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Endocrine Reviews 18 (3): 281-305
Copyright © 1997 by The Endocrine Society

Molecular Endocrinology of Hydroxysteroid Dehydrogenases1

Trevor M. Penning

Department of Pharmacology, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania 19104-6084


    Abstract
 Top
 Abstract
 I. Introduction
 II. 3{beta}-Hydroxysteroid...
 III. 17{beta}-Hydroxysteroid...
 IV. 11{beta}-Hydroxysteroid...
 V. 3{alpha}-Hydroxysteroid...
 VI. 20{alpha}-Hydroxysteroid...
 VII. HSDs Belong to...
 VIII. Structure/Function of HSDs
 IX. Conclusions
 References
 

I. Introduction
II. 3ß-Hydroxysteroid Dehydrogenase/Ketosteroid Isomerase (3ß-HSD/KSI)
A. Physiological and pharmacological significance
B. Cloning and expression of the 3ß-HSD/KSI cDNAs
C. Structure, regulation, and tissue-specific expression of the 3ß-HSD/KSI genes
D. 3ß-HSD deficiencies
III. 17ß-Hydroxysteroid Dehydrogenases
A. Physiological and pharmacological significance
B. Cloning and expression of the 17ß-HSD cDNAs
C. Structure, regulation, and tissue-specific expression of the 17ß-HSD genes
D. 17ß-HSD deficiency
IV. 11ß-Hydroxysteroid Dehydrogenases
A. Physiological and pharmacological significance
B. Cloning and expression of the 11ß-HSD cDNAs
C. Structure, regulation, and tissue-specific expression of the 11ß-HSD genes
D. 11ß-HSD deficiency
V. 3{alpha}-Hydroxysteroid Dehydrogenases
A. Physiological and pharmacological significance
B. Cloning and expression of the 3{alpha}-HSD cDNAs
C. Structure, regulation, and tissue-specific expression of the 3{alpha}-HSD genes
D. 3{alpha}-HSD deficiencies
VI. 20{alpha}-Hydroxysteroid Dehydrogenases
A. Physiological and pharmacological significance
B. Cloning and expression of the 20{alpha}-HSD cDNAs
C. Structure, regulation, and tissue-specific expression of the 20{alpha}-HSD genes
VII. HSDs Belong to Two Protein Families
A. HSDs that belong to the SDR superfamily
B. HSDs that belong to the AKR superfamily
VIII. Structure/Function of HSDs
A. Kinetic mechanism of HSDs
B. Catalytic mechanism of HSDs
C. x-Ray crystal structures of HSDs in the SDR superfamily
D. Site-directed mutagenesis on HSDs that are SDR members
E. x-Ray crystal structures of HSDs in the AKR superfamily
F. Site-directed mutagenesis on HSDs that are AKR members
G. Convergent evolution to a common reaction mechanism
H. Engineering alternate substrate specificity
IX. Conclusions


    I. Introduction
 Top
 Abstract
 I. Introduction
 II. 3{beta}-Hydroxysteroid...
 III. 17{beta}-Hydroxysteroid...
 IV. 11{beta}-Hydroxysteroid...
 V. 3{alpha}-Hydroxysteroid...
 VI. 20{alpha}-Hydroxysteroid...
 VII. HSDs Belong to...
 VIII. Structure/Function of HSDs
 IX. Conclusions
 References
 
HYDROXYSTEROID dehydrogenases (HSDs) play pivotal roles in the biosynthesis and inactivation of all steroid hormones. In steroidogenic tissues they catalyze the final steps in androgen, estrogen, and progesterone biosynthesis. In peripheral tissues, including steroid hormone target tissues, they convert potent steroid hormones into inactive metabolites and regulate the amount of hormone that can bind to members of the nuclear receptor superfamily, ultimately regulating gene expression. Target cells may depend on these reactions to control specificity of response to steroid hormones.

Because HSDs catalyze bidirectional reactions, it has been difficult to understand how they can be involved in both the synthesis and inactivation of steroid hormones. cDNA cloning indicates that each HSD exists in multiple isoforms, which show tissue specificity in expression; this, coupled with the properties of each isoform (reductase or dehydrogenase), can determine the role of the enzyme in steroid hormone action. Advances in cDNA isolation have led to the concept that HSDs belong to at least two distinct protein phylogenies: the short-chain dehydrogenase/reductase family (SDR; formerly short-chain alcohol dehydrogenase) whose members include the 3ß-HSD/ketosteroid isomerase (3ß-HSD/KSI), 11ß-HSD, and 17ß-HSD (1, 2), and the aldo-keto reductase (AKR) superfamily (3, 4, 5, 6) whose members include 3{alpha}-HSD and 20{alpha}-HSD. Three-dimensional structures now exist for mammalian HSDs that belong to each of the two families and serve as templates for structure-function studies on HSDs within each protein family. These represent the first available structures for mammalian enzymes involved in steroidogenesis and steroid metabolism.

Because of their central role in steroid hormone action, HSDs as a group of enzymes are considered therapeutic targets. Several reviews (7, 8) have been written on the design of HSD inhibitors, and that material will not be reviewed here. It is sufficient to say that specificity in drug design may depend on the successful targeting of a tissue-specific isoform.


    II. 3ß-Hydroxysteroid Dehydrogenase/Ketosteroid Isomerase (3ß-HSD/KSI)
 Top
 Abstract
 I. Introduction
 II. 3{beta}-Hydroxysteroid...
 III. 17{beta}-Hydroxysteroid...
 IV. 11{beta}-Hydroxysteroid...
 V. 3{alpha}-Hydroxysteroid...
 VI. 20{alpha}-Hydroxysteroid...
 VII. HSDs Belong to...
 VIII. Structure/Function of HSDs
 IX. Conclusions
 References
 
A. Physiological and pharmacological significance
The dual functional 3ß-HSD/KSI catalyzes the formation of {Delta}4-3-ketosteroids. The enzyme catalyzes two reactions, the dehydrogenation of 3ß-equatorial hydroxysteroids and the subsequent isomerization of the {Delta}5-3-ketosteroid products to yield the {alpha},ß-unsaturated ketones. The majority of steroid hormones, with the exception of estrogens and the 5{alpha}-reduced androgens, contain this functional group. Since these latter hormones are themselves derived from {Delta}4-3-ketosteroids, 3ß-HSD/KSI is required for all steroid hormone biosynthesis. It should be noted that, in the placenta and corpus luteum, 3ß-HSD/KSI is responsible for the final steps in progesterone biosynthesis necessary for the maintenance of pregnancy (Fig. 1Go). In the adrenal cortex the 3ß-HSD/KSI plays a pivotal role in the formation of glucocorticoids and mineralocorticoids.



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Figure 1. Reactions catalyzed by HSDs in steroidogenic tissues. Reactions (top) are those catalyzed by the bifunctional 3ß-HSD/KSI found in the adrenal, placenta, ovary, testis, and skin. Reactions (bottom) are those catalyzed by the estrogenic and androgenic 17ß-HSDs.

 
Development of selective inhibitors of tissue-specific isoforms of HSDs is a desirable goal. This is nowhere more apparent than in the 3ß-HSD/KSIs. Inhibitors of the placental and ovarian 3ß-HSD/KSI would prevent the biosynthesis of progesterone, and such agents would be useful as antiprogestational agents for the termination of pregnancy and could act as abortifacients and postcoital contraceptives. However, if the adrenal 3ß-HSD/KSI were inhibited, chronic administration of such agents would lead to adrenal hyperplasia. cDNA cloning indicates that because the human isoforms present in the adrenal and placenta are distinct (9, 10, 11), further chronic use of antiprogestational agents may not be required for an antiprogestational effect. This suggests that the development of antiprogestins targeting 3ß-HSD/KSI isoforms is an achievable goal. One effective compound, epostane (12), has withstood a clinical trial in Europe (13). In fact, epostane was found to lower circulating progesterone levels markedly and thereby terminate early and midstage pregnancy.

