The Anti-Inflammatory and Immunosuppressive Effects of Glucocorticoids, Recent Developments and Mechanistic Insights

Mol Cell Endocrinol. 2011 Mar 15;335(1):2-13. doi: 10.1016/j.mce.2010.04.005. Epub 2010 Apr 14.

Abstract

Since the discovery of glucocorticoids in the 1940s and the recognition of their anti-inflammatory effects, they have been amongst the most widely used and effective treatments to control inflammatory and autoimmune diseases. However, their clinical efficacy is compromised by the metabolic effects of long-term treatment, which include osteoporosis, hypertension, dyslipidaemia and insulin resistance/type 2 diabetes mellitus. In recent years, a great deal of effort has been invested in identifying compounds that separate the beneficial anti-inflammatory effects from the adverse metabolic effects of glucocorticoids, with limited effect. It is clear that for these efforts to be effective, a greater understanding is required of the mechanisms by which glucocorticoids exert their anti-inflammatory and immunosuppressive actions. Recent research is shedding new light on some of these mechanisms and has produced some surprising new findings. Some of these recent developments are reviewed here.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • 11-beta-Hydroxysteroid Dehydrogenase Type 1 / metabolism
  • Animals
  • Anti-Inflammatory Agents / pharmacology*
  • Anti-Inflammatory Agents / therapeutic use
  • Cell Differentiation / drug effects
  • Gene Expression Regulation / drug effects
  • Glucocorticoids / pharmacology*
  • Glucocorticoids / therapeutic use
  • Humans
  • Immune System / cytology
  • Immune System / drug effects
  • Immunosuppressive Agents / pharmacology*
  • Immunosuppressive Agents / therapeutic use
  • Inflammation / drug therapy
  • Inflammation / immunology
  • Inflammation / metabolism
  • Leukocytes / cytology
  • Leukocytes / drug effects
  • Receptors, Glucocorticoid / agonists
  • Receptors, Glucocorticoid / metabolism
  • Signal Transduction / drug effects
  • Transcription, Genetic / drug effects

Substances

  • Anti-Inflammatory Agents
  • Glucocorticoids
  • Immunosuppressive Agents
  • Receptors, Glucocorticoid
  • 11-beta-Hydroxysteroid Dehydrogenase Type 1