What is the Mechanism of Action of Corticosteroid?

 

Corticosteroid is synthetic drug that mimic the adrenal hormone, cortisol, used in the management of many inflammatory and autoimmune health conditions. They modify the functions of epidermal and dermal cells and of leukocytes involved in proliferative and inflammatory diseases of the skin.

Corticosteroids can be used in treating several health conditions, such as:

  • Asthma
  • Allergies
  • Eczema
  • Hives
  • Psoriasis
  • Chronic obstructive pulmonary disease
  • Gout
  • Lupus
  • Multiple sclerosis
  • Autoimmune diseases

Types of corticosteroids

Corticosteroids come in different forms. Some of the corticosteroids used in treating inflammations include cortisone, prednisone and methylprednisolone. Prednisone is the most commonly used type of steroids used in treating certain rheumatoid diseases like rheumatoid arthritis or lupus.

 

How to administer corticosteroid

Corticosteroid comes in different forms based on their ease of administration. They can be localized of systemic.

Localized steroids target a specific part of the body and can be applied through:

  • Eye drops
  • Ear drops
  • Skin cream and ointments
  • Inhalers

Systemic steroids circulate through the blood. They can be applied by oral, intravenous or subcutaneous injection.

 

Mechanism of action of Corticosteroids

In its mechanism of action, corticosteroid react with receptor proteins in the cytoplasm to form a steroid-receptor complex. The complex thus formed moves into the nucleus, where it binds to DNA. By binding to the DNA and changing the transcription of mRNA, corticosteroid stimulates the production of glycoprotein called Lipocortin. Lipocortin inhibits the activity of phospholipase A2, which releases arachidonic acid, the precusor of prostanoid and leukoctrienes, from phospholipids. Corticosteroid also inhibits the transcription of mRNA responsible for interleukine-1 formation. Thus, by inhibiting arachidonic acid metabolism and interleukin-1 formation, steroids produce anti-inflammatory, immunosuppressive and anti-mytogenic effects.

Adverse effects of corticosteroids

Corticosteroid in its mechanism of action, especially glucocorticosteroid, has been shown to stimulate osteoclastic activity in the first 6-12 months of therapy, followed by a decrease in bone formation and life span. It promotes the apoptosis of osteolasts and osteocytes. It can also cause adrenal suppression in patients that are been treated with it.  Other side effects of steroids include cushingoid appearance and weight gain, hyperglycemia and diabetes, cataracts and glaucoma.