B. Cloning and expression of the 3ß-HSD/KSI cDNAs
The purification of the dual functional 3ß-HSD/KSI from human placenta microsomes (14) led to the development of a polyclonal antibody, which enabled the screening of a human placental cDNA {lambda}gt-11 expression library (9). This was a remarkable achievement because numerous investigators had failed to solubilize and purify the 3ß-HSD/KSI activities from either adrenal or placental microsomes. Because the cDNA for human placental 3ß-HSD/KSI was the first to be isolated, it was termed type I 3ß-HSD/KSI. The cDNA for the type I enzyme encodes a protein of 372 amino acids with a calculated molecular weight of 42,216. The type I enzyme was transiently expressed in mammalian cells and catalyzed the conversion of dehydroepiandrosterone and pregnenolone to produce androstenedione and progesterone, respectively (10, 11). In addition, when transfected cell homogenates were supplemented with NAD+, they efficiently oxidized 5{alpha}-androstane-3ß,17ß-diol to 5{alpha}-dihydrotestosterone (5{alpha}-DHT), and upon addition of NADH the homogenates reduced 5{alpha}-DHT back to the diol. These data ended an ongoing and lengthy debate by establishing unequivocally that a single polypeptide chain could catalyze both the dehydrogenase and isomerase reactions. The availability of this cDNA clone led to the isolation of a cDNA for human adrenal or type II 3ß-HSD/KSI (11). Human type I and type II 3ß-HSD/KSI share in excess of 90% sequence identity. Transient expression of these two isoforms revealed that the catalytic efficiency (Vmax/Km) of type I is 5.9-, 4.5-, and 2.8-fold higher than that of the type II 3ß-HSD using pregnenolone, dehydroepiandrosterone, and dihydrotestosterone (reverse direction) as substrates, respectively (11). The higher Michaelis-Menten constant (Km) values observed for type II 3ß-HSD, which is expressed mainly in steroidogenic tissues, could be related to the higher levels of endogenous substrates present in these tissues (15).

Subsequently, four subtypes of rat 3ß-HSD/KSI have been cloned (type I through type IV); because numbers were assigned in order of discovery, the rat isoforms do not correspond to the human isoforms by number (16, 17, 18). Rat type I and type II 3ß-HSD/KSI share 93.8% sequence homology, yet the type I enzyme has a relative specific activity that is 64- and 46-fold higher than the type II enzyme for pregnenolone and dehydroepiandrosterone, respectively. The lower activity of the type II enzyme is due to a change in four amino acids in a membrane-spanning region predicted to exist by hydropathy plots (16). Construction of chimeric 3ß-HSDs, in which the membrane-spanning domain was reinserted into the type II enzyme, restored the specific activity of the protein (16). Rat type III 3ß-HSD/KSI appears to be found exclusively in the liver where it appears to function predominantly as a liver-specific 3-ketoreductase to inactivate steroid hormones (17). Rat type IV 3ß-HSD/KSI is a novel form found in the skin but, remarkably, is the predominant form found in rat placenta. Ribonuclease (RNase) protection studies have provided a thorough analysis of the tissue distribution of these isoforms (18). Such studies have shown that rat type IV is equivalent to human type I 3ß-HSD/KSI (placental form), and rat types I and II are related to human type II 3ß-HSD/KSI (adrenal form). Since the isolation of the human and rat clones, cDNA clones encoding for the murine adrenal (19), bovine ovary (20), and macaque ovary (21) have been isolated. Initial pair-wise comparison of these sequences indicate that they share in excess of 80–90% homology with each other but little or no homology with other HSDs (Table 1Go).


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Table 1. Percent amino acid sequence identities among the major forms of 3ßHSD/KSI

 
C. Structure, regulation, and tissue-specific expression of the 3ß-HSD/KSI genes
Most in vivo regulation studies on the 3ß-HSD isoforms have been performed in the rat and may be relevant to their human orthologs. Interest in the regulation of the adrenal 3ß-HSD/KSI exists because of its pivotal role in adrenal steroidogenesis and the knowledge that deficiencies in this enzyme can result in congenital adrenal hyperplasia. Studies on the rat adrenal 3ß-HSD/KSI revealed that its mRNA was up-regulated by ACTH in intact male rats and down-regulated by corticosterone. Hypophysectomy reduced mRNA levels markedly, and these could be elevated by the administration of ACTH (22). These data indicate that the gene is regulated by the adrenal-pituitary axis in a manner consistent with controlling circulating glucocorticoid levels. The stimulating effect of ACTH on 3ß-HSD/KSI expression has also been observed in bovine adrenocortical cells (23). The ACTH receptor is a member of the G protein-coupled receptor family and acts through the protein Gs to activate adenylyl cyclase and increase intracellular cAMP. The protein kinase A- dependent signaling mechanism that results in altered transcription of the 3ß-HSD/KSI gene, however, has not been fully elucidated.

Interest in the regulation of the ovarian 3ß-HSD/KSI exists because it catalyzes the final step in progesterone biosynthesis. Down-regulation of this enzyme may contribute to declining progesterone levels, which is a sign of luteolysis. In rat ovary, 3ß-HSD/KSI mRNA and enzyme activity are decreased by ovine PRL and up-regulated by human CG (hCG) (24, 25). These responses are physiologically relevant because PRL stimulates luteolysis whereas hCG is luteotrophic. Changes in mRNA were confirmed by in situ hybridization studies using luteinized porcine granulosa cells. The inhibitory effect of PRL on 3ß-HSD expression and activity is correlated with a progressive decrease in serum progesterone concentration while serum pregnenolone levels are elevated. These findings indicate that inhibition of 3ß-HSD/KSI gene expression in the corpus luteum occurs early in the luteolytic process induced by PRL and could well play a role in PRL-induced luteolysis.

In luteinized porcine granulosa cells, gonadotropins, as well as agents that increase intracellular cAMP accumulation (cholera toxin, forskolin, (Bu)2cAMP), increased 3ß-HSD mRNA levels (25). In contrast, activation of the protein kinase C pathway induced cAMP accumulation but led to a marked inhibition of the stimulatory effect of hCG, LH, forskolin, and cholera toxin on 3ß-HSD mRNA levels (24). The cross-talk that occurs between these two signaling pathways to regulate 3ß-HSD/KSI expression in granulosa cells remains to be elucidated.

In the rat testis, 3ß-HSD/KSI is required for androgen biosynthesis. Not surprisingly, hCG, acting as a mimic of LH, caused a 3.0-, 19.7-, and 11.5-fold increase in steady state levels of testicular 3ß-HSD mRNA, immunoreactive 3ß-HSD/KSI protein, and enzyme activity, respectively, in hypophysectomized male rats (15).

In rat placenta, the temporal modulation of type I, II, and IV 3ß-HSD/KSI has been measured during the second half of gestation. It will be recalled that rat type IV 3ß-HSD/KSI is most similar to human placental type I 3ß-HSD/KSI. It was found that type I and II 3ß-HSD mRNA levels are modulated in a closely parallel manner, peaking sharply on day 15 but falling abruptly thereafter. On the other hand, type IV 3ß-HSD mRNA levels remained elevated and were stable from days 10–17 of gestation, suggesting that this form of the enzyme is responsible for the substantial increase in 3ß-HSD and hence progesterone production that occurs in midpregnancy (15).

Collectively, the studies on the regulation of rat tissue-specific isoforms of 3ß-HSD/KSI indicate that expression is under the control of trophic hormones and that alterations in expression occurs in response to the need to change circulating steroid hormone levels. The ability of the appropriate trophic hormone to increase 3ß-HSD/KSI mRNA levels and protein and enzyme activities on demand in the adrenal, ovary, and testis points to common mechanisms of regulation that involve cAMP.

To gain insight into the regulation of the human 3ß-HSD/KSI genes, type I and type II genes have been cloned (26, 27). Each gene is 7.8 kb in length and consists of four exons and three introns. Both genes are localized to chromosome 1p13.1 (Fig. 2Go). Both genes encode for transcripts that are 1.7 kb in length. Because the type I gene is expressed at high levels in syncyctial trophoblasts and the type II gene is expressed at high levels in the adrenal cortex, gene regulation studies were performed in human choriocarcinoma (JEG-3) cells and human adrenocortical tumor cell lines H295 cells, respectively.



