The effects of selected inhibitors on human fetal adrenal steroidogenesis differs under basal and ACTH-stimulated conditions

Abstract Background Disordered fetal adrenal steroidogenesis can cause marked clinical effects including virilization of female fetuses. In postnatal life, adrenal disorders can be life-threatening due to the risk of adrenal crisis and must be carefully managed. However, testing explicit adrenal ste...

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Main Authors: Cecilie Melau, Malene Lundgaard Riis, John E. Nielsen, Signe Perlman, Lene Lundvall, Lea Langhoff Thuesen, Kristine Juul Hare, Mette Schou Hammerum, Rod T. Mitchell, Hanne Frederiksen, Anders Juul, Anne Jørgensen
Format: Article
Language:English
Published: BMC 2021-09-01
Series:BMC Medicine
Subjects:
Online Access:https://doi.org/10.1186/s12916-021-02080-8
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author Cecilie Melau
Malene Lundgaard Riis
John E. Nielsen
Signe Perlman
Lene Lundvall
Lea Langhoff Thuesen
Kristine Juul Hare
Mette Schou Hammerum
Rod T. Mitchell
Hanne Frederiksen
Anders Juul
Anne Jørgensen
author_facet Cecilie Melau
Malene Lundgaard Riis
John E. Nielsen
Signe Perlman
Lene Lundvall
Lea Langhoff Thuesen
Kristine Juul Hare
Mette Schou Hammerum
Rod T. Mitchell
Hanne Frederiksen
Anders Juul
Anne Jørgensen
author_sort Cecilie Melau
collection DOAJ
description Abstract Background Disordered fetal adrenal steroidogenesis can cause marked clinical effects including virilization of female fetuses. In postnatal life, adrenal disorders can be life-threatening due to the risk of adrenal crisis and must be carefully managed. However, testing explicit adrenal steroidogenic inhibitory effects of therapeutic drugs is challenging due to species-specific characteristics, and particularly the impact of adrenocorticotropic hormone (ACTH) stimulation on drugs targeting steroidogenesis has not previously been examined in human adrenal tissue. Therefore, this study aimed to examine the effects of selected steroidogenic inhibitors on human fetal adrenal (HFA) steroid hormone production under basal and ACTH-stimulated conditions. Methods This study used an established HFA ex vivo culture model to examine treatment effects in 78 adrenals from 50 human fetuses (gestational weeks 8–12). Inhibitors were selected to affect enzymes critical for different steps in classic adrenal steroidogenic pathways, including CYP17A1 (Abiraterone acetate), CYP11B1/2 (Osilodrostat), and a suggested CYP21A2 inhibitor (Efavirenz). Treatment effects were examined under basal and ACTH-stimulated conditions in tissue from the same fetus and determined by quantifying the secretion of adrenal steroids in the culture media using liquid chromatography-tandem mass spectrometry. Statistical analysis was performed on ln-transformed data using one-way ANOVA for repeated measures followed by Tukey’s multiple comparisons test. Results Treatment with Abiraterone acetate and Osilodrostat resulted in potent inhibition of CYP17A1 and CYP11B1/2, respectively, while treatment with Efavirenz reduced testosterone secretion under basal conditions. ACTH-stimulation affected the inhibitory effects of all investigated drugs. Thus, treatment effects of Abiraterone acetate were more pronounced under stimulated conditions, while Efavirenz treatment caused a non-specific inhibition on steroidogenesis. ACTH-stimulation prevented the Osilodrostat-mediated CYP11B1 inhibition observed under basal conditions. Conclusions Our results show that the effects of steroidogenic inhibitors differ under basal and ACTH-stimulated conditions in the HFA ex vivo culture model. This could suggest that in vivo effects of therapeutic drugs targeting steroidogenesis may vary in conditions where patients have suppressed or high ACTH levels, respectively. This study further demonstrates that ex vivo cultured HFAs can be used to evaluate steroidogenic inhibitors and thereby provide novel information about the local effects of existing and emerging drugs that targets steroidogenesis.
