Aldo-ketoreductase 1C (AKR1C) enzymes catalyze the NADPH-dependent reduction of ketosteroids to hydroxysteroids. They are Phase I metabolizing enzymes for natural and synthetic steroid hormones. They convert 5␣-dihydrotestosterone (Dht, potent androgen) to 3␣/-androstanediols (inactive androgens) and the prodrug tibolone (Tib) to estrogenic 3␣/-hydroxytibolones. Herein we demonstrate for the first time that human AKR1C enzymes (AKR1C1-4) are able to reduce conjugated steroids such as Dht-17-glucuronide (DhtG), Dht-17-sulfate (DhtS), and Tib-17-sulfate (TibS). Product identities were characterized by liquid chromatography-mass spectrometry, and kinetic parameters of the reactions were determined. The product profile of the reduction of each steroid conjugate by the individual AKR1C isoform was similar to that of the corresponding free steroid except for the reduction of DhtG catalyzed by AKR1C2, where a complete inversion in stereochemical preference to 3-reduction (with DhtG) from 3␣-reduction (with Dht and DhtS) was observed. The catalytic efficiency of 3-keto reduction was modestly affected by the presence of a 17-sulfate group but severely impaired by the presence of a 17-glucuronide group for AKR1C1-3 isoforms. AKR1C4, however, showed superior catalytic efficiencies versus the other isoforms, and those were unaffected by steroid conjugation. Our findings provide evidence for alternative pathways of steroid metabolism where the phase I reaction (reduction) occurs after the phase II reaction (conjugation). Specifically, it is indicated that Dht is metabolized to its metabolite 3␣-androstanediol-17-glucuronide via the previously unrecognized "conjugation pathway" involving the sequential reactions of UGT2B17 and AKR1C4 in liver but via the conventional "reduction pathway" involving the sequential reactions of AKR1C2 and UGT2B15/17 in prostate.
Aldo-ketoreductase (AKR)2 1C enzymes are cytosolic hydroxysteroid dehydrogenases (HSDs) that catalyze the NADPH-dependent reduction of ketosteroids to hydroxysteroids (1). Four isoforms are known to exist in humans: AKR1C1 (20␣[3␣]-HSD), AKR1C2 (human 3␣-HSD type 3; also known as bile acid-binding protein), AKR1C3 (human 3␣-HSD type 2; also known as human 17-HSD type 5), and AKR1C4 (human 3␣-HSD type 1). Despite their high sequence identity (Ͼ86%), each individual human AKR1C enzyme displays distinct positional and stereochemical substrate preference and tissue distribution patterns. These enzymes are able to reduce 3-, 17-, and 20-ketosteroids and accept a broad spectrum of natural or synthetic steroids as substrates. They are implicated in diverse physiological functions by regulating the metabolism of androgens, estrogens, and progestins (1-3). Interestingly, distantly related human aldose reductase AKR1B1 shows superior turnover of glutathione conjugated lipid aldehydes than the unconjugated aldehydes (4). However, the ability of AKR1C isoforms to turnover steroid conjugates has not been previously examined.AKR1C isoforms are involved in the metabolism of 5␣-di...