol. Cortisol does however also affect fat tissue and can lead to high blood pressure, weight gain and type 2 diabetes.
Corticosterone, another steroid, has been the subject of a recent study done at the University of Edinburgh’s British Heart Foundation Centre for Cardiovascular Science. Although corticosterone is produced naturally by the body, it has not really been studied up to now.
In a study done with mice, the team proved that corticosterone affected fat cells a lot less than cortisol does. This effect is a result of fat cells removing corticosterone with an internal pump, while cortisol is not removed in this manner.
The therapy was then tested in a small group of patients with Addison’s disease. Although corticosterone was found to be as effective as cortisol, it had a lesser effect on fat cells.
According to Professor Brian Walker, Head of the BHF Centre for Cardiovascular Science at the University of Edinburgh, the results suggest that as a replacement therapy for conditions such as congenital adrenal hyperplasia and Addison’s disease, corticosterone provides a safer alternative to cortisol. Although further research is required, other conditions such as rheumatoid arthritis and asthma may in future also benefit from improved steroid replacement therapies.
The BHF Centre for Cardiovascular Science at the University of Edinburgh’s Dr Mark Nixon believes a completely new approach to the search for safer steroid medications will be taken in future as a result of the discovery of the selective corticosterone pump in fat cells.
The study was published in the journal Science Translational Medicine.