Steroidogenesis begins with
cholesterol transfer into mitochondria through the transduceosome, a complex composed of cytosolic
proteins that include steroidogenesis acute regulatory
protein (STAR), 14-3-3 adaptor
proteins, and the outer mitochondrial membrane
proteins Translocator
Protein (TSPO) and
Voltage-Dependent Anion Channel (VDAC). TSPO is a drug- and
cholesterol-binding protein found at particularly high levels in
steroid synthesizing cells. Its aberrant expression has been linked to
cancer, neurodegeneration, neuropsychiatric disorders and primary
hypogonadism. Brain
steroids serve as local regulators of neural development and excitability. Reduced levels of these
steroids have been linked to depression, anxiety and neurodegeneration. Reduced serum
testosterone is common among subfertile young men and aging men, and is associated with depression,
metabolic syndrome and reduced sexual function. Although
testosterone-replacement
therapy is available, there are undesired side-effects. TSPO drug
ligands have been proposed as therapeutic agents to regulate
steroid levels in the brain and testis.