Corticosteroids
Overview
Corticosteroids are a class of steroid hormones that are produced in the adrenal cortex of vertebrates, as well as the synthetic analogues of these hormones. They are involved in a wide range of physiological processes, including stress response, immune response, regulation of inflammation, carbohydrate metabolism, protein catabolism, blood electrolyte levels, and behavior.
Classification
Corticosteroids are classified into two main types: glucocorticoids and mineralocorticoids. This classification is based on their primary biological effect.
Glucocorticoids
Glucocorticoids, named for their involvement in glucose metabolism, have potent anti-inflammatory and immunosuppressive properties. This class includes drugs such as prednisone, prednisolone, dexamethasone, budesonide, and hydrocortisone. They are used to treat a variety of inflammatory and autoimmune conditions, such as rheumatoid arthritis, lupus, and asthma.
Mineralocorticoids
Mineralocorticoids, named for their effect on body mineral levels, particularly sodium and potassium, help control blood pressure and maintain electrolyte balance. The primary mineralocorticoid is aldosterone.
Mechanism of Action
Corticosteroids work by binding to the glucocorticoid or mineralocorticoid receptor, which is located inside the cell. The steroid-receptor complex then moves into the cell nucleus, where it binds to specific DNA sequences and regulates the transcription of targeted genes.
Therapeutic Use
Corticosteroids are used in a wide variety of diseases, including inflammatory diseases such as asthma and autoimmune diseases, and in the treatment of adrenal insufficiency and congenital adrenal hyperplasia. They are also used to suppress the immune system in patients who have undergone organ transplantation to prevent organ transplant rejection.
Side Effects
Long-term use of corticosteroids can lead to serious side effects, including osteoporosis, diabetes, and Cushing's syndrome. Short-term use can cause increased appetite, insomnia, and mood changes.