The researchers clarified the cause of side effects with cortisone preparations
Although cortisone is used successfully in many diseases, it often causes undesired side effects, including metabolism. Because this is so, now it was an international research team that lit up.
Drugs with a wide range of applications
Cortisone is prescribed by doctors for many different conditions. Often it is used for inflammation and allergic reactions. Among other things, it is also given for skin diseases, rheumatism, bonquial asthma, intestinal disease or multiple sclerosis. Although almost no other drug has a range of applications, many patients have reservations or fear the side effects of cortisone. Researchers have already been able to clarify the cause of certain side effects with cortisone preparations.
Side effects not metabolism
In patients with long-term anti-inflammatory steroids, side effects may occur in metabolism.
Researchers at the Helmholtz Zentrum München and Ludwig-Maximilians-Universität München (LMU), members of the German Diabetes Research Center (DZD), have now been able to clarify a mechanism with international partners that lead to this so-called steroid diabetes.
The results were published in the journal "Nature Communications".
"Glucocorticoids and 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 group leader at the Helmholtz Zentrum München Institute for Diabetes and Obesity (IDO) and at the LMU Gene Center.
"According to estimates, between one and three percent of people in the Western world deal with them, which currently corresponds 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 have linked the receptor to the body's cells, it begins to activate and deactivate many genes.
"This includes several metabolic genes that, accordingly, can lead to so-called steroid diabetes," explains Henriette Uhlenhaut.
New options for therapeutic intervention
In the current study, his team, together with colleagues from the Max Delbrück Center for Molecular Medicine in Berlin, the Salk Institute of San Diego and the University of Freiburg, investigated the exact mechanisms that follow the binding of steroids to the recipient.
"We were particularly impressed by the transcription factor E47, which, along with the glucocorticoid receptor, prevents altered genetic activities, especially in liver cells," says Charlotte Hemmer, Ph.D. student at IDO and the first author of current work.
"We can solve this connection through genome analysis and genetic experiments."
To prove their findings, scientists also examined relationships in a preclinical model.
"In fact, the absence of E47 in this case was protected against the negative effects of glucocorticoids, while the administration of steroids in the E47 intact was associated with metabolic changes such as hypoglycaemia, elevated blood lipids or fatty liver," explains Charlotte Hemmer.
Since the components of the newly found mechanism also exist in humans, Uhlenhaut and his team, along with clinical cooperation partners, want to discover in the future whether the results will be confirmed there.
"In this case, new options for therapeutic intervention could be offered to counteract the side effects of steroid therapy with safer immunosuppressant medications," hopes Henriette Uhlenhaut. (Ad)