Estrogen-induced transcortin increase and progesterone and cortisol interactions: implications from pregnancy studies

The concentrations of progesterone, cortisol, estradiol, and transcortin binding capacity (TBC) were measured in plasma samples of women during normal pregnancy. Between 10 weeks and 20 weeks gestation, the mean of TBC increased linearly, and the mean increase in TBC for a given estradiol increment was constant until the estradiol concentrations reached approximately 30 nmol per liter. The results were consistent with the increase in TBC having been induced by estradiol; however, there was an inherent upper limit of response. Progesterone and cortisol were each linearly related to TBC, but the ratios of progesterone:TBC and cortisol:TBC showed no systematic trend throughout the period studied, and there was no systematic relationship between TBC and the progesterone:cortisol ratio. There was, however, a linear relationship between TBC and the progesterone + cortisol sum, such that a unit increase in TBC was accompanied by an approximate unit increase in the total concentration of the two main transcortin binding steroids. Some cases of spontaneous abortion or habitual abortion might be due to aberrant metabolic influence on progesterone of binding protein; in the instances studied, no evidence was found for this.