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Related Experiment Videos

Clinical application of corticoids

F Hartmann

    International Dental Journal
    |December 1, 1981
    PubMed
    Summary

    Therapeutic corticoids, regardless of application method, can disrupt the body's natural cortisol regulation. Even localized treatments may suppress cortisol secretion, though current tests might miss subtle changes.

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    Area of Science:

    • Endocrinology
    • Pharmacology
    • Dermatology

    Background:

    • The hypothalamic-pituitary-adrenal (HPA) axis regulates plasma cortisol levels through a negative feedback loop.
    • Therapeutic administration of corticosteroids is known to potentially interfere with this feedback mechanism.

    Purpose of the Study:

    • To investigate the impact of various topical and oral corticosteroid applications on plasma cortisol levels.
    • To determine if localized corticosteroid administration affects the HPA axis feedback loop.

    Main Methods:

    • Review of studies involving therapeutic corticoid use in dermatoses and polyarthritis.
    • Experimental administration of corticoids to skin, oral, gingiva, and periodontal pockets in patients and rats.
    • Measurement of plasma cortisol levels to assess HPA axis suppression.

    Main Results:

    • Systemic corticoid administration (oral) demonstrably interrupts the cortisol feedback loop.
    • Localized application of corticoids to the skin and in periodontal pockets showed suppression of cortisol secretion in individual patients.
    • Endomethasone root fillings in rats exhibited a similar suppressive effect on cortisol levels.

    Conclusions:

    • All forms of corticoid administration, including localized applications, have the potential to suppress cortisol secretion.
    • Current analytical methods may lack the sensitivity to detect minor suppressions in plasma cortisol levels.
    • Further research with more sensitive assays may be needed to fully elucidate the extent of HPA axis suppression by various corticoid applications.

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