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Figure 2. Organization of the human type I 3ß-HSD/KSI, type II 3ß-HSD/KSI, and Type I 17ß-HSD genes. Noncoding exons are open boxes, coding exons are stippled boxes, and narrow solid lines are introns. [Reprinted from F. Labrie et al.: Baillieres Clin Endocrinol Metab 8:451–474, 1994 (15) by permission of the publisher, W. B. Saunders Company Limited, London.]

 
In human JEG-3 cells, the 1.7-kb transcript is up-regulated by a cAMP-dependent mechanism and by phorbol esters. The phorbol ester response is not mediated by a diacylglycerol-dependent kinase (28). The increases in steady state levels observed in 3ß-HSD/KSI mRNA after treatment with cAMP or phorbol esters can be observed in the presence of cycloheximide and occur independently of new protein synthesis.

In human adrenal cells, activators of the protein kinase A-signaling pathway [e.g. forskolin, (Bu)2cAMP] enhance the production of dehydroepiandrosterone and androstenedione with a concomitant increase in steady state levels of type II 3ß-HSD and 17{alpha}-hydroxylase (CYP17). In contrast, phorbol ester treatment dramatically elevated 3ß-HSD mRNA but attenuated 17{alpha}-hydroxylase mRNA. The 5'-flanking region of the 3ß-HSD type II gene was found to contain a consensus sequence for the orphan nuclear receptor steroidogenic factor 1 (SF-1). The functionality of the SF-1 site was tested in promoter-chloramphenicol acetyl transferase constructs in which the SF-1 site was either present or deleted. It was found that the phorbol ester response had an absolute requirement for the SF-1 element, and that the response was further enhanced if the cDNA encoding for SF-1 was cotransfected (29).

In an attempt to identify cis-regulating elements that may control tissue-specific expression of the type I and type II 3ß-HSD/KSI genes in the placenta and adrenal, respectively, it was found that a strong positive regulatory element exists in the first intron of the type II gene. This 3ß 1-A element was able to drive transcription of a reporter gene in both placenta cells (JEG-3) and adrenal cells (SW13) and was found to bind four proteins including SP-1 (30). Therefore, this intronic element appears to be important for gene transcription but is not responsible for the tissue-specific expression of the type II gene (30).

D. 3ß-HSD deficiencies
Classic 3ß-HSD/KSI deficiency can cause the salt-wasting and non-salt-wasting forms of congenital adrenal hyperplasia due to cortisol deficiency with or without aldosterone deficiency, respectively. It is estimated that defects in this enzyme are responsible for 10% of the patients presenting with congenital adrenal hyperplasia and that the remainder have defects in either the steroid 21-hydroxylase (CYP21) or 17{alpha}-hydroxylase/20-lyase genes (CYP17). In its most severe form, 3ß-HSD deficiency results in the blockade of steroidogenesis in both the adrenal and gonads, and as a result there is an elevated steroid-5-ene to steroid-4-ene ratio. This manifests itself in males as pseudohermaphroditism and in females as virilization at birth. Since the human type II 3ß-HSD gene is the predominant form in these tissues, it is not surprising that the defects occur in this gene product. Simard and colleagues (31, 32, 33) analyzed 12 male and four female patients who had defects in this gene. It was found that there were 14 unique point mutations in the type II 3ß-HSD gene. In the most severe form of the disease, which is salt-wasting, the mutations detected were as follows: W171Stop (nonsense), which may coexist with an insertion of a single C between codon 186 and 187, which leads to a truncated protein at 202; deletion of K273 (frameshift) and point mutations Q142K; Y253N; G15D; L108W; and P86L (missense) (34, 35, 36). In the more moderate form of the disease, the non-salt-wasting disease, the following point mutations (missense) were detected: A245P; G129R; N100S; Y254D; L173R; and A82T (31, 37, 38). Several of these mutations were introduced into the type II 3ß-HSD/KSI cDNA, and the resultant mutant proteins were expressed in COS-1 cells. Kinetic analysis of the mutants revealed that of the point mutations present in the salt-wasting form, the G15D and the G15A mutants showed a 4-fold decrease in catalytic efficiency for the conversion of pregnenolone to progesterone, and the L108W and P186L mutants resulted in a decrease in catalytic efficiency of 40-fold (Table 2Go). The reduction in catalytic efficiencies observed with the G15D and G15A mutants has been partially explained by the increase in Km for NAD+. This glycine residue is predicted to form part of a Gly-XXX-Gly-X motif found in the Rossmann fold for cofactor binding (39)(see Sections VII and VIII). Interestingly, the N100S mutant found in the non-salt-wasting form of the disease resulted in a 30-fold decrease in catalytic efficiency. The similar decreases in catalytic efficiency observed with mutations found in the salt and non-salt wasting forms of the disease indicate that they alone cannot explain the genetic lesions responsible for the differences in the two diseases.


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Table 2. Kinetic parameters of native type II 3ß-HSD and mutant proteins found in patients with the salt-wasting form of classic 3{alpha}-HSD deficiency (G15D, G15A, N100S, L108W, and P186L) and mutant proteins found in patients with the non-salt-wasting form of classic 3ß-HSD deficiency (N100S)

 

    III. 17ß-Hydroxysteroid Dehydrogenases
 Top
 Abstract
 I. Introduction
 II. 3{beta}-Hydroxysteroid...
 III. 17{beta}-Hydroxysteroid...
 IV. 11{beta}-Hydroxysteroid...
 V. 3{alpha}-Hydroxysteroid...
 VI. 20{alpha}-Hydroxysteroid...
 VII. HSDs Belong to...
 VIII. Structure/Function of HSDs
 IX. Conclusions
 References
 
A. Physiological and pharmacological significance
Like the 3ß-HSD/KSIs, the 17ß-HSDs play essential roles in steroidogenesis. 17ß-HSD isozymes catalyze the final steps in androgen and estrogen biosynthesis. In the Leydig cells of the testis, 17ß-HSD converts androstenedione (a weak androgen) into testosterone (a potent androgen) (40). By contrast, 17ß-HSD in the placenta and ovary will catalyze the final step in estrogen biosynthesis by converting estrone (a weak estrogen) into 17ß-estradiol (a potent estrogen) (41, 42) (Fig. 1Go). When these actions occur in androgen or estrogen target tissues, 17ß-HSD subtypes are in a unique position to control ligand occupancy of the respective steroid hormone receptor and could work as molecular switches. Such actions of 17ß-HSD may control the growth of hormonally dependent cancers of the prostate and mammary gland (15, 43, 44). There is thus a need to develop isozyme-specific 17ß-HSD inhibitors, and this area has been reviewed recently (8).

B. Cloning and expression of the 17ß-HSD cDNAs
Different isozymes have been designated for 17ß-HSD (types I-IV) and are named according to the chronological order in which their cDNAs were cloned. The type I 17ß-HSD is the soluble form originally purified from human placenta by Jarabak et al. (41, 42); it converts estrone to 17ß-estradiol using NADPH as cofactor and is also known as estrogenic 17ß-HSD. This is the principal activity of this enzyme since it displays a 100-fold higher affinity for C18 than for C19 steroids. It functions as a homodimer and displays modest 20{alpha}-HSD activity. Its availability led to the development of a polyclonal antibody that was used to screen a bacteriophage expression library. The cDNA clone for human type I 17ß-HSD was isolated by three groups (45, 46, 47) and encodes a protein of 327 amino acids. It contains no obvious membrane-spanning domains. When the recombinant enzyme was transiently expressed in cultured mammalian cells, it almost exclusively catalyzed the reduction of estrone to 17ß-estradiol as predicted by the earlier biochemical studies (48). The enzyme has also been overexpressed in Baculovirus-infected Sf9 insect cells, and the resultant recombinant protein retained the properties of the purified enzyme (49, 50).

