Glucocorticoids immunosuppressive action

Glucocorticoids phospholipase A2 activity —> contributes to both antiinflammatory and immunosuppressive actions... 

De Bosscher, K., Vanden Berghe, W., and Haegeman G., Mechanisms of anti-inflammatory action and of immunosuppression by glucocorticoids Negative interference of activated glucocorticoid receptor with transcription factors, J. Neuroimmunol., 109, 16, 2000. 

The anti-inflammatory and immunosuppressive effects of glucocorticoids are largely due to the actions described above. In humans, complement activation is unaltered, but its effects are inhibited. Antibody production can be reduced by large doses of steroids, although it is unaffected by moderate doses (eg, 20 mg/d of prednisone). 

Franchimont D. Overview of the actions of glucocorticoids on the immune response a good model to characterize new pathways of immunosuppression for new treatment strategies. Ann NY Acad Sci. 2004 1024 124-137. 

Mechanism of Action. Cyclosporine and tacrolimus (see below) are known as calcineurin inhibitors because they inhibit a specific protein (calcineurin) in lymphoid tissues. This inhibition ultimately suppresses the production of IL-2, a cytokine that plays a critical role in immune response by promoting the growth and proliferation of activated T lymphocytes and other immune cells, such as NK. cells (see Fig. 37—1).5,52 Thus, cyclosporine is one of the premier immunosuppressants because of its relative selectivity for T cells and its inhibition of a key mediator of the immune response (IL-2).41 This relatively specific inhibition is often advantageous when compared with other nonse-lective drugs such as azathioprine, cyclophosphamide, and glucocorticoids that inhibit virtually all the cells and chemical mediators involved in the immune response. 

Note The glucocorticoids possess a plethora of physiological actions, including a role in differentiation and development. They are vital in die treatment of adrenal insufficiency and are used extensively in large pharmacological doses as anti-inflammatory and immunosuppressive agents. 

The glucocorticoids are immunosuppressants both by virtue of their antiinflammatory properties and their actions against the immune responses. The basis of these is discussed under other headings see antiinflammatory agents corticosteroids glucocorticoids. 

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