Conversion of Cortisone to Cortisol and Prednisone to Prednisolone

Abstract

The conversion of cortisone and prednisone to the biologically active steroids cortisol and prednisolone has been studied in normal patients and in liver disease. The cortisol levels in the blood in normal subjects after oral cortisone were much lower than after cortisol itself, especially when high doses were used. In contrast, prednisone was converted to prednisolone with a high degree of efficiency. The difference appeared to be due to reduction of some of the cortisone to tetrahydrocortisone, whereas prednisone does not readily form tetrahydro derivatives. In four patients with liver disease, reduction of the 1 1-oxo group of cortisone and prednisone, which is necessary for biological activity, was well maintained. © 1967, British Medical Journal Publishing Group. All rights reserved.