Where do the side effects of cortisone come from? Cause research successfully completed

Where do the side effects of cortisone come from? Cause research successfully completed

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Researchers have clarified the cause of side effects in cortisone supplements

Cortisone is used successfully in numerous diseases, but there are often undesirable side effects - including in the metabolism. An international team of researchers has now been able to clarify why this is the case.

Medicines with a wide range of uses

Cortisone is prescribed by doctors for many different diseases. It is often used for inflammation and allergic reactions. It is also administered for skin diseases, rheumatism, asthma bonchiale, intestinal diseases or multiple sclerosis. Although hardly any other product has such a wide range of applications, many patients have reservations or fear of the side effects of cortisone. Researchers have now been able to determine the cause of certain side effects in cortisone preparations.

Side effects in metabolism

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

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

The results have been published in the "Nature Communications" magazine.

Steroid diabetes

"Glucocorticoids like 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. Henriette Uhlenhaut in a message.

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

"According to estimates, between one and three percent of people in the Western world are treated with what would currently correspond to over a million people in Germany."

However, their versatile use is limited by various side effects that can occur during therapy. Among other things, this includes undesirable influences on the metabolism.

After the glucocorticoids have bound to their receptor in the body cells, it begins to switch numerous genes on and off.

"This also includes various metabolic genes, which can lead to so-called steroid diabetes," explains Henriette Uhlenhaut.

New therapeutic intervention options

In the current study, her team, together with colleagues from the Max Delbrück Center for Molecular Medicine in Berlin, the Salk Institute in San Diego and the University of Freiburg, examined the exact mechanisms that take place after the steroids bind to the receptor.

"We particularly noticed the transcription factor E47, which together with the glucocorticoid receptor ensures the changed gene activities, especially in liver cells," says Charlotte Hemmer, PhD student at IDO and first author of the current work.

"We were able to work out this connection through genome-wide analyzes and genetic experiments."

In order to corroborate their findings, the scientists also examined the relationships in a preclinical model.

"In fact, the lack of E47 provided protection against the negative effects of glucocorticoids, whereas steroid administration with intact E47 was associated with metabolic changes such as sugar, increased blood lipids or fatty liver," explains Charlotte Hemmer.

Since the components of the newly found mechanism also exist in humans, Uhlenhaut and her team would like to work with clinical cooperation partners to find out whether the results are confirmed there.

"In this case, new therapeutic intervention options could be offered to counteract the side effects of steroid therapy with safer immunosuppressants," hopes Henriette Uhlenhaut. (ad)

Author and source information

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