Type II 17ß-HSD is a microsomal form and uses NAD+ as cofactor. It catalyzes the oxidation of testosterone and 17ß-estradiol to form androstenedione and estrone, respectively. Its principal function is to inactivate circulating androgens and estrogens. It is located in the liver, small intestine, secretory endometrium, and placenta, which would be consistent with its role in steroid hormone inactivation (40). The cDNA for type II 17ß-HSD was isolated by expression cloning of a cDNA library from human prostate mRNA using cytomegalovirus promoter constructs (51). The cDNA encodes a protein of 387 amino acids, which contained an amino-terminal signal anchor motif and a carboxy-terminal endoplasmic reticulum retention motif that would locate the enzyme in the membrane. The presence of a hydrophobic amino acid terminus in type II 17ß-HSD distinguishes the enzyme from the type I 17ß-HSD, which has a hydrophilic amino acid terminus. When the cDNA for type II 17ß-HSD was expressed in human embryonal kidney 293 cells, it also displayed modest 20{alpha}-HSD activity and converted 20{alpha}-hydroxyprogestrone to progesterone (51), a reaction that produces an active progestin.

Type III 17ß-HSD, also known as androgenic 17ß-HSD, is found in the microsomes of the testis where it reduces androstenedione to testosterone (40). It prefers NADPH as cofactor. Using an expression-cloning strategy, the cDNA for human testis type III 17ß-HSD was obtained (52). The cDNA encodes a protein of 310 amino acids. Analysis of the amino acid sequence for the type III enzyme shows a hydropathy profile that does not support the presence of any membrane-spanning regions, but the short hydrophobic N- and C-termini may associate the protein with the endoplasmic reticulum. Pairwise comparisons between the three 17ß-HSD isozymes show that the amino acid identities between the type I, type II, and type III proteins are approximately 23% (51, 52), indicating that these enzymes are members of the same family (53).

Recently, a type IV 17ß-HSD has been found in human, mouse, and pig. It is similar to the type II isoform in that it is NAD+ dependent and is principally involved in the oxidation and therefore inactivation of estrogens and androgens. In porcine gonads, immunofluorescence detected the type IV 17ß-HSD in granulosa cells as well as the Leydig cells and Sertoli cells in the testis. The cDNA encodes an 80-kDa protein featuring domains not present in other 17ß-HSDs (54). The 80-kDa protein is cleaved at the N terminus to yield a 32-kDa fragment with 17ß-HSD activity. Both the 80-kDa and the N-terminal 32-kDa fragment have 17ß-HSD activity (55). The central domain (324–596 amino acids) is 40% identical to the C-terminal domain of the fatty acid hydratase/dehydrogenase of yeast and catalyzes ß-oxidation of fatty acids. The C-terminal domain is 39% identical with sterol carrier protein. Type IV 17ß-HSD is found in a number of human cells including those from the breast (MCF-7 and T47D) and liver (HepG2) (56). The peroxisomal location of this isozyme suggests that the protein may have other as yet undefined roles in lipid and steroid metabolism (57).

C. Structure, regulation, and tissue-specific expression of the 17ß-HSD genes
Two major mRNA species for type I 17ß-HSD, 2.2 kb and 1.3 kb in length, have been identified in human placenta. S1 nuclease analysis indicates that in placenta the major transcript is 1.3 kb in length and starts nine nucleotides upstream from the start codon. The 2.2-kb transcript is a minor species and contains approximately 971 nucleotides upstream from the same in frame start codon (58). Type I 17ß-HSD mRNA is distributed in placenta, liver, ovary, endometrium, prostate, testis, and adipose tissue. Immunochemical analyses have confirmed the presence of the type I enzyme in the syncytiotrophoblast of human placenta (59), the granulosa cells of human ovary (60), the epithelial cells of human breast (43), and the endometrium (61). In studies on estrogen-sensitive human breast cancer cell lines (ZR-75–1, MCF-7, T-47D, and R-27), type I 17ß-HSD was elevated and favored formation of 17ß-estradiol. In estrogen receptor-negative cell lines, the activity and expression were considerably lower (44, 62) and estrone formation was favored. Data such as these indicate that type I 17ß-HSD may be an important component in estrogen-dependent growth of mammary tissues and a target for drug development.

The regulation of the type I 17ß-HSD 1.3- kb transcript has been measured in JEG-3 cells. The mRNA for 17ß-HSD was elevated with an analog of cAMP and a protein kinase C agonist, phorbol-12-myristrate-13-acetate. The effects of cAMP were mimicked with forskolin and isobutyl methyl xanthine (a phosphodiesterase inhibitor) but were not abolished by a cAMP-dependent protein kinase inhibitor. By contrast, the effects of protein kinase C were abolished with a diacylglycerol kinase inhibitor. This indicates that type I 17ß-HSD is regulated by a nonclassic cAMP-dependent mechanism that remains to be elucidated (28, 63).

The expression pattern of the type II 17ß-HSD mRNA in human tissues supports its role as a steroid hormone inactivator. The 1.5-kb transcript is most highly expressed in liver, followed by the placenta, small intestine, and endometrium. The glandular epithelium of the endometrium almost exclusively expressed the type II 17ß-HSD, and it is positively regulated by progestins to inactivate estrogens (64).

The 1.3-kb mRNA encoding type III 17ß-HSD has been detected only in the testis, which is consistent with its role in the formation of testicular androgens (52).

To understand the basis of the tissue-specific and regulated 17ß-HSD gene expression, the human type I, II, and III 17ß-HSD genes have been cloned (52, 53, 58, 65). The type I gene consists of seven exons and five introns that span 6.2 kb and encode a transcript of 2.2 kb with a long 5'-untranslated region (UTR) (Fig. 2Go). A highly homologous pseudogene (previously designated 17ß-HSD I) has also been cloned, but there is evidence that the pseudogene is not expressed (46, 63, 66). The pseudogene contains eight exons and five introns. The two genes appear in tandem and together span more than 21 kb. These genes were mapped to the long arm of chromosome 17 and more specifically to the region q11-q12 or q12–21 (46, 63, 66). It is now known that the gene for human type I 17ß-HSD is closely linked to the susceptibility gene for hereditary breast and ovarian cancer, the BRCA1 gene on chromosome 17q21 (46). Both 17ß-HSD genes contain a promoter region with a TATA box as well as GC and inverse CAAT boxes. The 5'-flanking regions contained consensus sequences for cis-acting elements that may function as regulators of 17ß-HSD gene expression. These sequences included estrogen, progesterone, and glucocorticoid response elements and a cAMP response element (67). No functional studies on the 17ß-HSD type I gene promoter have been reported.

The type II 17ß-HSD gene is located on chromosome 16q24. The gene was isolated from a human leukocyte genomic DNA library (65). The type II gene contains seven exons and spans 40 kb. This gene gives rise to two alternatively spliced mRNAs, but only the major transcript (1.45 kb) is functional and encodes for the 387-amino acid protein. The cap site is between 179 and 167 nucleotides upstream from the ATG start codon (65).

In contrast, the type III 17ß-HSD gene (androgenic 17ß-HSD) is found on chromosome 9q22. This gene contains 11 exons and is in excess of 60 kb in length (52, 53). Although the lack of chromosomal synteny between the type I-III 17ß-HSDs and the low degree of sequence homology suggested that they arose by convergent evolution, they appear to be SDR family members (53).

