Role of Spiral Steroids in Pregnancy and Pre-Eclampsia

My laboratory discovered a new type of steroids. The structure of these steroids is unique in three ways: (i) they have 23, 24 or 25 carbon atoms – no other known vertebrate steroid has more than 21 carbon atoms; (ii) they are phosphodiesters – no other steroid phosphodiesters are known; and (iii) some of them have a spiral steroid at carbon 17 – no other endogenous spiral steroids are known. In total, our laboratory had elucidated the structure and path of biosynthesis for more than 20 related compounds. We have developed an LC–MS method and a MS–MS method to measure the compounds in small samples (< 1 ml). Synthetic compounds with similar spiral steroids (e.g., spironolactone) function as potassium sparing hormones but there were no known endogenous hormones with this function. We propose that the natural spiral steroids have that function. Endogenous compounds with these functions would have important roles in the physiology of pregnancy, pre-eclampsia, and eclampsia. This chapter will review the proposed physiology and pathology of the spiral steroids during pregnancy. There are many details to confirm but this is a useful paradigm.