Neuroactive steroids are naturally occurring metabolites of endogenous steroid hormones, which exert rapid and nongenomic effects on membrane-bound neurotransmitter receptors. Those synthesized in the brain, termed neurosteroids, are believed to alter neuronal excitability through interaction with specific neurotransmitter receptors.1) Of the neurosteroids, 3a,5a-tetrahydroprogesterone (3a,5a-THP) and 3a,5a-tetrahydrodeoxycorticosterone (3a,5a-THDOC) are the most potent and efficacious of known positive allosteric modulators of g-aminobutyric acid type A (GABA A ) receptors.1-3) Numerous animal studies have shown that 3a,5a-THP and 3a,5a-THDOC are synthesized from progesterone and deoxycorticosterone, respectively, through the respective intermediates, 5a-dihydroprogesterone (5a-DHP) and 5a-dihydrodeoxycorticosterone (5a-DHDOC).3,4) The two sequential enzymatic reactions are catalyzed by steroid 5a-reductase and cytosolic NADPH-dependent 3a-hydroxysteroid dehydrogenase (3a-HSD, EC 1.1.1.213). On the other hand, microsomal NAD ϩ -dependent 3a-HSD oxidizes the neurosteroids back to 5a-DHP and 5a-DHDOC, and is thought to be involved in the catabolism of the potent GABA A ergic steroids.In the human, four isoenzymes of cytosolic NADP(H)-dependent 3a-HSD, which share at least 83% amino acid sequence identity and belong to the aldo-keto reductase (AKR) family, 5) have been identified. According to the nomenclature for the AKR family, these are termed AKR1C1, AKR1C2, AKR1C3 and AKR1C4, which correspond to previously known 3(20)a-HSD or 20a-HSD, 6,7) type 3 3a-HSD, 8) type 2 3a-HSD 9,10) and type 1 3a-HSD, 10) respectively. The four isoenzymes have recently been demonstrated to exhibit broad substrate specificities for 3a-, 17b-and 20a-hydroxysteroids, 11) but the preferences for the respective types of steroid substrates are different among the isoenzymes, as AKR1C1 shows high 20a-HSD activity 6) and AKR1C3 has been shown to be identical to type 5 17b-HSD 12) and prostaglandin F synthase. 13,14) Analyses of mRNA species for AKR1C isoenzymes in human tissues have shown that the isoenzymes, except for liver-specific AKR1C4, are expressed ubiquitously. 7,[9][10][11][14][15][16][17] In human brain AKR1C1, AKR1C2 and AKR1C3 are highly expressed, 11,16) although the distribution and localization of the enzymes in the brain remain unknown. These findings have suggested not only the roles of AKR1C1-AKR1C3 in the synthesis of the 3a,5a-THP and 3a,5a-THDOC, but also a possibility that the isoenzymes convert the potent neurosteroids to weak neurosteroids, 3a,20a-dihydroxypregnanes, 2,3) by exhibiting their 20a-HSD activities. However, there is limited information on the substrate specificity of human AKR1C isoenzymes for the neurosteroids and their precursors. To address the roles of human AKR1C isoenzymes in the metabolism of the neurosteroids, kinetic constants for the steroids have been determined with homogeneous recombinant AKR1C1-AKR1C3. Furthermore, we have found that several benzodiazepines, which bind to the GABA A recep...