D. 17ß-HSD deficiency
Defects in 17ß-HSD were originally described by Saez and colleagues (68), who reported familial male pseudohermaphroditism due to a deficiency in testicular 17-ketoreductase. The characteristic phenotype is a 46,XY individual with testes and male Wolffian duct-derived urogenital structures (e.g. epididymus, vas deferens, and seminal vesicles), but with external female genitalia. These individuals are usually classified as females at birth but are genetic males and develop a male phallus at puberty. It is recognized that the 17ß-HSD deficiency, which results in pseudohermaphroditism, results from autosomal recessive mutations in the type III 17ß-HSD gene (androgenic form) (69, 70, 71). This defect underscores the importance of the type III 17ß-HSD in androgen formation. Examination of 14 male pseudohermaphrodites showed that a number of unique mutations occurred within the type III 17ß-HSD gene. These mutations included 10 point mutations (missense): S65L, R80Q, Q176P, V205E, A203V, F208I, E215D, S232L, M235V, and P282L (53, 72); three splice-junction abnormalities; and one small deletion {Delta}777 that results in a frame shift and slightly truncated protein. Mutations were also found in introns 3 and 8, which disrupted the splice-acceptor sites. The point mutations in the open-reading frame were introduced into the cDNA for type III 17ß-HSD, and their effect on enzyme activity was measured after transient transfection into human embryonal kidney 293 cells. It was found that eight of the nine missense mutant enzymes were devoid of catalytic activity, establishing that these mutations were the cause of the deficiency. The exception was the R80Q mutation, which had one fifth the specific activity of the wild type enzyme, and the decrease in activity was found to result from a reduced affinity for NADPH. The residual activity observed was consistent with the low formation of testosterone observed in the affected patient.


    IV. 11ß-Hydroxysteroid Dehydrogenases
 Top
 Abstract
 I. Introduction
 II. 3{beta}-Hydroxysteroid...
 III. 17{beta}-Hydroxysteroid...
 IV. 11{beta}-Hydroxysteroid...
 V. 3{alpha}-Hydroxysteroid...
 VI. 20{alpha}-Hydroxysteroid...
 VII. HSDs Belong to...
 VIII. Structure/Function of HSDs
 IX. Conclusions
 References
 
A. Physiological and pharmacological significance
The concept that HSDs can function as molecular switches and regulate occupancy of steroid hormone receptors is a theme that can be developed for many of the HSDs. This concept is seen vividly with 11ß-HSD. A paradox that existed for some time was that both gluco- and mineralocorticoids have the same affinity for the mineralocorticoid receptor in the kidney, yet glucocorticoids are present at much higher concentrations than aldosterone; thus, one would predict that the outcome would be hypertension due to mineralocorticoid excess. This, in fact, is prevented in kidney cells because 11ß-HSD converts cortisol (an active hormone) into cortisone (an inactive hormone) and thereby prevents glucocorticoids from binding to the type I mineralocorticoid receptor and exerting their mineralocorticoid activity. In this example steroid hormone specificity is not receptor-driven but is HSD-dependent (73, 74, 75) (Fig. 3Go).



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Figure 3. Reactions catalyzed by HSDs in steroid target tissues. In these reactions, 3{alpha}-HSD and 11ß-HSD act as molecular switches by interconverting potent steroid hormones with their cognate inactive metabolites. Kd values are for steroid receptors.

 
Apparent mineralocorticoid excess (AME) is associated with a deficiency in the kidney-specific type II 11ß-HSD (76). AME is characterized by hypertension, excessive salt retention, and hypokalemia. The disease can be mimicked by the ingestion of licorice, the active ingredient being glycyrrhetinic acid, which is the aglycone of glycyrrhizic acid and a potent inhibitor of 11ß-HSD (77, 78).

B. Cloning and expression of the 11ß-HSD cDNAs
Rat liver 11ß-HSD was one of the first mammalian HSDs to be cloned (79) and was expressed using a vaccina virus infection protocol (80). The cDNA contained a 861-bp open reading frame that encodes a protein of 287 amino acids. Sequence comparison indicated that there was low but significant identity to ribitol dehydrogenase, the product of the Nod G gene, and Drosophila alcohol dehydrogenase, which are recognized as being members of the SDR family (79). It is now known that two isoforms of 11ß-HSD exist and both belong to this superfamily.

The type I 11ß-HSD refers to the form that was originally purified and cloned from rat liver. It is a glycoprotein and the molecular mass of the mature protein is 34 kDa. It catalyzes oxidation and reduction using NADP(H) as cofactor, and it is expressed in a variety of rat and human tissues including liver, lung, testis, colon, and kidney. A remarkable feature of this enzyme is that, when it is purified from rat liver, it functioned only as a dehydrogenase. However, the recombinant enzyme, expressed using vaccina virus, exhibited both oxidation and reduction of steroids (80). These observations led to the speculation that the level of glycosylation determined directionality of enzyme catalysis (80). When tunicamycin, an inhibitor of glycosylation, was added to the vaccina virus expression system, enzyme activity was reduced by more than 50%. This represents one of the first examples in which the function of a mammalian HSD may be regulated by posttranslational modification. It was originally proposed that the type I 11ß-HSD was responsible for conferring mineralocorticoid specificity; however, immunocytochemical studies within the rat kidney indicate that it is localized in the proximal tubular elements and not colocalized with the type I mineralocortioid receptor in the distal tubular elements (81). Studies on the hepatic form of 11ß-HSD in the squirrel monkey also indicate that the type 1 11ß-HSD does not protect against AME. This enzyme shares 75% sequence identity with the rat type 1 11ß-HSD but is only expressed in the liver and fibroblasts. Since squirrel monkeys have highly elevated cortisol levels but do not display Cushing’s disease or AME, an enzyme other than the hepatic 11ß-HSD must protect the mineralocorticoid receptor from cortisol occupancy (82).

In contrast, a type II 11ß-HSD was found in the kidney and placenta microsomes of sheep and humans. Clones encoding the kidney isozyme have been isolated from sheep and human kidney cDNA libraries (83, 84). The human type II 11ß-HSD is 41 kDa in length and consists of 405 amino acids. It is NAD+ specific and it has a lower Km (10–100 nM) for steroid substrate than the type I enzyme (75). It catalyzes only 11ß-dehydrogenation, i.e. it inactivates cortisol. The type II 11ß-HSD and the type II 17ß-HSD share 35% sequence identity and suggest that both these dehydrogenases belong to the SDR superfamily.

The pattern of diformazan disposition (a dye that produces a blue color after the reduction of cortisol by cofactor in the presence of enzyme) colocalized the type II 11ß-HSD activity with the mineralocortioid receptor (85). It is now clear that it is the type II enzyme that is important in regulating occupancy of the mineralocorticoid receptor (75, 76, 85).

C. Structure, regulation, and tissue-specific expression of the 11ß-HSD genes
At least four different mRNA species hybridize with the type I 11ß-HSD cDNA in rat kidney (86), indicating that one or more alternative forms of 11ß-HSD exist that may be products of either alternative splicing of the pre-mRNA or the use of a different cap site. The multiple RNA transcripts for type I 11ß-HSD can be generated by either differential promoter usage by the type I 11ß-HSD gene (86) or by differential polyadenylation. Isoforms have been termed type IA and type IB 11ß-HSD. Type IB is exclusively expressed in the kidney medulla and cortex, and interest originally existed in this form because this enzyme had the potential to colocalize with the mineralocorticoid receptor (87). The type IB 11ß-HSD mRNA encodes for a protein in which the first 26 amino acids from the N terminus are missing (87). This truncated enzyme is encoded by a transcript that originates from intron-1 of the type I gene. This truncation results in the loss of a hydrophobic polypeptide chain that may be important in intracellular transport of the enzyme. Expression of the type IB 11ß-HSD cDNA failed to yield active enzyme using either cortisol or corticosterone as substrates and suggests that the truncated region is essential for enzyme activity. This truncation stops just before the NADP+ binding site, which is predicted to be located at the N terminus.

Using the cDNA for type I 11ß-HSD and polyclonal antibody, it was found that this enzyme was expressed in tissues that were not mineralocorticoid target tissues (e.g. liver, lung, skin, and testis) (88). In addition, no type I 11ß-HSD was found in several mineralocorticoid target segments in the kidney (e.g. cortical collecting ducts and collecting tubules) (85, 88, 89). This profile of tissue-specific expression further confirms that type I 11ß-HSD does not protect against mineralocorticoid activity of the glucocorticoids.

