The researchers explained the cause of the side effects of cortisone preparations
Although cortisone is successfully used in numerous diseases, it often causes side effects, including metabolism. Why this is so, now the international research team enlightened.
Lek with a wide range of applications
Cortisone is prescribed by a physician for many different conditions. It is often used for inflammation and allergic reactions. Among other things, it is also given for skin diseases, rheumatism, asthma bonchiale, intestinal illness or multiple sclerosis. Although barely any other drug has such a large number of applications, many patients have a reserve or fear of the side effects of cortisone. The researchers were now able to clarify the cause of certain side effects in cortisone preparations.
Side effects in metabolism
In patients who are long-lasting with anti-inflammatory steroids, adverse effects in metabolism may occur.
Researchers at the Helmholtz Zentrum Munich and the Ludwig-Makimilians-Universitat Munich (LMU), members of the German Diabetes Research Center (DZD), could now clarify the mechanism with international colleagues leading to so-called steroidal diabetes.
The results were published in the journal Nature Communications.
"Glucocorticoids, such as cortisone, have been used for decades to treat inflammatory diseases such as asthma or rheumatism, and most often prescribed anti-inflammatory treatments," explains prof. Dr. Med. Henriette Uhlenhaut in the message.
"But they are also used for autoimmune diseases, organ transplants or cancer," said a group leader at the Institute for Diabetes and Obesity at Helmholtz Zentrum Munich (IDO) and at the Gene Center in LMU.
"According to estimates, between one and three percent of the people in the Western world are treated with it, which currently corresponds to more than a million people in Germany."
However, their diversity is limited by the various side effects that may occur during therapy. This includes unwanted effects on metabolism.
Since glucocorticoids bind to their receptors in body cells, it begins to include and exclude numerous genes.
"This includes different metabolic genes, which can lead to so-called steroid diabetes," explains Henriette Uhlenhaut.
New options for therapeutic intervention
In this study, her team, together with colleagues from the Center for Molecular Medicine, Mak Delbruck, Berlin, the Salk Institute in San Diego and the University of Freiburg, have explored the exact mechanisms that monitor the binding of steroids to the receptor.
"Especially the transcriptional factor E47 has hit us, which together with the glucocorticoid receptor provides altered gene activity, especially in the liver cells," said Charlotte Hemmer, an IDO doctor and the first author of the present paper.
"We have succeeded in resolving this relationship through genome and genetic experiments."
To confirm their findings, scientists also examined relationships in the preclinical model.
"In fact, the absence of E47 in this case is protected against the negative effects of glucocorticoids, while the use of steroids in intact E47 is associated with metabolic changes such as hypoglycaemia, elevated lipids in the blood or fatty liver," explains Charlotte Hemmer.
Since components of the newly discovered mechanism exist in humans, Uhlenhaut and its team, together with clinical collaboration partners, want to find out whether the results will be confirmed in the future.
"In this case, new therapeutic intervention options can be offered to counter the side effects of steroid therapy with safer immunosuppressive drugs," said Henriette Uhlenhaut. (Commercials)