Glucocorticoid action on connective tissue: from molecular mechanisms to clinical practice

Glucocorticosteroids are highly effective in treating various acute and chronic diseases, but their long-term use is often accompanied by side effects, such as osteoporosis of skeleton and bones and atrophy of the skin. Clinically, many of these side effects involve changes in connective tissue. Glucocorticoid effects on connective tissue metabolism are, however, sometimes beneficial for instance, in the treatment of keloids or autoimmune connective tissue diseases. Recent advances in the biochemical technology have provided tools to examine the molecular mechanisms by which glucocorticoids affect connective tissue. These studies have shown distinct alterations in the extracellular matrix as a result of glucocorticoid treatment. This knowledge is useful for the further development of glucocorticosteroids with desirable action spectrum and with minimal side effects.