Researchers have clarified the causes of cortisone preparations
Although cortisone is successfully used in many diseases, it often causes unwanted side effects, including metabolism. Why it was, there was now an international research team that enlightened.
Medicines with a wide range of applications
Cortisone is prescribed by doctors in many different circumstances. It is often used for inflammation and allergic reactions. It is also used inter alia for skin diseases, rheumatism, asthma bonchiale, intestinal diseases or multiple sclerosis. Although almost no other drug has so many uses, many patients have reservations or fears about cortisone side effects. Researchers could now explain the causes of some side effects when using cortisone preparations.
Side effects of metabolism
Patients taking long-term anti-inflammatory steroids may experience side effects during 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 their international colleagues, leading to this so-called steroid diabetes.
The results are published in Nature Communications.
"Glucocorticoids, such as cortisone, have been used for decades to treat inflammatory diseases such as asthma or rheumatism, and are the most accurate anti-inflammatory treatment," explains Prof. Henriette Uhlenhaut's report.
"But they are also used for autoimmune diseases, organ transplantation, or cancer," says group leader Helmholtz Zentrum München (IDO) and LMU Gene Center at the Institute of Diabetes and Obesity.
"According to estimates, one to three percent of the Western world population is treated with what is currently equivalent 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 unwanted effects on metabolism.
Because after glucocorticoids bind to their receptor in the body's cells, it starts to turn on and off many genes.
"It includes a variety of metabolic genes that can lead to so-called steroid diabetes," explains Henriette Uhlenhaut.
New therapeutic options
In this study, her team, together with colleagues from the Berlin Molecular Medicine Center Max Delbrück, the San Diego Salk Institute and the University of Freiburg, studied the exact mechanisms that follow the binding of steroids to receptors.
"We were particularly impressed by the transcription factor E47, which, together with glucocorticoid receptors, makes changes in gene activity, especially in liver cells," says Charlotte Hemmere, PhD student at IDO and first author of current work.
"We were able to develop this compound using genome-wide analysis and genetic experiments."
To justify their conclusions, scientists also tested the relationship in the preclinical model.
"In fact, the lack of E47 in this case is protected against the negative effects of glucocorticoids, while steroid administration to the intact E47 was associated with metabolic changes such as hypoglycaemia, increased lipid levels in the blood or fatty liver," explains Charlotte Hemmer.
As the components of the newly created mechanism also exist for people, Uhlenhaut and her team, together with their clinical partners, want to know in the future whether the results will be approved.
"In this case, new therapeutic interventions could be offered to prevent the side effects of steroid therapy with safer immunosuppressive drugs," hopes Henriette Uhlenhaut. (Ads)