Researchers have explained the cause of the undesirable effects of cortisone preparations
Although cortisone is successfully used in many diseases, it often causes undesirable side effects, including metabolism. Why is that so, he was now enlightened by an international research team.
Drug with a wide range of applications
Cortizone is prescribed by a doctor under many different conditions. It is often used in inflammation and allergic reactions. Among others, it is also applied to skin diseases, rheumatism, asthma, bowel disease, or multiple sclerosis. Although almost no other drugs have such a range of applications, many patients have reservations or fear of side effects of cortisone. Scientists were now able to explain the cause of certain side effects with cortisone preparations.
Undesirable effects in metabolism
Patients with long-acting anti-inflammatory steroids may experience side effects in metabolism.
Researchers Helmholtz Zentrum München and Ludwig-Maximilians-Universität München (LMU), members of the German Diabetes Research Center (DZD), have now been able to clarify the mechanism with international colleagues leading to this so-called Steroidal Diabetes.
The results were published in Nature Communications.
"Glucocorticoids, such as cortisone, have been used for many decades to treat inflammatory diseases such as asthma or rheumatism, and are the most prescribed preparation for anti-inflammatory therapy," explains prof. Dr. copper. Henriette Uhlenhaut in the report.
"But they are also used for autoimmune diseases, organ transplantation, or cancer," says the group leader at the Institute for Diabetes and Obesity at Helmholtz Zentrum München (IDO) and Gene Gene of LMU.
"It is estimated that between one and three per cent of people in the Western world are treated, which currently accounts for more than one million people in Germany."
However, their versatility is limited by the various side effects that may occur during treatment. These include metabolic side effects.
Since glucocorticoids are bound to the receptor in the cells of the body, they start to turn on and turn off many genes.
"There are various metabolic genes that can lead to so-called steroidal diabetes," explains Henriette Uhlenhaut.
New possibilities of therapeutic intervention
In the current study, her team, along with colleagues from Max Delbrück's Molecular Medicine Center in Berlin, the Salk Institute in San Diego, and the University of Freiburg, investigated the precise mechanisms that monitor steroid binding to the receptor.
"We have been particularly affected by the transcription factor E47, which together with the glucocorticoid receptor provides for a change in gene activity, especially in the liver cells," says Charlotte Hemmer, PhD student of IDO and the first author of the present work.
"We were able to do this through genomic analyzes and genetic experiments."
In order for scientists to prove their findings, they also examined relationships in the preclinical model.
"In fact, the absence of E47 in this case was protected from the negative effects of glucocorticoids, while administration of steroids in intact E47 was associated with metabolic changes such as hypoglycemia, elevated blood lipids or fatty liver," explains Charlotte Hemmer.
Because the components of the newly found mechanism exist in humans, Uhlenhaut and her team, together with clinical collaboration partners, want to know if the results will be confirmed in the future.
"In this case, new possibilities of therapeutic intervention could be offered to suppress the side effects of steroid therapy with safer immunosuppressive drugs," hopes Henriette Uhlenhaut. (Ad)