Glucocorticoids are a type of hormone secreted by the adrenal cortex that regulates the synthesis of sugar, fat, and protein.
It is also used in the treatment of asthma because of its anti-inflammatory effect. When glucocorticoids are used for diseases, they can usually be used for asthma (inhalation), anti-inflammatory, anti-immune, anti-toxic, and anti-shock (systemic application) and skin inflammation (topical application).
Whether natural or synthetic, glucocorticoids can be used to treat a variety of treatments, such as anti-inflammatory, anti-toxic, anti-shock, and immunosuppressive therapy.
For patients with rheumatic autoimmune diseases, the most commonly used hormone drug is glucocorticoids. Under physiological conditions, it is mainly secreted by the human adrenal glands and plays an important regulatory role in the body's development, growth, metabolism, and immune function. In medical terms, it is the most widely used anti-inflammatory and immunosuppressant in clinical practice.
Most glucocorticoids of different preparations have the same bioequivalence and similar absorption rates. It can be administered in a variety of ways, including oral, intramuscular, intravenous or intravenous infusions, and other systemic medications, as well as inhalation, nasal spray, local injection, drip, and smear.
What is an example of a glucocorticoid?
There are many types of glucocorticoid drugs, which can be divided into short-acting, medium-acting, and long-acting types according to the drug half-life (the time required for the drug concentration in the blood to drop by half).
1. Short-acting glucocorticoids: The duration of action is about 8 to 12 hours, such as cortisone and hydrocortisone.
2. Intermediate-acting glucocorticoids: The duration of action is about 18 to 36 hours, such as prednisone, prednisolone, methylprednisolone, etc.
3. Long-acting glucocorticoids: The duration of action is about 36 to 54 hours, such as dexamethasone and betamethasone.
The longer the half-life, the longer the drug stays in the body and takes effect. At the same time, the intensity of the anti-inflammatory effect of different types of glucocorticoids is also different, with short-acting being the weakest and long-acting being the strongest.
The research and development directions of new preparations based on the mechanism of action of glucocorticoids include:
• New glucocorticoid receptor (GR) ligands, whose anti-inflammatory and immunosuppressive effects can be separated from metabolic side effects;
• Modify glucocorticoids to change their physicochemical properties and pharmacokinetic characteristics, and increase local tissue concentrations, such as pegylation, increasing lipophilicity, etc.;
• Improve the targeting effect of glucocorticoids, such as combining glucocorticoids with antibodies or peptides; or encapsulate glucocorticoids, such as liposomal prednisolone that has completed phase II clinical trials;
• Combined treatment of glucocorticoids with peroxisome proliferator-activated receptors (PPARs) agonists, in order to synergistically exert anti-inflammatory effects and thereby reduce the adverse reactions of glucocorticoids;
• Anti-inflammatory proteins induced by glucocorticoids, such as GILZ (glucocorticoid-induced leucine zipper), are anti-inflammatory molecules that can mediate the immunomodulatory activity of glucocorticoids, have fewer adverse reactions, and can be used as new targeted molecular drugs for the treatment of inflammatory diseases.
