Corticosteroid Metabolism and Rheumatoid Arthritis

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Abstract
The existence of extensive metabolism of cortisol in extra-hepatic tissues was deduced from studies of the disposition of non-protein-bound tritiated cortisol and its non-protein-bound unconjugated metabolites in body fluids. Evidence of abnormal extra-hepatic metabolism of cortisol and prednisolone in rheumatoid arthritic patients was sought: By measuring the urinary excretion of cortisol and its unconjugated metabolites and of prednisolone and its unconjugated metabolites; By studying the pattern of tritiated cortisol and tritiated prednisolone metabolites in synovial fluid. No evidence of an abnormality common to rheumatoid arthritic patients has been found, but it is pointed out that the study of the metabolism of cortico-steroids at the cell level is as yet in its infancy.