Commentary Open Access
Sandhu et al., J Steroids Hormon Sci 2013, S4
DOI: 10.4172/2157-7536.S4-001
J Steroids Hormon Sci Neurosteroids ISSN:2157-7536 JSHS an open access journal
Keywords: Tetrahydrodeoxycorticosterone; Allopregnanolone;
Pregnancy; Postpartum period; Neuroactive steroid; Depression
Introduction
Neurosteroids like tetrahydrodeoxycorticosterone (THDOC) and
allopregnanolone (ALP) are metabolites of steroids and formed by the
action of 5α-reductase type-1 and 3α-hydroxysteroid dehydrogenase
enzymes [1,2]. THDOC and ALP has anticonvulsant, anxiolytic,
sedative efects [3,4] and induces behavioural/health changes during
pregnancy and menstruation while, anxiety and depression in epilepsy
[5-9]. Neuroactive steroids are manufactured in the neurons, astrocytes
and glial cells and can be produced from the same tissue [10]. Te
γ-aminobutyric acid (GABA) system is one of the many inhibitory
systems and present in about 25% of the brain receptors [11]. Tere are
three types of GAB
A
receptors viz. GABA
A
, GABA
B
and GABA
C
. Both
of these neuroactive hormones are GABA
A
receptor agonist which
is pentameric and has an ion channel in its center [12]. Barbiturates
are also GABAA agonist, and these anesthetics inhibit ovulation
in rats [13]. Tere is also a known correlation of ALP and THDOC
with GnRH, LH and FSH [14]. Since, there are few studies on the
function and working of ALP and THDOC, however, the correlation of
neurosteroid infuencing the pregnancy and postpartum period is not
yet well known. It is likely that GABAergic progesterone metabolites
work singularly or coordinal to induce physiological/pathologic efects.
What is allopregnanolone?
ALP is a 3α-hydroxy-A ring-reduced steroid. It is synthesized
de novo either in brain [15], in the adrenal gland cortex [10,16], and
in corpus luteum during the ovulatory menstrual period [17]. Te
alteration in physiological rhythms of progesterone depends upon
stress, stage of menstrual cycle, menopause, and pregnancy. When
there is sudden decrease in body progesterone before premenstrual
bleeding is the cause of premenstrual syndrome with similar symptoms
in the postmenopausal women [18,19]. ALP levels gets higher during
early and postmenopausal women receiving dehydroepiandrosterone
and the values get as much higher as are pragmatic in pregnancy [20].
Tis steroid metabolite exerts neuromodulatory possessions in CNS
and is a GABA
A
receptor agonist that afects mood, modulating anxiety,
and memory [21,22]. Tere is a positive correlation between body ALP
levels and the level of progesterone [23,24]. In estrus cycle, the body
ALP level diverges with the change in phases of estrus. During luteal
phase the level of ALP is about four times higher than the follicular
phase [25] and gets at its peak with the advancement in pregnancy
[24]. Animal studies show that the ALP levels remain elevated in the
brain than blood circulation [16]. Afer the exposure to stress there is
an increase of circulating ALP [25] than the normal calm and quite
state, however, in adrenalectomized rats [10] the concentration of ALP
remained undetectable in the plasma.
What is THDOC?
An increased activity of hypothalamic-pituitary-adrenal (HPA)-
axis is due to more production of corticotropin releasing hormone
(CRH), which is a key arbitrator of CNS stress [26]. Afer acute stress
the hypothalamus production of CRH increases that prompts the
discharge of ACTH from the anterior pituitary gland, which ultimately
excites cortex of the adrenal for the production of glucocorticoids
and neuroactive steroid precursors [27]. Tere are two types of
glucocorticoids present eg. cortisol (human & non-human primates)
and corticosterones (rodents); these give negative feedback upon
*Corresponding author: Mansur A Sandhu, Department of Veterinary
Biomedical Sciences, Faculty of Veterinary and Animal Sciences, PMAS, Arid
Agriculture University, Rawalpindi, Pakistan, Tel: +92-321-7830305; E-mail:
mansoorsandhu@uaar.edu.pk
Received November 22, 2013; Accepted December 19, 2013; Published
December 26, 2013
Citation: Sandhu MA, Anjum MS, Mukhtar N, Hussain R, Khan IA (2013) Does
Interrelationship of Allopregnanolone and Tetrahydrodeoxycorticosterone during
Pregnancy and Postpartum Depression Exist? A Review of the Current Evidence.
J Steroids Hormon Sci S4: 001. doi:10.4172/2157-7536.S4-001
Copyright: © 2013 Sandhu MA, et al. This is an open-access article distributed
under the terms of the Creative Commons Attribution License, which permits
unrestricted use, distribution, and reproduction in any medium, provided the
original author and source are credited.
Does Interrelationship of Allopregnanolone and
Tetrahydrodeoxycorticosterone during Pregnancy and Postpartum
Depression Exist? A Review of the Current Evidence
Mansur A Sandhu
1
*, Muhammad S Anjum
1
, Nasir Mukhtar
1
, Riaz Hussain
1
and Imtiaz A Khan
2
1
Department of Veterinary Biomedical Sciences, PMAS-Arid Agriculture University Rawalpindi, 46300, Shamasabad square, Pakistan
2
Department of Veterinary Pathobiology, PMAS-Arid Agriculture University Rawalpindi, 46300, Shamasabad square, Pakistan
Abstract
Pregnancy and postpartum changes affect more than a half of women in the world. Neuroactive steroids play a vital
role in mental health, behavior, mood development, neuron-protection and memory. This review sums up what is well-
known regarding the two types of neuroactive steroids viz. allopregnanolone (ALP) and tetrahydrodeoxycorticosterone
(THDOC). There is a strong correlation between body progesterone concentration and ALP production. The stage of
estrus cycles determines the levels of ALP in body, however, THDOC is a stress induced neuroactive steroid and its
level is changeable with the type and severity of stress. The physiological response of stress is affected by THDOC and
infuences paraventricular nucleus in hypothalamus which in turn controls hypothalamic-pituitary-adrenal and gonadal
axis. Both neuroactive steroids are potent endogenous modulators of γ-aminobutyric acid type A (GABA
A
) receptors and
their production gets higher during pregnancy. Now a question arises “do both classes of neuroactive steroids have a
potent correlation in their action?” This manuscript will bring you up to date on the interaction and function of these two
during pregnancy and postpartum depression.
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Steroids & Hormonal Science
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ISSN: 2157-7536