{"id":42802,"date":"2018-08-10T18:21:56","date_gmt":"2018-08-10T17:21:56","guid":{"rendered":"https:\/\/blogs.bmj.com\/bmj\/?p=42802"},"modified":"2018-08-20T09:34:26","modified_gmt":"2018-08-20T08:34:26","slug":"jeffrey-aronson-when-i-use-a-word-a-spectrum-of-steroids","status":"publish","type":"post","link":"https:\/\/blogs.bmj.com\/bmj\/2018\/08\/10\/jeffrey-aronson-when-i-use-a-word-a-spectrum-of-steroids\/","title":{"rendered":"Jeffrey Aronson: When I use a word . . . A spectrum of steroids"},"content":{"rendered":"<p><a href=\"https:\/\/blogs.bmj.com\/bmj\/files\/2014\/12\/jeffrey_aronson.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"alignleft wp-image-32935\" src=\"https:\/\/blogs.bmj.com\/bmj\/files\/2014\/12\/jeffrey_aronson-223x300.jpg\" alt=\"jeffrey_aronson\" width=\"122\" height=\"146\" \/><\/a><a href=\"https:\/\/blogs.bmj.com\/bmj\/2018\/08\/03\/jeffrey-aronson-when-i-use-a-word-sterols-and-steroids\"><span style=\"font-weight: 400\">Last week<\/span><\/a><span style=\"font-weight: 400\"> I discussed the origins of the words \u201csterol\u201d and \u201csteroid\u201d. Today we use the term \u201csteroids\u201d to refer almost exclusively to endogenous compounds that are secreted in the cortex of the adrenal gland and semisynthetic derivatives, such as prednisolone and dexamethasone. However, the term is also used to refer to other types of compound.<\/span><\/p>\n<p><span style=\"font-weight: 400\">In 1936, in a <\/span><a href=\"http:\/\/rspa.royalsocietypublishing.org\/content\/157\/890\/194\"><span style=\"font-weight: 400\">paper<\/span><\/a><span style=\"font-weight: 400\"> in the <\/span><i><span style=\"font-weight: 400\">Proceedings of the Royal Society of London<\/span><\/i><span style=\"font-weight: 400\">, titled \u201cRelations between optical rotatory power and constitution in the steroids\u201d, Callow &amp; Young wrote, \u201cThe term \u2018steroids\u2019 is proposed as generic name for the group of compounds comprising the sterols, bile acids, heart poisons, saponins and sex hormones\u201d (Figure 1).<\/span><\/p>\n<p><img loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-42811 alignnone\" src=\"https:\/\/blogs.bmj.com\/bmj\/files\/2018\/08\/aronson_steoids_spectrum.jpg\" alt=\"\" width=\"607\" height=\"614\" srcset=\"https:\/\/blogs.bmj.com\/bmj\/files\/2018\/08\/aronson_steoids_spectrum.jpg 607w, https:\/\/blogs.bmj.com\/bmj\/files\/2018\/08\/aronson_steoids_spectrum-297x300.jpg 297w\" sizes=\"auto, (max-width: 607px) 100vw, 607px\" \/><\/p>\n<p><b>Figure 1. <\/b><span style=\"font-weight: 400\">A range of different types of steroid molecules, each containing the four-ringed <\/span><a href=\"http:\/\/iupac.org\/publications\/pac\/pdf\/1989\/pdf\/6110x1783.pdf\"><span style=\"font-weight: 400\">cyclopenta[a]phenanthrene skeleton<\/span><\/a><span style=\"font-weight: 400\">; <\/span><a href=\"https:\/\/www.ncbi.nlm.nih.gov\/pubmed\/8910693\"><span style=\"font-weight: 400\">osladin<\/span><\/a><span style=\"font-weight: 400\"> is a steroid saponin, 500 times sweeter than sucrose; the differences in pharmacological actions arise from differences in substituents in the skeleton and the compounds\u2019 three dimensional structures <\/span><\/p>\n<p><span style=\"font-weight: 400\">The bile acids, also known as cholic acids, include ursodeoxycholic acid, used to treat gallstones. The IndoEuropean root <\/span><a href=\"http:\/\/blogs.bmj.com\/bmj\/2015\/10\/23\/jeffrey-aronson-when-i-use-a-word-all-gall\"><span style=\"font-weight: 400\">GHEL<\/span><\/a><span style=\"font-weight: 400\"> meant bright, smooth, or shiny and gave rise to a gallimaufry of shiny words, including glare, glass, glaze, gleam, glimmer, glint, glitter, glitz, glow, gloss, glacial, glide, glissando, glib, gleet, glabrous and glabella, glaucous and glaucoma, gelid and gelatin, gold, gild, and guilder, yolk and yellow. From the Greek derivative \u03c7\u03bb\u03c9\u03c1\u03cc\u03c2 we get chlorine, chlorophyll, and