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spelling doaj.art-4b092556ccf84c61a965df50527835b12022-12-21T20:06:10ZengBMCBMC Medicine1741-70152021-09-0119111710.1186/s12916-021-02080-8The effects of selected inhibitors on human fetal adrenal steroidogenesis differs under basal and ACTH-stimulated conditionsCecilie Melau0Malene Lundgaard Riis1John E. Nielsen2Signe Perlman3Lene Lundvall4Lea Langhoff Thuesen5Kristine Juul Hare6Mette Schou Hammerum7Rod T. Mitchell8Hanne Frederiksen9Anders Juul10Anne Jørgensen11Department of Growth and Reproduction, Copenhagen University Hospital – RigshospitaletDepartment of Growth and Reproduction, Copenhagen University Hospital – RigshospitaletDepartment of Growth and Reproduction, Copenhagen University Hospital – RigshospitaletDepartment of Gynaecology, Copenhagen University Hospital – RigshospitaletDepartment of Gynaecology, Copenhagen University Hospital – RigshospitaletDepartment of Obstetrics and Gynaecology, Copenhagen University Hospital - Hvidovre and Amager HospitalDepartment of Obstetrics and Gynaecology, Copenhagen University Hospital - Hvidovre and Amager HospitalDepartment of Obstetrics and Gynaecology, Copenhagen University Hospital - Herlev and Gentofte HospitalMRC Centre for Reproductive Health, The Queen’s Medical Research Institute, The University of EdinburghDepartment of Growth and Reproduction, Copenhagen University Hospital – RigshospitaletDepartment of Growth and Reproduction, Copenhagen University Hospital – RigshospitaletDepartment of Growth and Reproduction, Copenhagen University Hospital – RigshospitaletAbstract Background Disordered fetal adrenal steroidogenesis can cause marked clinical effects including virilization of female fetuses. In postnatal life, adrenal disorders can be life-threatening due to the risk of adrenal crisis and must be carefully managed. However, testing explicit adrenal steroidogenic inhibitory effects of therapeutic drugs is challenging due to species-specific characteristics, and particularly the impact of adrenocorticotropic hormone (ACTH) stimulation on drugs targeting steroidogenesis has not previously been examined in human adrenal tissue. Therefore, this study aimed to examine the effects of selected steroidogenic inhibitors on human fetal adrenal (HFA) steroid hormone production under basal and ACTH-stimulated conditions. Methods This study used an established HFA ex vivo culture model to examine treatment effects in 78 adrenals from 50 human fetuses (gestational weeks 8–12). Inhibitors were selected to affect enzymes critical for different steps in classic adrenal steroidogenic pathways, including CYP17A1 (Abiraterone acetate), CYP11B1/2 (Osilodrostat), and a suggested CYP21A2 inhibitor (Efavirenz). Treatment effects were examined under basal and ACTH-stimulated conditions in tissue from the same fetus and determined by quantifying the secretion of adrenal steroids in the culture media using liquid chromatography-tandem mass spectrometry. Statistical analysis was performed on ln-transformed data using one-way ANOVA for repeated measures followed by Tukey’s multiple comparisons test. Results Treatment with Abiraterone acetate and Osilodrostat resulted in potent inhibition of CYP17A1 and CYP11B1/2, respectively, while treatment with Efavirenz reduced testosterone secretion under basal conditions. ACTH-stimulation affected the inhibitory effects of all investigated drugs. Thus, treatment effects of Abiraterone acetate were more pronounced under stimulated conditions, while Efavirenz treatment caused a non-specific inhibition on steroidogenesis. ACTH-stimulation prevented the Osilodrostat-mediated CYP11B1 inhibition observed under basal conditions. Conclusions Our results show that the effects of steroidogenic inhibitors differ under basal and ACTH-stimulated conditions in the HFA ex vivo culture model. This could suggest that in vivo effects of therapeutic drugs targeting steroidogenesis may vary in conditions where patients have suppressed or high ACTH levels, respectively. This study further demonstrates that ex vivo cultured HFAs can be used to evaluate steroidogenic inhibitors and thereby provide novel information about the local effects of existing and emerging drugs that targets steroidogenesis.https://doi.org/10.1186/s12916-021-02080-8HumanAdrenalEx vivoSteroid hormonesACTHOsilodrostat
spellingShingle Cecilie Melau
Malene Lundgaard Riis
John E. Nielsen
Signe Perlman
Lene Lundvall
Lea Langhoff Thuesen
Kristine Juul Hare
Mette Schou Hammerum
Rod T. Mitchell
Hanne Frederiksen
Anders Juul
Anne Jørgensen
The effects of selected inhibitors on human fetal adrenal steroidogenesis differs under basal and ACTH-stimulated conditions
BMC Medicine
Human
Adrenal
Ex vivo
Steroid hormones
ACTH
Osilodrostat
title The effects of selected inhibitors on human fetal adrenal steroidogenesis differs under basal and ACTH-stimulated conditions
title_full The effects of selected inhibitors on human fetal adrenal steroidogenesis differs under basal and ACTH-stimulated conditions
title_fullStr The effects of selected inhibitors on human fetal adrenal steroidogenesis differs under basal and ACTH-stimulated conditions
title_full_unstemmed The effects of selected inhibitors on human fetal adrenal steroidogenesis differs under basal and ACTH-stimulated conditions
title_short The effects of selected inhibitors on human fetal adrenal steroidogenesis differs under basal and ACTH-stimulated conditions
title_sort effects of selected inhibitors on human fetal adrenal steroidogenesis differs under basal and acth stimulated conditions
topic Human
Adrenal
Ex vivo
Steroid hormones
ACTH
Osilodrostat
url https://doi.org/10.1186/s12916-021-02080-8
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