The human type I 11ß-HSD gene has been cloned and is located on chromosome 1 and contains six exons that span a total length of 9 kb (90) (Fig. 4Go). The human type II 11ß-HSD gene consists of five exons and four introns and is 6.2 kb in length and, by contrast to the type I gene, is located on chromosome 16q22 (91). The 5'-flanking regions of these genes have not been analyzed for the presence of cis-acting elements, and functional studies on these promoters have not been described.



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Figure 4. Organization of the human type I and type II 11ß-HSD genes. A, Organization of the type I 11ß-HSD gene is shown. Noncoding exons are open boxes, coding exons are stippled boxes, and narrow solid lines are introns. Exons encoding the N-terminal tail and the conserved cofactor-binding (NADP+) and catalytic (Y/K) domains are indicated. [Derived from Ref. 92.] B, Organization of the type II 11ß-HSD gene. Noncoding exons are open boxes, coding exons are stippled boxes, and narrow solid lines are introns. Mutations detected in patients with AME are shown. Dotted lines around mutations denote heterozygosity and solid lines denote homozygosity. [Derived from Ref. 76.]

 
D. 11ß-HSD deficiency
AME is an inborn error in metabolism that effects occupancy of the type I mineralocorticoid receptor in the kidney tubule. The defect is characterized by increased half-lives for cortisol, retention of sodium (despite low mineralocorticoid levels), and hypokalemia. It is treatable with the aldosterone receptor antagonist, spironolactone, and a low salt diet. Mutations in the gene for type I 11ß-HSD were suspected, but early analysis revealed that none existed (92). The molecular basis for the deficiency has been elucidated after the isolation of the gene for type II 11ß-HSD, which is the human kidney-specific isoform (76). The gene encoding this enzyme has been analyzed in 11 AME patients. Mutations were found on both alleles in nine of the 11 patients, and these mutations were found to adversely affect enzyme activity. The mutations detected included R208C, R213C, R337H, deletion mutants of Y232 and Y338, and the point mutations L250P and L251S. In an independent study a missense mutation of R337C was observed in three siblings (93, 94). Several of these mutations were generated in the type II 11ß-HSD cDNA, and the mutant enzymes were expressed in mammalian cells. The majority of mutant enzymes had less than 10% of the enzyme activity of the wild type recombinant protein, whereas the R337C mutant displayed a 10-fold increase in the Km for cortisol (95). One additional mutation in the gene was observed 14 bp downstream from the splice site in intron 4. It was found that this mutation adversely affected the splicing of the pre-mRNA and resulted in the elimination of exon 4 from the expressed protein. The low activity of many of the point or deletion mutants in 11ß-HSD can be rationalized on the basis of the crystal structure for Streptomyces hydrogenans 3{alpha},20ß-HSD; both these enzymes are members of the short-chain dehydrogenase/reductase family and are inhibited by carbenoxolone (a derivative of glycyrrhetinic acid, the active ingredient of licorice) (see Sections VII and VIII). Deletion of Y232 is anticipated to result in inactive enzyme since this residue is part of a Tyr-X-X-X-Lys catalytic motif that is conserved (see Sections VII and VIII). Similarly, R208 and R213 are predicted to make up portions of the steroid-binding pocket, and changes in Km for steroid substrate are anticipated.


    V. 3{alpha}-Hydroxysteroid Dehydrogenases
 Top
 Abstract
 I. Introduction
 II. 3{beta}-Hydroxysteroid...
 III. 17{beta}-Hydroxysteroid...
 IV. 11{beta}-Hydroxysteroid...
 V. 3{alpha}-Hydroxysteroid...
 VI. 20{alpha}-Hydroxysteroid...
 VII. HSDs Belong to...
 VIII. Structure/Function of HSDs
 IX. Conclusions
 References
 
A. Physiological and pharmacological significance
Mammalian 3{alpha}-HSDs work in concert with the 5{alpha}- and 5ß-reductases to reduce 3-ketosteroids to produce the 5{alpha},3{alpha}- and 5ß,3{alpha}-tetrahydrosteroids. Although these reactions are responsible for the metabolism of the majority of steroid hormones, they are not without consequence. In the prostate, 3{alpha}-HSD works as a molecular switch and regulates occupancy of the androgen receptor. In this tissue the enzyme interconverts 5{alpha}-DHT [dissociation constant (Kd) for the androgen receptor of 10-11 M] to 3{alpha}-androstanediol [Kd for the androgen receptor of 10-6 M], thereby reducing the affinity of the steroid ligand for the androgen receptor by 5 orders of magnitude (96, 97, 98, 99) (Fig. 3Go). In the dog prostate, evidence has mounted that the enzyme works predominantly as a dehydrogenase and works in concert with 5{alpha}-reductase to maintain high levels of 5{alpha}-DHT, which is required for both the normal and abnormal growth of the prostate (100, 101). Inhibitors of prostatic 3{alpha}-HSD would block the interconversion of 5{alpha}-DHT to 3{alpha}-androstanediol and may be useful in preventing the build-up of 5{alpha}-DHT. Such inhibitors could be useful in combination with Finasteride for the treatment of benign prostatic hyperplasia and prostatic cancer.

In the brain, 3{alpha}-HSD converts 5{alpha}-reduced steroids (e.g. 5{alpha}-dihydroprogesterone) to yield tetrahydrosteroids (e.g. 5{alpha},3{alpha}-tetrahydroprogesterone), which are potent allosteric effectors of the {gamma}-aminobutyric acid (GABA)a receptor (Fig. 3Go). These steroids do not bind to the GABAa receptor by themselves but, in the presence of GABA, nanomolar concentrations of these steroids increase the affinity of the receptor for this neurotransmitter. As a consequence, these neurosteroids increase GABA-dependent chloride conductance and have anxiolytic and anesthetic properties (102, 103, 104). The 3{alpha}-hydroxysteroid, alphaxalone, was developed as an anesthetic based on this mechanism of action (105). Thus, 3{alpha}-HSD regulates occupancy of steroid hormone receptors, whether they are members of the nuclear receptor superfamily, such as the androgen receptor, or a membrane-bound chloride-ion gated channel such as the GABAa receptor.

B. Cloning and expression of the 3{alpha}-HSD cDNAs
The first mammalian 3{alpha}-HSD to be purified was from rat liver cytosol. This enzyme was obtained in milligram amounts (106) and led to the development of a polyclonal antibody (107). Immunoscreening of a {lambda}gt-11 expression library led to the isolation of a full-length cDNA clone that encodes a protein of 322 amino acids (3). The fidelity of the clone was confirmed by its overexpression in E. coli (108). The same cDNA was cloned and expressed independently by several groups (109, 110, 111). The cDNA for rat liver 3{alpha}-HSD was found to share no sequence identity with other HSDs that had been cloned at that time, including 3ß-HSD/KSI (9, 10, 11, 16), 11ß-HSD (79), and 17ß-HSD (45, 46, 47). Instead, a search of GenBank revealed that it shared high sequence identity with aldose-reductases from rat and bovine lens (112, 113), human placental aldose reductase (114, 115), prostaglandin F2{alpha} synthase (116), and {rho}-crystallin from frog lens (117). These proteins all share in excess of 58% sequence identity and are known members of the AKR superfamily (see Section VII).

