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The mechanism of action of side effects has been clarified

Researchers find out the cause of side effects with cortisone medications

Although cortisone has been used successfully in many diseases, it often causes undesirable side effects, including metabolism. Why it is so, now there was an international educational team of researchers.

Drug with a wide range of applications

Cortisone is prescribed by doctors to treat a variety of different conditions. Often it is used for inflammation and allergic reactions. In addition, it is also prescribed for skin diseases, rheumatism, asthma, bowel disease or multiple sclerosis. Although it is unlikely that any other medicine has such a range of application, many patients have doubts or fear of the side effects of cortisone. Now researchers were able to find out the cause of some side effects with cortisone medications.

(Image: eenevski/fotolia.com)
Patients receiving cortisone preparations may have undesirable side effects. Researchers have now figured out the cause of certain side effects. (Image: eenevski/fotolia.com)

Side effects in metabolism

Patients who take anti-inflammatory steroids for a long time may experience side effects during metabolism.

Researchers at Helmholtz Zentrum München and Ludwig-Maximilians-Universität München (LMU), members of the German Center for Diabetes Research (DZD), were now able to figure out the mechanism with international colleagues that leads to the so-called steroid diabetes.

The results were published in the journal Nature Communications.

steroid diabetes

“Glucocorticoids, such as cortisone, have been used for decades to treat inflammatory diseases, such as asthma or rheumatism, and are the most prescribed drug for anti-inflammatory treatment,” explains Prof. Dr. med. Henriette Ulenhout in the message.

“But they are also used for autoimmune diseases, organ transplants, or cancer,” says the team leader at the Institute for Diabetes and Obesity at Helmholtz Zentrum München (IDO) and at the LMU Genome.

"It is estimated that between one and three percent of people in the Western world are treated by this, which currently corresponds to more than one million people in Germany."

However, their versatility is limited by the various side effects that may occur during therapy. These include undesirable effects on metabolism.

Because after glucocorticoids have contacted their receptor in the cells of the body, it begins to turn on and off numerous genes.

“This includes various metabolic genes, which can result in so-called steroid diabetes as a result,” explains Henriette Uhlenhout.

New options for therapeutic intervention

In the current study, her team, along with colleagues from the Max Delbrück Center for Molecular Medicine in Berlin, the Salk Institute in San Diego and the University of Freiburg, investigated the exact mechanisms that follow the binding of steroids to the receptor.

“We were particularly struck by the transcription factor E47, which, together with the glucocorticoid receptor, provides altered gene activity, especially in the liver cells,” says Charlotte Hemmer, an IDO graduate student and first author of current work.

"We were able to work out this relationship through genomic analysis and genetic experiments."

To substantiate their findings, scientists also studied the relationship in the preclinical model.

“In fact, the absence of E47 in this case protected against the negative effects of glucocorticoids, while the administration of steroids in intact E47 was associated with metabolic changes, such as hypoglycemia, elevated blood lipids or liver obesity,” explains Charlotte Hemmer.

Since the components of the newly found mechanism also exist in humans, Ulenhout and her team, together with their clinical collaboration partners, want to find out in the future whether the results will be confirmed there.

“In this case, new therapeutic interventions can be proposed to counteract the side effects of steroid therapy with safer immunosuppressive drugs,” hopes Henriette Uhlenhout. (Ad)

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