17,21-DIHYDROXY-20-KETOSTEROIDS IN PLASMA DURING AND AFTER PREGNANCY

Abstract

THE beneficial effects of pregnancy on rheumatoid arthritis have been established (1). The prompt and dramatic improvement of patients with rheumatoid arthritis following the administration of cortisone, suggested to Hench (2) that the ameliorating effects observed during pregnancy may be due to the increased secretion of adrenocortical hormones of the glucocorticoid type. However, the underlying mechanism for the beneficial effect of pregnancy upon rheumatoid arthritis is still obscure (3–4). Recently Meyer and coworkers (5), studying the formation of granulation tissue induced by subcutaneous implanted cotton pellets in rats, found that during pregnancy there was a progressive reduction in the amount of granulation tissue formed, the least amount being formed at the time of parturition. The inhibition of granuloma formation noted by these authors is quantitatively similar to that occurring when cortisone or hydrocortisone is administered (6). Gemzell (7) determined the blood levels of 17-hydroxycorticosteroids in pregnant women using the method of Nelson and Samuels (8), and concluded that the 17-hydroxysteroids were elevated during pregnancy, but the plasma levels dropped to normal within six days after delivery. This rapid fall in plasma concentration is not in keeping with the relatively prolonged beneficial effects of pregnancy in rheumatoid arthritis. Extensive studies by Hench (9) have shown that the typical relief pattern in pregnancy extends through 4 ± 3 weeks post partum. In view of the availability of a new and relatively simple chemical method for measuring plasma 17,21-dihydroxy-20-ketosteroids, it seemed of interest to measure the plasma levels of these substances during and after pregnancy.