Glucocorticoids have long been an indispensable part of the treatment of immune-mediated acute and chronic inflammatory diseases. While highly effective, these medicines are accompanied by significant side effects, including insulin resistance and osteoporosis, underscoring the critical need for a better understanding of their anti-inflammatory and immunosuppressive mechanisms. “Transrepression” in immune cells—namely, direct ligation of the glucocorticoid receptor (GR) by a corticosteroid molecule followed by translocation to the nucleus to modulate transcription of numerous inflammatory genes—has been widely implicated as the major mechanism of action for glucocorticoids.
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