11deoxycorticosterone

11-Deoxycorticosterone (DOC) is a corticosteroid produced in the adrenal cortex that functions as a biosynthetic precursor in the production of corticosterone and aldosterone and possesses mineralocorticoid activity, though it is less potent than aldosterone.

In steroidogenesis, progesterone is converted by the enzyme 21-hydroxylase to 11-deoxycorticosterone, which is then converted by 11β-hydroxylase to corticosterone. Corticosterone can subsequently be transformed into aldosterone through additional enzymatic steps, including action by aldosterone synthase in the zona glomerulosa.

DOC acts as a mineralocorticoid, promoting sodium reabsorption and potassium excretion in the nephron and contributing to baseline mineralocorticoid activity. Its potency as a mineralocorticoid is lower than that of aldosterone.

Clinically, DOC levels are relevant in congenital adrenal hyperplasia (CAH). In 11β-hydroxylase deficiency, DOC accumulates along with 11-deoxycortisol, leading to mineralocorticoid excess and hypertension. In 21-hydroxylase deficiency, DOC production is impaired, contributing to salt-wasting. Measurement of DOC and related intermediates can aid in distinguishing forms of CAH.

Historically, synthetic derivatives of DOC, such as deoxycorticosterone acetate (DOCA), have been used as mineralocorticoid replacements. Modern management of mineralocorticoid insufficiency more commonly employs agents like fludrocortisone, with DOC-related pathways primarily of interest in research and diagnostic contexts.