After this initial work a number of potential human 3{alpha}-HSD cDNAs were cloned, including human liver DD1, DD2, and DD4, where DD refers to the associated dihydrodiol dehydrogenase activity. These enzymes display greater than 70% sequence similarity with rat liver 3{alpha}-HSD. Expression of these clones reveals that DD1 acts predominantly as a 20{alpha}-HSD rather than a 3{alpha}-HSD and differs from DD2 in only seven amino acids (118, 119). Recombinant DD2 corresponds to the human bile acid-binding protein (119, 120). In contrast, DD4 appears to be identical to chlordecone reductase (119). Chlordecone reductase is now known to be human type I 3{alpha}-HSD (121). Neither DD2 nor DD4 functions as the human ortholog of the rat liver 3{alpha}-HSD. DD2, like the rat liver enzyme, binds bile acids with high affinity but differs in that it is not an efficient 3{alpha}-HSD. In contrast, DD4 is an efficient 3{alpha}-HSD but does not bind bile acids well. Recently, a type II 3{alpha}-HSD has been cloned from human liver (121). Recombinant type I and type II 3{alpha}-HSDs differ in their Km values for 5{alpha}-DHT. The type I enzyme has a Km of 1.2 µM, and the type II enzyme has a Km of 19.2 µM. Type I and type II 3{alpha}-HSDs display high sequence identity. The availability of these clones has also led to the cloning and expression of two different 3{alpha}-HSDs from human prostate libraries (122, 123). The prostatic 3{alpha}-HSD cDNA isolated by Lin et al. (122) was originally expressed as a his-tag protein in E. coli and was devoid of 3{alpha}-HSD activity, even though it displayed high sequence identity with the rat and human liver isoforms. Subsequently, expression without the his-tag has led to the overexpression of the human prostatic 3{alpha}-HSD activity in E. coli. Kinetic characterization of the recombinant enzyme reveals that it favors 5{alpha}-DHT formation (H.-K. Lin and T. M. Penning, unpublished results). The prostatic 3{alpha}-HSD cDNA clone isolated by Dufort et al. (123) was transiently expressed in human embryonal kidney 293 cells and also had demonstrable 3{alpha}-HSD activity and weak 20{alpha}-HSD activity. This clone has 86% sequence identity with human liver type II 3{alpha}-HSD. Which of the two cDNAs represents the major human prostatic 3{alpha}-HSD is unknown. No attempt has been made to determine which prostate cells (epithelial vs. stromal cells) express 3{alpha}-HSD, and no RNase protection studies have been performed to determine their relative abundance across tissues.

C. Structure, regulation, and tissue-specific expression of the 3{alpha}-HSD genes
Using rat liver 3{alpha}-HSD cDNA as a probe, expression of a 2.7-kb transcript was found to be limited to peripheral tissues such as the liver, lung, and small intestine (124). When poly(A)+ RNA was used, expression was also detected in the testis, mammary gland, and ovary. In the ovary two smaller transcripts, 1.2 and 1.6 kb, were observed. 3{alpha}-HSD is a member of the AKR superfamily and, because members share high-sequence identity, probes based on open-reading frames may result in cross-hybridization and complicate data interpretation concerning tissue-specific expression.

In rat liver, 3{alpha}-HSD displays high constitutive expression and represents 0.5–1.0% of the soluble protein. It also displays sexual dimorphic expression; mRNA, enzyme protein, and enzyme activity are all elevated in adult female rat liver, and expression appears to be under the control of estrogens. Maximal expression is seen after 21 days in males but will decline unless estrogens are administered (125). This sexual dimorphism has been observed primarily in rat liver for other enzymes involved in steroid hormone metabolism. Feminization of steroid hormone metabolism involves elevation of microsomal 5{alpha}-reductase and decreased 6ß- and 16{alpha}-hydroxylase levels and has been shown to be governed by gonadal regulation of GH secretion (126, 127, 128). In these studies estrogens stimulated the constant secretion of GH, and androgens stimulated the pulsatile release of GH (128). The mechanism by which constant exposure to GH controls the coordinate expression of select steroid-metabolizing enzymes is unknown. In hypophysectomized female and male rats, levels of 3{alpha}-HSD mRNA, enzyme protein, and enzyme activity were decreased 8-fold. However, the administration of either GH or estrogens alone failed to elevate levels to those seen in intact animals. The data would suggest that GH is insufficient by itself to cause increased expression of the 3{alpha}-HSD gene. One explanation for this phenomenon is that in rat liver the estrogen receptor is regulated by GH (129), and the liver may need priming by GH before it will respond to estrogens.

The genes for rat 3{alpha}-HSD (130), human type I 3{alpha}-HSD (chlordecone reductase/DD4) (121), and human type II 3{alpha}-HSD (121) have been cloned and show similar organization (Fig. 5Go). They contain at least nine exon-intron boundaries that are highly conserved within members of the AKR superfamily (131, 132). The rat 3{alpha}-HSD gene is more than 47 kb long, whereas the type I and type II human 3{alpha}-HSD genes are 20 and 16 kb in length, respectively (121). The human type I 3{alpha}-HSD is located on chromosome 10 at p14 (133). No location of the human type II 3{alpha}-HSD gene has been reported.



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Figure 5. Organization of the rat and human 3{alpha}-HSD genes. Noncoding exons are open boxes, coding exons are stippled boxes, and narrow solid lines are introns. A label indicates that the exon has been completely sequenced and located. ORF, Open reading frame; UTR, untranslated region. [The structure of the rat 3{alpha}-HSD gene has been modified from T. M. Penning: J Endocrinol 150:S175–S187, 1996, and the structures of the human type I and type II genes have been derived from Ref. 133.]

 
To understand what controls high constitutive expression and regulated expression in rat liver, detailed functional studies have been performed on the rat 3{alpha}-HSD gene (130). The bulk of the 2.7-kb transcript encodes for a long 3'-UTR which may be an important determinant in mRNA stability (134, 135). Estimates of the t1/2 of rat liver 3{alpha}-HSD mRNA are of the order of 12 h. Exons encoding for the long 3'-UTR present in the mRNA have not been isolated (Fig. 5Go). Primer extension analysis has located the transcription start site at -54 or -55 bp upstream (+1). Upstream from this site is a TATTA box that presumably binds RNA polymerase in forming the basal transcriptional complex. A genomic clone containing 9.5 kb of the 5'-flanking region of the gene has been isolated, and 2.5 kb immediately upstream from the start site have been sequenced. Analysis of this region for transcription factor consensus sequences shows the presence of a large number of imperfect steroid hormone response elements, including estrogen response elements, progesterone response elements, and glucocorticoid response elements. Interspersed between these elements are several AP-1, AP-2, and Oct sites. It has been suggested that these elements may comprise a steroid response unit.

Nested deletions of the 5'-flanking region of the gene fused to the reporter gene chloramphenicol acetyltransferase (CAT) have been generated and cotransfected into human hepatoma (HepG2) cells to identify the cis-elements involved in regulating constitutive expression (130). With respect to the transcription start site (+1), it was found that -199 to +55 bp contained the basal promoter, and gave a level of CAT expression similar to that observed in a pSV40-CAT positive control. Between -499 and -199 bp, a proximal enhancer was identified that elevated CAT activity 1.8- to 2.5-fold; between -755 and -498 bp, a silencer was observed that prevented CAT expression. Further upstream a powerful distal enhancer was located between -4.0 and -2.0 kb, which elevated CAT expression 40-fold and is thought to control high liver-specific expression. An examination of the silencer or negative response element (NRE) indicated that it contained two unique Oct sites, one on either strand. Band shift and supershift assays using a radiolabeled NRE and anti-Oct monoclonal antibodies provided evidence for the binding of Oct transcription factors to the NRE and suggest that Oct factors may be repressors of the 3{alpha}-HSD gene (130).

The function of the steroid response unit on the 5'-flanking region of the 3{alpha}-HSD gene has also been examined (136). It was found that in isolated rat hepatocytes, dexamethasone was able to increase steady state 3{alpha}-HSD mRNA levels, in a time- and concentration-dependent manner, and that this effect was blocked by antiglucocorticoids such as RU486. Nuclear-run off assays established that the effect of dexamethasone was at the level of new gene transcription (136). It was Tomkins (137, 138) who first implicated hepatic 3{alpha}-HSD as playing a major role in glucocorticoid metabolism. These findings suggest that glucocorticoids may increase their own metabolism by inducing 3{alpha}-HSD gene expression. This may comprise a positive feedback loop to eliminate these steroids.

D. 3{alpha}-HSD deficiencies
Although, no 3{alpha}-HSD deficiencies have been described, a clue may exist in glaucoma patients. These patients are sensitive to increases in intraocular pressure induced by the administration of corticosteroids (139). Studies on the metabolism of glucocorticoids in peripheral blood monocytes obtained from glaucoma patients indicate that 5ß-reductase activity is elevated, and 3{alpha}-HSD activity is attenuated (139). This would cause a build up of 5ß-dihydrocorticoids, which are known to increase intraocular pressure (140). Whether this is a mere correlation or a casual relationship, resulting from a genetic defect, requires further work.


