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Corticosteroid

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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 (C21H30O4), cortisone (C21H28O5, 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



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