The nitrosterols--a step forward from the steroid anti-inflammatory drugs?

Nitric oxide (NO)-releasing non-steroidal anti-inflammatory drugs have been shown to have improved efficacy and lower toxicity than their parent agents, and are currently in clinical trials as anti-inflammatory agents. The same approach is now being taken with the glucocorticoids, and initial studies show that NO-releasing forms of prednisolone, flunisolide and hydrocortisone (the nitrosterols) are more potent anti-inflammatory agents than their parent molecules in animal models of acute and chronic inflammation. Experimental studies also suggest that the nitrosterols are less likely to cause the side effects associated with glucocorticoids. Thus, to date, the nitrosterols do seem to be a step forward from the steroid anti-inflammatory drugs. However, given that prolonged exposure to high concentrations of NO may be pro-inflammatory, further long-term studies are needed to determine whether the increased anti-inflammatory effects observed with short-term treatment with nitrosterols are maintained.