Treatment of Addison's Disease with Desoxy-corticosterone Acetate, a Synthetic Adrenal Cortical Hormone (preliminary Report).

The successful preparation of extracts of the adrenal cortex which possessed the property of maintaining adrenalectomized animals (1, 2, 3) stimulated attempts to isolate the substance or substances responsible for this activity. Reichstein has pointed out in his review article (4) that, thus, far, several steroid compounds have been isolated from adrenal cortical extracts by Kendall, Reichstein, Wintersteiner, Pfiffner, and Grollman. At least 3 of these compounds have been shown to be capable, on injection, of maintaining adrenalectomized animals in good condition (4). The small quantity of active material present in the adrenal cortex and the necessarily limited supply of adrenal glands restrict greatly the quantity of crystalline material which may be obtained from this natural source. The use of crystalline compounds would be of distinct advantage in the treatment of patients with Addison's disease because of the practical difficulties encountered in attempting to prepare extracts of uniform potency. It appears that a synthetic preparation offers the most likely possibility of obtaining an adequate quantity of crystalline material possessing " cortinlike " properties. In 1937 Steiger and Reichstein (5) announced the preparation of desoxy-corticosterone acetate (A'4-pregnene-21-ol-3, 20-dione, acetate) from stigmasterol. Recently, Reichstein and von Euw (6) have succeeded in obtaining desoxy-corticosterone from an extract of beef adrenals, thus establishing the natural occurrence of this compound. The effectiveness of desoxy-corticosterone acetate (synthetic) in maintaining bilaterally adrenalectomized dogs (7, 8) prompted us to investigate the possibility of using this compound