The highly regulated process of moving free cholesterol from the outer mitochondrial membrane to the inner mitochondrial membrane, representing the rate-limiting step in the synthesis of all steroid hormones. This transport is clinically significant as it dictates the substrate availability for the entire steroidogenic cascade, profoundly influencing the production of cortisol, DHEA, and sex hormones. It is the initial, controlled step in the conversion of cholesterol to pregnenolone.
Origin
This core process is fundamental to the biochemical pathway of steroidogenesis, occurring primarily in the adrenal cortex, gonads, and placenta. The term highlights the indispensable role of the mitochondrion as the initial, critical site of steroid hormone synthesis within the cell.
Mechanism
The Steroidogenic Acute Regulatory protein (StAR) is the key molecular mediator, facilitating the transfer of cholesterol across the intermembrane space. StAR’s activity is itself regulated by upstream signaling cascades, notably those initiated by pituitary hormones like ACTH and LH. Efficient cholesterol transport ensures that the P450 side-chain cleavage enzyme (P450scc) on the inner membrane has the necessary substrate to begin the conversion to pregnenolone, thereby governing the entire output of the adrenal and gonadal axes.
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