Mechanism of Anti-Inflammatory Action
The pharmacological effect of steroid drugs is realized at several levels:
- Biochemical level: The main mechanism consists of inhibiting the activity of the enzyme phospholipase A2. As a result, the arachidonic acid cascade is blocked, leading to a decreased production of inflammatory mediators such as prostaglandins and leukotrienes.
- Genetic and molecular level: The drugs suppress the synthesis of pro-inflammatory factors, such as interleukin-1 (IL-1), tumor necrosis factor-alpha (TNF-α), and cyclooxygenase-2 (COX-2), while simultaneously stimulating the synthesis of anti-inflammatory factors.
- Pathophysiological level: At the level of inflammatory stages, vascular wall permeability is reduced, exudation and tissue infiltration are decreased, and phagocyte activity is suppressed.
Clinical Application
The primary clinical profile for using these drugs is the therapy of various autoimmune pathologies.
In clinical practice, glucocorticoids are prescribed for:
- Rheumatoid arthritis.
- Systemic lupus erythematosus.
- Skin diseases, including neurodermatitis and eczema.
Safety Profile and Side Effects
Adverse reactions develop primarily with prolonged administration of the drugs, which is necessary for treating chronic autoimmune conditions.
- Systemic disorders: They cause immunosuppression (reduced immunity), hyperglycemia, redistribution of adipose tissue, as well as impaired mineral and protein metabolism. Growth and developmental retardation are possible in children, and osteoporosis in adults.
- Organ damage: They exert an ulcerogenic effect, leading to ulceration of the gastric mucosa. Mental disorders involving the central nervous system are possible, as well as the development of glaucoma and cataracts.