[Factors and conditions affecting transcortin production and function in blood plasma]

It is well-established that the majority of steroid hormones in the bloodstream are in a bound state, complexed with carrier proteins. Transcortin (corticosteroid-binding globulin, SERPINA6) serves as the principal transport protein for steroid hormones and is predominantly synthesized in the liver. Its primary function is to regulate the systemic bioavailability of glucocorticoids and mineralocorticoids. This review article presents an analysis of the existing literature on the impact of various factors and conditions on Transcortin, encompassing its synthesis, secretion, and affinity, as well as its role in physiological and pathophysiological processes within the human body. A reduction in Transcortin levels has been observed in several contexts, including old age, obesity, and metabolic syndrome. Additionally, this decrease is evident in the presence of cirrhosis, sepsis, polytrauma, extensive burns, and during surgical interventions. The concentration of Transcortin in the bloodstream can be influenced by a variety of medications. For instance, estrogen therapy, such as combined oral contraceptives, has been shown to induce a significant increase in Transcortin levels. Conversely, the administration of glucocorticoids has been associated with a decrease in Transcortin levels. Furthermore, this review article includes an analysis of studies that have investigated the influence of Transcortin and alterations in its blood levels in the context of endogenous hypercortisolism. These studies contribute to a deeper understanding of the complex interplay between Transcortin and steroid hormone regulation in various physiological and pathological conditions.