chlorinated drugs, such as chloroform. Drop the rho from \u03c7\u03bb\u03c9\u03c1\u03cc\u03c2 and you get \u03c7\u03cc\u03bb\u03bf\u03c2 (later \u03c7\u03bf\u03bb\u03ae), gall, bile, or anger, which makes you choleric and gives us cholic acids, <\/span><a href=\"https:\/\/blogs.bmj.com\/bmj\/2018\/08\/03\/jeffrey-aronson-when-i-use-a-word-sterols-and-steroids\"><span style=\"font-weight: 400\">cholesterol<\/span><\/a><span style=\"font-weight: 400\">, and various bilious words, such as cholagogues, cholecystectomy, cholangiectasis, chloangiocarcinoma, and of course hepaticocholangiocholecystenterostomy. <\/span><\/p>\n<p><span style=\"font-weight: 400\">The \u201cheart poisons\u201d on Callow &amp; Young\u2019s list are cardiac glycosides (i.e. steroids attached to saccharides of varying lengths), such as ouabain and digoxin, used to treat atrial fibrillation and cardiac failure, although much less so nowadays or not at all. Such compounds are rife in nature, and are found in a huge range of plants (Table 1). One <\/span><a href=\"https:\/\/www.jstor.org\/stable\/j.ctt1w0ddx8\"><span style=\"font-weight: 400\">incomplete list<\/span><\/a><span style=\"font-weight: 400\"> runs to nearly 400 compounds and spans genera such as the Apocynaceae, Asclepiadaceae, Cruciferae, Liliaceae, Moraceae, Ranunculaceae, and Scrophulariaceae. The IndoEuropean root DLKU meant sweet, giving us dulcet billet-doux, la dolce vita, and Dulcinea del Toboso, Don Quixote\u2019s would-be sweetheart. The Greek derivative \u03b3\u03bb\u03c5\u03ba\u03cd\u03c2, sweet, gives us glycerol, glyceraldehyde, glycerine and nitroglycerine, glucose and glucoside, glycolysis and glycoside.<\/span><\/p>\n<p><b>Table 1.<\/b><span style=\"font-weight: 400\"> Some plants that contain cardiac glycosides<\/span><\/p>\n<p><img loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-42805 alignnone\" src=\"https:\/\/blogs.bmj.com\/bmj\/files\/2018\/08\/aronson_steroid_spectrum2.jpg\" alt=\"\" width=\"423\" height=\"679\" srcset=\"https:\/\/blogs.bmj.com\/bmj\/files\/2018\/08\/aronson_steroid_spectrum2.jpg 423w, https:\/\/blogs.bmj.com\/bmj\/files\/2018\/08\/aronson_steroid_spectrum2-187x300.jpg 187w\" sizes=\"auto, (max-width: 423px) 100vw, 423px\" \/><\/p>\n<p><span style=\"font-weight: 400\">Some saponins are also steroid glycosides, and are also found in many plants. The IndoEuropean root SEIBH meant to drip or trickle, like the sap from a sapling or water seeping from a leaking siphon or through a fine sieve. Sapo in Latin originally meant a type of hair dye, but it later came to mean soap; hence saponins, which foam soapily in aqueous solution. Soapworts (genus <\/span><i><span style=\"font-weight: 400\">Saponaria<\/span><\/i><span style=\"font-weight: 400\">) were at one time used as soaps. As John Gerard wrote in his <\/span><i><span style=\"font-weight: 400\">Herball<\/span><\/i><span style=\"font-weight: 400\"> (1597), \u201cThe stalkes of Sopewoort are slipperie\u201d. William Salmon (<\/span><i><span style=\"font-weight: 400\">Synopsis Medicin\u00e6<\/span><\/i><span style=\"font-weight: 400\">, 1671), claimed that soapwort was good for cuts, dropsy, and the stone. <\/span><a href=\"https:\/\/botanical.com\/botanical\/mgmh\/s\/soawor61.html\"><span style=\"font-weight: 400\">Mrs Grieve<\/span><\/a><span style=\"font-weight: 400\"> said it cures the itch and old venereal complaints. Other soapy plants include the soapbark (<\/span><i><span style=\"font-weight: 400\">Quillaja saponaria<\/span><\/i><span style=\"font-weight: 400\">) and the soapberry or soapnut (<\/span><i><span style=\"font-weight: 400\">Sapindus saponaria <\/span><\/i><span style=\"font-weight: 400\">or <\/span><i><span style=\"font-weight: 400\">Acacia concinna<\/span><\/i><span style=\"font-weight: 400\">).