Straub, Rainer H. and Cutolo, Maurizio (2016) Glucocorticoids and chronic inflammation. RHEUMATOLOGY, 55. pp. 6-14. ISSN 1462-0324, 1462-0332
Full text not available from this repository. (Request a copy)Abstract
Glucocorticoids are steroid hormones that once bound to their receptor interact with the DNA binding domain. Almost 1000-2000 genes are sensitive to their effects, including immune/inflammatory response genes. However, their role in pathophysiology and therapy is still debated. We performed a literature survey using the key words glucocorticoids, inflammation, autoimmune disease, rheumatology and adrenal glands in order to define important targets for this review on glucocorticoids. Considering endogenous/exogenous glucocorticoids in chronic inflammatory diseases brought up five major points for discussion: inadequately low production of endogenous cortisol relative to systemic inflammation (the disproportion principle); changes of the systemic and local cortisol-to-cortisone shuttle (reactivation and degradation of cortisol); inflammation-induced glucocorticoid resistance; highlights of present glucocorticoid therapy; and the role of circadian rhythms in action of cortisol. Much of this information becomes understandable in the context of neurohormonal energy regulation as recently summarized. The optimization of long-term lowdose glucocorticoid therapy in chronic inflammatory diseases arises from the understanding of the above mentioned aspects. Since glucocorticoid resistance is a consequence of inflammation, adequate antiinflammatory therapy is mandatory.
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | MIGRATION INHIBITORY FACTOR; 11-BETA-HYDROXYSTEROID DEHYDROGENASE TYPE-1; ADRENAL AXIS FUNCTION; RHEUMATOID-ARTHRITIS; DIFFERENTIAL EXPRESSION; RELEASE PREDNISONE; RECEPTOR-BINDING; DISEASES; RESISTANCE; MECHANISMS; glucocorticoids; relative adrenal insufficiency; substitution of the adrenal gland; cortisol-to-cortisone shuttle; glucocorticoid resistance; role of circadian rhythm |
| Subjects: | 600 Technology > 610 Medical sciences Medicine |
| Divisions: | Medicine > Lehrstuhl für Innere Medizin I |
| Depositing User: | Dr. Gernot Deinzer |
| Date Deposited: | 12 Apr 2019 06:00 |
| Last Modified: | 12 Apr 2019 06:00 |
| URI: | https://pred.uni-regensburg.de/id/eprint/3820 |
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