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Update on glucocorticoid action and resistance.
Donald Y M Leung1, John W Bloom
1Division of Pediatric Allergy/Immunology, National Jewish Medical and Research Center, Denver, CO 80206, USA.
The Journal of Allergy and Clinical Immunology
|January 18, 2003
Summary
Glucocorticoids (GCs) are common anti-inflammatory drugs. Some patients have persistent inflammation due to steroid resistance, requiring alternative treatments.
Area of Science:
- Immunology
- Pharmacology
- Genetics
Background:
- Glucocorticoids (GCs) are primary treatments for allergic and autoimmune diseases.
- GCs exert anti-inflammatory effects by regulating gene expression.
- A subset of patients exhibits persistent inflammation despite high-dose GC therapy, a condition known as steroid resistance.
Purpose of the Study:
- To investigate the underlying mechanisms of glucocorticoid resistance in allergic and autoimmune disorders.
- To outline a systematic approach for managing patients with treatment-refractory inflammation.
- To explore alternative therapeutic strategies for steroid-resistant conditions.
Main Methods:
- Literature review of glucocorticoid mechanisms and resistance.
- Analysis of factors contributing to steroid resistance (genetic, environmental, immunological).
- Review of diagnostic and therapeutic strategies for refractory cases.
Main Results:
- Steroid resistance is multifactorial, involving gene-environment-immune interactions.
- A systematic diagnostic approach is crucial to identify underlying causes of treatment failure.
- Alternative anti-inflammatory strategies are necessary for managing steroid-resistant patients.
Conclusions:
- Effective management of steroid-resistant allergic and autoimmune diseases requires a comprehensive approach.
- Identifying and addressing the specific causes of resistance is key to successful treatment.
- Further research into alternative therapies is warranted for persistent inflammation.