Cortisol synthesis

Cortisol synthesis is the metabolic process by which cholesterol is converted to cortisol, a glucocorticoid hormone, in the zona fasciculata of the adrenal cortex. This pathway involves several key cytochrome P450 enzymes (CYP11A1, CYP17A1, CYP21A2, CYP11B1), regulated by the hypothalamic-pituitary-adrenal axis (CRH → ACTH → adrenal cortex). The synthesized cortisol regulates diverse physiological responses including stress adaptation, glucose metabolism, immune modulation, and maintenance of homeostasis. Abnormal cortisol synthesis contributes to several endocrine and metabolic diseases, and thus, enzymes within this pathway are important pharmacological targets. For structure, the relevant therapeutic targets are the specific steroidogenic enzymes, not the overall process. Therefore, for precise targeting, refer to a key enzyme (e.g., "Cytochrome P450 11β-hydroxylase (CYP11B1)") rather than "cortisol synthesis".

Other names

SteroidogenesisCortisol biosynthesisAdrenal steroid pathway

Enzyme inhibition (e.g., inhibition of specific cytochrome P450 enzymes) Decreased production of cortisol Direct destruction of adrenal tissue (mitotane) Negative feedback suppression via exogenous glucocorticoids