    VI. 20{alpha}-Hydroxysteroid Dehydrogenases
 Top
 Abstract
 I. Introduction
 II. 3{beta}-Hydroxysteroid...
 III. 17{beta}-Hydroxysteroid...
 IV. 11{beta}-Hydroxysteroid...
 V. 3{alpha}-Hydroxysteroid...
 VI. 20{alpha}-Hydroxysteroid...
 VII. HSDs Belong to...
 VIII. Structure/Function of HSDs
 IX. Conclusions
 References
 
A. Physiological and pharmacological significance
One of the least studied HSDs is 20{alpha}-HSD; this enzyme was originally characterized and purified from rat ovary (141, 142, 143). In the ovary it plays an important role in converting progesterone (a potent progestin) into 20{alpha}-hydroxyprogesterone (a weak progestin) (Fig. 6Go). In steroid target tissues, it would regulate the amount of progestin that can bind to the progesterone receptor, and in this regard may be important in the placenta and endometrium. Early studies on the luteolytic effects of prostaglandin F2{alpha} on rat ovary established that 20{alpha}-HSD activity is induced 150-fold. Because of the ability of this enzyme to metabolize progesterone to its inactive metabolite, 20{alpha}-hydroxyprogesterone, the underlying induction mechanism may contribute to luteolysis (144). 20{alpha}-Hydroxyprogesterone is unable to sustain pregnancy and, in the rat, the increase in luteal 20{alpha}-HSD activity contributes to the lower circulating progestin levels associated with the termination of pregnancy. The possibility exists that inhibitors of the human isoform may help maintain pregnancy before the luteal-placental shift in steroidogenesis.



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Figure 6. Reaction catalyzed by ovarian 20{alpha}-HSD.

 
It is now clear that there are several distinct proteins that catalyze 20{alpha}-HSD activity. In the ovary 20{alpha}-HSD catalyzes the inactivation of progesterone as described. But this should be distinguished from the enzyme found in other steroidogenic tissues (testis and adrenal) where its principal substrates may be either 17{alpha}-hydroxypregnenolone or 17{alpha}-hydroxyprogesterone. By converting the C20 ketone to an alcohol, the 17,20-lyase would be deprived of substrate, and this would prevent the conversion of C21 to C19 steroids. In the human placenta, 20{alpha}-HSD activities are catalyzed by type I or type II 17ß-HSD.

B. Cloning and expression of the 20{alpha}-HSD cDNAs
cDNAs for rat and rabbit ovarian 20{alpha}-HSD have been cloned (5, 6). These enzymes display high-sequence identity with the mammalian 3{alpha}-HSDs and are members of the AKR superfamily. Recently, bovine testicular 20{alpha}-HSD has been cloned and has been found to be identical to aldose reductase (145). The testicular enzyme will only catalyze the reduction of 17{alpha}-hydroxypregnenolone and 17{alpha}-hydroxyprogesterone and will not utilize progesterone as a substrate. The mRNA for this enzyme is also found in the adrenal cortex. Both type I and type II 17ß-HSD also display 20{alpha}-HSD activity (51, 146). It is proposed that the type I enzyme (which is estrogenic and a reductase) inactivates progesterone whereas the type II enzyme (which inactivates estrogens and acts as a dehydrogenase) converts 20{alpha}-hydroxyprogesterone to progesterone. This switching mechanism may contribute to the estrogen- and progestin-dependent regulation of endometrial growth.

C. Structure, regulation, and tissue-specific expression of the 20{alpha}-HSD genes
In rat granulosa cells, GnRH or FSH alone increases 20{alpha}-HSD activity whereas PRL decreases the activity of the enzyme (147). The availability of the cDNA for rat ovarian 20{alpha}-HSD, which detects a 1.2-kb transcript in corpora lutea, has led to an extension of these studies. mRNA levels were markedly reduced by PRL treatment and appear to be under tight control by PRL (148). Tissue distribution studies indicate that the expression of the 1.2-kb transcript is specific for the rat corpus luteum, it being almost nondetectable in the uterus, kidney, lung, and heart. Its tissue-specific expression and tight control by gonadotrophs confirm the potential importance of this enzyme in luteolysis.

The structure of genes encoding ovarian 20{alpha}-HSD has not been reported. By contrast, the gene structures of several AKRs have been described (131, 132). These have a genomic organization similar to that described for rat 3{alpha}-HSD and contain the nine highly conserved exon-intron boundaries. A similar genomic organization is anticipated for 20{alpha}-HSDs that are AKRs.


    VII. HSDs Belong to Two Protein Families
 Top
 Abstract
 I. Introduction
 II. 3{beta}-Hydroxysteroid...
 III. 17{beta}-Hydroxysteroid...
 IV. 11{beta}-Hydroxysteroid...
 V. 3{alpha}-Hydroxysteroid...
 VI. 20{alpha}-Hydroxysteroid...
 VII. HSDs Belong to...
 VIII. Structure/Function of HSDs
 IX. Conclusions
 References
 
A. HSDs that belong to the SDR superfamily
Analysis of the cDNAs for 3ß-HSD/KSI, 11ß-HSD, and 17ß-HSD isoforms indicates that they belong to the SDR family (Fig. 7Go) (149, 150, 151, 152). SDR family members are nonmetalloenzymes that have monomers of 25–28 kDa. The monomer molecular masses of the type I-IV 17ß-HSDs and the type II 11ß-HSD are somewhat larger. These proteins often function as multimers, and they share approximately 25% sequence identity. Despite this relatively low homology, family members share identical protein folds (1, 2). Part of the protein fold includes an arrangement of {alpha}-helix and ß-strands (ß-{alpha}-ß-{alpha}-ß)2 to produce a Rossmann fold for cofactor binding. Binding of the cofactor, NAD(P)(H) (all nicotinamide adenine dinucleotides) is in the N-terminal part of the molecules, where a common Gly-XXX-Gly-X-Gly motif occurs. In addition, they all share a conserved consensus sequence Tyr-X-X-X-Lys, which has been implicated by site-directed mutagenesis to play a role in catalysis (Table 2Go) (153, 154, 155). Originally, 3ß-HSD/KSI was not considered part of this family but these enzymes contain both the Gly-XXX-Gly-X-Gly and the Tyr-X-X-X-Lys motifs. Other SDR family members include porcine testicular 20ß-HSD (156), 3{alpha},20ß-HSD from Streptomyces hydrogenans (157), 15-hydroxyprostaglandin dehydrogenase (158), Drosophilia alcohol dehydrogenase (154), ribitol dehydrogenase from Klebsiella aerogenes (159), carbonyl reductase (160), the ACT111 gene product of Streptomyces coelicolor (161), and AP27, an adipocyte protein of unknown function (162). There are currently 57 members in the protein family, and two crystal structures exist for HSDs that belong to this family; these are for 3{alpha},20ß-HSD from Streptomyces hydrogenans and the human placenta type-1 17ß-HSD (163, 164, 165, 166).



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Figure 7. A schematic of representative members of the SDR family. Conserved domains (A-F) are indicated by stippled boxes. Domain A represents the cofactor-binding region, and domain D represents the active site of the enzyme. The functions of the other conserved domains are unknown. Abbreviations are as follows: 11ß-HSD1A, 11ß-hydroxysteroid dehydrogenase from liver and kidney; 11ß-HSD1B, the truncated 11ß-hydroxysteroid dehydrogenase protein as predicted from the cDNA cloned from the kidney; RTLDH, ribitol dehydrogenase; 15OH-PGDH, 15-hydroxyprostaglandin dehydrogenase; 17ß-HSD, type 1 17ß-hydroxysteroid dehydrogenase; ACTIII, gene product of Streptomyces coelicolor; AP27, an adipocyte protein of