Mechanism of action of side effects were deciphered


Researchers have clarified the cause of side effects with cortisone preparations

Although cortisone is successfully used in numerous diseases, it often causes unwanted side effects, including metabolism. Because this is so, now it was an international research team to clarify.

Drugs with a wide range of applications

Cortisone is prescribed by doctors for many different conditions. It is often used for inflammatory and allergic reactions. Among other things, it is also given for skin diseases, rheumatism, asthma bonchiale, intestinal diseases or multiple sclerosis. Although almost no other drug has this range of applications, many patients have reservations or fear of the side effects of cortisone. The researchers were able to elucidate the cause of certain side effects with cortisone preparations.

(Image: eenevski /
Patients treated with cortisone preparations may have unwanted side effects. Researchers have already elucidated the cause of certain side effects. (Image: eenevski /

Side effects on metabolism

In patients who are long-term with anti-inflammatory steroids, side effects may occur in metabolism.

Researchers at Helmholtz Zentrum München and Ludwig-Maximilians-Universität München (LMU), members of the German Center for Research on Diabetes (DZD), have been able to elucidate a mechanism with international colleagues leading to this so-called steroid diabetes.

The results were published in the journal Nature Communications.

steroid diabetes

"Glucocorticoids, such as cortisone, have been used for many decades for the treatment of inflammatory diseases, such as asthma or rheumatism, and are the most prescribed preparation for anti-inflammatory treatment," explains Prof. Dr. med. Henriette Uhlenhaut in a message.

"But they are also used for autoimmune diseases, organ transplants or cancer," says the group leader at the Institute of Diabetes and Obesity at Helmholtz Zentrum München (IDO) and the LMU Gene Center.

"According to estimates, between one and three percent of the people in the Western world are treated, which would now correspond to more than one million people in Germany."

However, its versatility is limited by several side effects that may occur during therapy. These include undesirable effects on metabolism.

Because after the glucocorticoids bind to their receptor in the body cells, it begins to activate and deactivate several genes.

"This includes several metabolic genes, which in consequence can lead to the so-called steroid diabetes," explains Henriette Uhlenhaut.

New options for therapeutic intervention

In the current study, his team, along with colleagues at 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 steroid binding to the recipient.

"We were particularly impressed with the E47 transcription factor, which along with the glucocorticoid receptor provides altered gene activities, especially in liver cells," says Charlotte Hemmer, a doctoral student at IDO and the first author of the current paper.

"We have been able to resolve this connection through genetic analysis and genetic experiments."

To substantiate their findings, the scientists also examined the relationships in a 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 abnormalities such as hypoglycemia, elevated blood lipids or fatty liver," explains Charlotte Hemmer.

As the components of the newly discovered mechanism also exist in humans, Uhlenhaut and his team, along with clinical cooperation partners, want to find out in the future whether the results will be confirmed there.

"In this case, new therapeutic intervention options could be offered to counteract the side effects of steroid therapy with safer immunosuppressive drugs," said Henriette Uhlenhaut. (Ad)


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