INHIBITORS OF 11-BETA-HYDROXYSTEROID DEHYDROGENASE AND 5-BETA-STEROIDREDUCTASE IN URINE FROM PATIENTS WITH CONGESTIVE-HEART-FAILURE

Recently, the current authors reported the presence in norinotensive m ale and female urines of reproducibly measurable levels of naturally o ccurring substances in partially purified extracts of urine with inhib itory activity like glycyrrhetic acid (GA) towards both 11beta-hydroxy steroid dehydrogenase (11beta-OHSD) and steroid 5beta-reductase (5beta -SR) in vitro. Since these substances mimic two known inhibitory activ ities of GA, they have been named 'Glycyrrhetic Acid-Like Factors', ab breviated as 'GALFs' or, more specifically 11beta-GALF for substance(s ) active against 11beta-OHSD, and 5beta-GALF for those inhibitory to 5 beta-SR. Administration of glycyrrhetic acid in man leads to cortisol- dependent mineralocorticoid hypertension, owing to impaired inactivati on of cortisol by 11beta-OHSD, and may be associated with increased se nsitivity to mineralocorticoids owing to impaired 5beta-SR. In this pr eliminary report, the results are described of a study on the presence of GALF factors in urines collected from patients with congestive hea rt failure (CHF) and mild essential hypertension. The results show tha t in such patients there are increased amounts of both 11beta- and 5be ta- GALFs compared to normotensive. The possible physiological signifi cance of these results is discussed.