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Glucocorticoid therapy for immune-mediated diseases: basic and clinical correlates
D T Boumpas1, G P Chrousos, R L Wilder
1National Institutes of Health, Bethesda, MD 20892.
Annals of Internal Medicine
|December 15, 1993
Summary
Glucocorticoids are potent anti-inflammatory hormones that work at molecular and cellular levels to suppress immune responses. Careful administration and monitoring are crucial to balance therapeutic benefits against significant side effects.
Area of Science:
- Endocrinology
- Immunology
- Pharmacology
Background:
- Glucocorticoids are vital hormones with significant anti-inflammatory and immunosuppressive properties.
- Their actions span molecular, cellular, and systemic levels, influencing gene expression and immune cell function.
Purpose of the Study:
- To elucidate the mechanisms of action of glucocorticoids in modulating inflammatory and immune responses.
- To review clinical administration strategies and associated side effects of glucocorticoid therapy.
Main Methods:
- Review of molecular mechanisms involving glucocorticoid receptors and DNA interactions.
- Analysis of cellular effects on leukocytes, endothelial cells, and inflammatory mediators.
- Examination of clinical administration routes (daily, alternate-day, pulse therapy) and their indications.
Main Results:
- Glucocorticoids modulate gene expression, affecting inflammatory and immune pathways.
- They inhibit leukocyte migration and interfere with inflammatory cell functions.
- Clinical use varies by disease severity, with potential for severe side effects.
Conclusions:
- Glucocorticoid therapy offers potent anti-inflammatory effects but requires careful management due to potential side effects.
- Minimizing adverse events involves dose adjustment, adjunctive therapies, and preventive measures.
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