Corticosteroid

Corticosteroid
Drug class
Cortisol (hydrocortisone), a corticosteroid with both glucocorticoid and mineralocorticoid activity and effects.
Class identifiers
Synonyms	Corticoid
Use	Various
ATC code	H02
Biological target	Glucocorticoid receptor, Mineralocorticoid receptor
Chemical class	Steroids
Legal status
In Wikidata

Corticosteroids are a class of steroid hormones that are produced in the adrenal cortex of vertebrates, and also their synthetic analogues. The two main classes of corticosteroids – glucocorticoids and mineralocorticoids – are involved in a wide range of physiological processes, including stress response, immune response, and regulation of inflammation, carbohydrate metabolism, protein catabolism, blood electrolyte levels, and behavior.

Some common naturally occurring steroid hormones are cortisol (C
₂₁H
₃₀O
₅), corticosterone (C
₂₁H
₃₀O
₄), cortisone (C
₂₁H
₂₈O
₅) and aldosterone (C
₂₁H
₂₈O
₅) (cortisone and aldosterone are isomers). The main corticosteroids produced by the adrenal cortex are cortisol and aldosterone.

Etymology

The etymology of the cortico- part of the name refers to the adrenal cortex, which makes these steroid hormones. Thus a corticosteroid is a "cortex steroid".

Classes

Cortisol

Cortisone

Corticosterone

Aldosterone

• Glucocorticoids such as cortisol affect carbohydrate, fat, and protein metabolism, and have anti-inflammatory, immunosuppressive, anti-proliferative, and vasoconstrictive effects. Anti-inflammatory effects are mediated by blocking the action of inflammatory mediators (transrepression) and inducing anti-inflammatory mediators (transactivation). Immunosuppressive effects are mediated by suppressing delayed hypersensitivity reactions by direct action on T-lymphocytes. Anti-proliferative effects are mediated by inhibition of DNA synthesis and epidermal cell turnover. Vasoconstrictive effects are mediated by inhibiting the action of inflammatory mediators such as histamine.
• Mineralocorticoids such as aldosterone are primarily involved in the regulation of electrolyte and water balance by modulating ion transport in the epithelial cells of the renal tubules of the kidney.

Medical uses

Synthetic pharmaceutical drugs with corticosteroid-like effects are used in a variety of conditions, ranging from hematological neoplasms to brain tumors or skin diseases. Dexamethasone and its derivatives are almost pure glucocorticoids, while prednisone and its derivatives have some mineralocorticoid action in addition to the glucocorticoid effect. Fludrocortisone (Florinef) is a synthetic mineralocorticoid. Hydrocortisone (cortisol) is typically used for replacement therapy, e.g. for adrenal insufficiency and congenital adrenal hyperplasia.

Medical conditions treated with systemic corticosteroids:

• Allergy and respirology medicine
  • Asthma (severe exacerbations)
  • Chronic obstructive pulmonary disease (COPD)
  • Allergic rhinitis
  • Atopic dermatitis
  • Hives
  • Angioedema
  • Anaphylaxis
  • Food allergies
  • Drug allergies
  • Nasal polyps
  • Hypersensitivity pneumonitis
  • Sarcoidosis
  • Eosinophilic pneumonia
  • Some other types of pneumonia (in addition to the traditional antibiotic treatment protocols)
  • Interstitial lung disease
• Dermatology
  • Pemphigus vulgaris
  • Contact dermatitis
• Endocrinology (usually at physiologic doses)
  • Addison's disease
  • Adrenal insufficiency
  • Congenital adrenal hyperplasia
• Gastroenterology
  • Ulcerative colitis
  • Crohn's disease
  • Autoimmune hepatitis
• Hematology
  • Lymphoma
  • Leukemia
  • Hemolytic anemia
  • Idiopathic thrombocytopenic purpura