🧬 What is Cortexolone (11-Deoxycortisol)?
- Cortexolone is an intermediate steroid hormone in the biosynthesis of cortisol.
- It is produced in the adrenal cortex, specifically in the zona fasciculata.
- It is synthesized from 17-hydroxyprogesterone and is converted into cortisol by the enzyme 11β-hydroxylase (CYP11B1).
Cortexolone Associated Diseases and Disorders
🔑 Physiological Functions of Cortexolone
Although it is a precursor, it does have some intrinsic biological activity.
1. 🧪 Cortisol Precursor
- Cortexolone is the immediate precursor to cortisol, the body’s main glucocorticoid.
- It plays a crucial role in the adrenal steroidogenesis pathway.
2. ⚖️ Glucocorticoid-Like Activity
- It has weak glucocorticoid activity on its own.
- Some effects on metabolism and immune regulation may occur at high levels.
3. 🧠 Stress Response & HPA Axis
- As a cortisol precursor, it’s part of the hypothalamic-pituitary-adrenal (HPA) axis response.
- Essential for adapting to stress, inflammation, and blood sugar regulation via cortisol.
🧫 Clinical Relevance
🔺 Elevated Cortexolone:
Often indicates a block or deficiency in the 11β-hydroxylase enzyme (CYP11B1), leading to:
◾ Congenital Adrenal Hyperplasia (CAH) – 11β-hydroxylase deficiency
- Cortexolone accumulates because it can’t be converted to cortisol.
- Results in:
- Excess androgen production (virilization, hirsutism)
- Hypertension (via buildup of deoxycorticosterone)
- Low cortisol, triggering increased ACTH
🧴 Fun Fact: Cortexolone 17α-propionate
- A synthetic derivative of cortexolone used topically as a hair loss treatment (brand name: Breezula).
- Acts as a local anti-androgen, blocking DHT at the follicle level — without systemic effects.