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etiocholanolone aetiocholanolone 5-isoandrosterone etiocholane steroid endogenous metabolism testosterone fever immunostimulation leukocytosis adrenal cortex bone marrow neoplastic disease immune system inhibitory androstane neurosteroid positive allosteric modulator gabaa receptor anticonvulsant 3d hormone hormonal function endocrine endocrinology level prohormone metabolite biosynthesis cycle mechanism pathway path catabolism biosynthetic intermediate biogenesis substrate precursor synthesis derivative bioprecursor metabolic enzyme contractor