Corticosteroids are
steroid hormones, produced either artificially or in the
adrenal cortex[?]. The hormone affects
carbohydrate metabolism,
electrolyte levels and
protein catabolism as well as immune responses,
gluconeogenesis (glyconeogenesis) and gonad function.
Glucocorticoids control carbohydrate, fat and protein metabolism and are anti-inflammatory by preventing
phospholipid release, decreasing eosinophils action and a number of other mechanisms.
Mineralocorticoids control electrolyte and water levels, mainly by promoting sodium retention in the
kidney. The most common natural hormones are
corticosterone (C
21H
30O
4),
cortisone (C
21H
28O
5, 17-hydroxy-11-dehydrocorticosterone) and
aldosterone.
 |
| Corticosterone |
Use of corticosteroids as a drug treatment had been in use for some time, extracted from the adrenal glands of oxen. This preparation cost hundreds of dollars a drop, and was available to few.
Percy Julian[?] developed a way to synthesize cortisone from
soy beans, thus making it affordable to all at pennies a gram. The exact nature of cortisone's anti-inflammatory nature remained a mystery for years after however, until the
Leukocyte Adhesion Cascade[?] was fully understood in the early 1980s.
Synthetic drugs with corticosteroid-like effect are used in a variety of conditions, ranging from brain tumors to skin diseases. Dexamethasone[?] and its derivatives are almost pure glucocorticoids, while prednisolon[?] and its derivatives have some mineralocorticoid action in addition to the glucocorticoid effect. Fludrocortisone[?] is a synthetic mineralocorticoid. Hydrocortisone (cortisol) is available for replacement therapy.
Typical undesired effects of glucocorticoids present quite uniformly as drug-induced Cushing's syndrome. Typical mineralocorticoid side effects are hypertension, hypokalemia, hypernatremia, and metabolic alkalosis.
Synthetic glucocorticoids are used in the treatment of joint pain or inflammation (arthritis)[?], dermatitis, allergic reactions, asthma, hepatitis, lupus, ulcerative colitis[?], Crohn's disease, sarcoidosis[?] and for glucocorticoid replacement in Addison's disease[?]. Topical formulations for treatment of skin or bowel diseases are available.
See also: Cushing's syndrome
