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Side effects with cortisone preparations – a reason explained by researchers



The researchers explained the cause of side effects with cortisone preparations

Although cortisone is successfully used in numerous diseases, it often causes undesirable side effects, including metabolism. Why so, he was now a global research team.

Drugs with a wide range of applications

Cortisone is prescribed by doctors for many different conditions. It is often used for inflammation and allergic reactions. Among other things, it is administered for skin diseases, rheumatism, asthma bonchiale, intestinal disorders or multiple sclerosis. Although barely another drug has such a variety of applications, many patients have reservations or fear of side effects of cortisone. The researchers could now explain the cause of certain side effects with cortisone preparations.

(Photo: eenevski / fotolia.com)
Patients treated with cortisone preparations may have side effects. The researchers have now clarified the cause of certain side effects. (Photo: eenevski / fotolia.com)

Side effects in metabolism

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

Researchers at the Centers of the Helmholtz Center in Munich and the University Ludwig-Maximilians-University of Munich (LMU), members of the German Diabetes Research Center (DZD), were now able to explain the mechanism with international colleagues leading to this so-called steroidal diabetes.

The results are published in the journal Nature Communications.

steroid diabetes

"Glucocorticoids like cortisone have been used for many decades to treat inflammatory diseases such as asthma or rheumatism and are the oldest prescribed anti-inflammatory drug," explains prof. Dr Honey. Henriette Ullhout in a message.

"But they are also used for autoimmune diseases, for organ transplants or for cancer," said the group leader at the Institute of Diabetes and Obesity at the Helmholtz Center in Munich (IDO) and the LMU Center of Genes.

"According to the estimates, between one and three percent of the people in the Western world are treated with what will currently suit more than one million people in Germany."

However, their diversity is limited by a variety of side effects that may occur during therapy. These include adverse effects on metabolism.

Because glucocorticoids are bound to their receptor in the body cells, it begins to include and exclude numerous genes.

"This includes different metabolic genes, which as a consequence can lead to a so-called steroidal diabetes," explains Henriette Ullhout.

New options for therapeutic intervention

In the current study, her team, together with colleagues from the Max Delbruec Center for Molecular Medicine in Berlin, the Salk Institute in San Diego and the University of Freiburg, examined the exact mechanisms that follow the steroid binding of the receptor.

"We were particularly affected by the transcription factor E47, which together with the glucocorticoid receptors provides changes in gene activity, especially in the liver cells," said Charlotte Hemmer, a doctoral student at IDO and the first author of the current work.

"We managed to look at this link through genome analysis and genetic experiments."

To confirm their findings, scientists also examined the relationships in a preclinical model.

"In fact, the absence of E47 in this case protects against the negative effects of glucocorticoids, while steroid administration in unchanged E47 was associated with metabolic changes such as hypoglycaemia, elevated blood lipids or fatty liver," explains Charlotte Hemmer.

Because the components of the newly discovered mechanism exist in humans, Ulenhaut and her team, together with clinical collaboration partners, want to find out in the future whether the results will be confirmed there.

"In this case, new options for therapeutic intervention may be offered to prevent the side effects of steroid therapy with safer immunosuppressive drugs," said Henriette Ullhout. (AD)


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