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dihydrodeoxycortisol metabolite metabolism biosynthesis cycle mechanism pathway path catabolism biosynthetic intermediate biogenesis substrate precursor synthesis derivative bioprecursor metabolic enzyme endogenous contractor hormone hormonal therapy replacement function action endocrine endocrinology level prohormone analogue catecholamine norsteroid mineralocorticoid corticosteroid glucocorticosteroid steroid glucocorticoid receptor inflammation immune system autoimmune disease stress response carbohydrate protein anti-inflammatory 3d