<\/span><\/p>\n<p><span style=\"font-weight: 400\">The last item in Callow &amp; Young\u2019s 1936 list is sex hormones, which would have included one of the oestrogens, progesterone, and testosterone, all of which had been recently described. The IndoEuropean root ER, the simplest root imaginable, meant to move or set in motion. Teutonic derivatives give us arise, rise, raise, rear, and verbal forms of being, are and art. In Latin oriri meant to rise or come into being, giving us origins, the orient, and abortion. In Greek \u1f41\u03c1\u03bc\u1fb6\u03bd, to start or set in motion, and \u1f41\u03c1\u03bc\u03ae, onset or impulse, gives us hormone, a word that was introduced by Ernest Henry Starling (propounder, with Otto Frank, of the Frank\u2013Starling law), in a <\/span><a href=\"https:\/\/www.sciencedirect.com\/science\/article\/pii\/S0140673601118775\"><span style=\"font-weight: 400\">Croonian Lecture<\/span><\/a><span style=\"font-weight: 400\"> titled \u201cThe chemical correlation of the functions of the body\u201d, given at the Royal College of Physicians of London on 20 June 1905. Hormesis, a term <\/span><a href=\"http:\/\/dose-response.org\/chester-m-southam\/\"><span style=\"font-weight: 400\">introduced<\/span><\/a><span style=\"font-weight: 400\"> by Chester Southam &amp; John Ehrlich in 1943 (but see Figure 2), is a unusual biphasic pharmacological phenomenon, in which high concentrations of a substance, typically inhibitory, produce opposite effects to those produced by low concentrations, typically stimulatory. It has even been <\/span><a href=\"https:\/\/www.ncbi.nlm.nih.gov\/pubmed\/29674603\"><span style=\"font-weight: 400\">discussed<\/span><\/a><span style=\"font-weight: 400\"> in relation to female sex hormones.<\/span><\/p>\n<p><img loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-42806 alignnone\" src=\"https:\/\/blogs.bmj.com\/bmj\/files\/2018\/08\/aronson_steroid_spectrum3.jpg\" alt=\"\" width=\"600\" height=\"413\" srcset=\"https:\/\/blogs.bmj.com\/bmj\/files\/2018\/08\/aronson_steroid_spectrum3.jpg 600w, https:\/\/blogs.bmj.com\/bmj\/files\/2018\/08\/aronson_steroid_spectrum3-300x207.jpg 300w\" sizes=\"auto, (max-width: 600px) 100vw, 600px\" \/><\/p>\n<p><b>Figure 2.<\/b><span style=\"font-weight: 400\"> An extract (page 21) from Chester Southam\u2019s 1941 undergraduate thesis, describing studies performed in the School of Forestry in the University of Idaho, and titled \u201cA Study of the Saprogenicity, and Factors Influencing Decay, of Certain Brown-Rot Fungi on Western Redcedar Heartwood Test Blocks\u201d; he originally used the word \u201ctoxicotrophism\u201d to describe what we now call \u201chormesis\u201d, but subsequently wrote the latter in its place; however, since we do not know the date of the amendment, we cannot be sure that this usage antedates the 1943 paper by Southam &amp; Ehrlich (Phytopathology 1943; 33: 517\u201324)<\/span><\/p>\n<p><em><strong>Jeffrey Aronson<\/strong>\u00a0is a clinical pharmacologist, working in the Centre for Evidence Based Medicine in Oxford&#8217;s Nuffield Department of Primary Care Health Sciences. He is also president emeritus of the British Pharmacological Society.<\/em><\/p>\n<p><strong>Competing interests:<\/strong>\u00a0None declared.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Last week I discussed the origins of the words \u201csterol\u201d and \u201csteroid\u201d. Today we use the term \u201csteroids\u201d to refer almost exclusively to endogenous compounds that are secreted in the [&#8230;]<\/p>\n<p><a class=\"btn btn-secondary understrap-read-more-link\" href=\"https:\/\/blogs.bmj.com\/bmj\/2018\/08\/10\/jeffrey-aronson-when-i-use-a-word-a-spectrum-of-steroids\/\">More&#8230;<\/a><\/p>\n","protected":false},"author":1,"featured_media":38359,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[5762],"tags":[],"class_list":["post-42802","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-jeff-aronsons-words"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.5 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>Jeffrey Aronson: When I use a word . . . 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