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Glucocorticoids, a class of anti-inflammatory drugs, are pivotal in treating moderate to severe Crohn's disease by inducing remission. They exhibit their anti-inflammatory action by inhibiting the production of inflammatory cytokines such as tumor necrosis factor (TNF)-α, interleukin (IL)-1, and chemokines like IL-8. In addition, they reduce the expression of inflammatory cell adhesion molecules and inhibit gene transcription of nitric oxide synthase, phospholipase A2, cyclooxygenase-2...
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Crohn's disease is an inflammatory bowel disorder marked by chronic inflammation of the GI tract. Various treatment strategies for Crohn's disease are employed, such as immunomodulatory agents, glucocorticoids, and biologics or anti-TNF therapy. Azathioprine (Imuran), a commonly used immunomodulatory drug for Crohn's disease, is converted in the body to mercaptopurine, which inhibits purine biosynthesis and cell proliferation. Both are utilized in severe cases of Inflammatory Bowel...
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Inhaled corticosteroids (ICS) are anti-inflammatory drugs used primarily in treating persistent asthma and providing long-term maintenance. They target the bronchial mucosa, the lining of the airways, to control inflammation, a critical factor in asthma progression and exacerbation.
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Corticosteroids in Immunosuppression.

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Handbook of Experimental Pharmacology
|February 14, 2022
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Summary
This summary is machine-generated.

Corticosteroids are crucial for organ transplant success but balancing immune tolerance with steroid side effects remains challenging. Optimizing steroid use and weaning protocols is essential to minimize long-term adverse events in transplant patients.

Keywords:
ImmunosuppressionOrgan transplantationSteroids

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Area of Science:

  • Immunology
  • Pharmacology
  • Transplantation Medicine

Background:

  • Corticosteroids have been a cornerstone of immunosuppression in organ transplantation since its inception.
  • Achieving a balance between graft tolerance and minimizing steroid-related toxicity is a significant clinical challenge.
  • While used universally in early post-transplant care, significant variability exists in steroid duration and weaning protocols across different organs and institutions.

Purpose of the Study:

  • To review the established role of corticosteroids in organ transplantation.
  • To highlight the challenges in balancing immunosuppression efficacy with steroid-induced adverse events.
  • To discuss the variability in current steroid use and weaning strategies.

Main Methods:

  • Literature review of corticosteroid use in solid organ transplantation.
  • Analysis of current clinical practices and protocols for steroid administration and withdrawal.
  • Examination of the known adverse event profile of corticosteroids across multiple organ systems.

Main Results:

  • Corticosteroids are integral to immediate post-transplant immunosuppression.
  • Significant heterogeneity in steroid dosing, duration, and weaning protocols is observed globally.
  • The extensive adverse event profile of corticosteroids impacts numerous organ systems.

Conclusions:

  • Optimizing corticosteroid regimens is critical for improving long-term outcomes in organ transplant recipients.
  • Standardized protocols for steroid weaning may help mitigate cumulative toxicity.
  • Further research is needed to refine steroid use and minimize adverse effects in transplantation.