New glucocorticoids are more selective. Current knowledge can eliminate serious adverse effects
Nilsson, S.; Gustafsson, J.A.
Lakartidningen 94(26-27): 2465-2471
1997
ISSN/ISBN: 0023-7205 PMID: 9235445 Document Number: 478916
Glucocorticoids have been used as anti-inflammatory, anti-allergic and immunosuppressive agents since the beginning of the 1940s, and during recent years the mechanisms by which they exert their anti-inflammatory effects have begun to be better understood. Inhibition of inflammatory response is primarily mediated via the glucocorticoid receptor and the two transcription factors, AP-1 and NF kappa B, which are of crucial importance for the expression of pro-inflammatory cytokines and other genes involved in the inflammatory process. Unfortunately, long-term treatment with glucocorticoids is associated with a series of adverse effects such as hypertension, bone fragility, diabetes, dermatrophy and personality changes. However, owing to advances in biotechnology and recent clarification of the molecular mechanisms involved, it is now becoming possible to develop new glucocorticoids with a more selective anti-inflammatory effect without serious side-effects.