Physiologic Effects of Glucocorticoids

Glucocorticoids exert a number of diverse physiologic effects, which are briefly discussed below. 

FIGURE 29-4 T Effects of cortisol on muscle, fat, and liver cells. Cortisol causes the breakdown of muscle and fat into amino acids and free fatty acids, which can be used by the liver to produce glucose. 

Glucocorticoids are effective and potent anti-inflammatory agents. Regardless of the cause of the inflammation, glucocorticoids attenuate the heat, erythema, swelling, and tenderness of the affected area. The exact way that these agents intervene in the inflammatory process is complex and not completely under- 

Finally, high doses of glucocorticoids appear to stabilize lysosomal membranes, thereby making them less fragile and susceptible to rupture.35 Lysosomes are subcellular organelles that contain a variety of degra- 

Cortisol and similar glucocorticoids affect a variety of other tissues.62 These hormones affect renal function by enhancing sodium and water reabsorption and by impairing the ability of the kidneys to excrete a water load. They alter central nervous system (CNS) func- 

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The primary glucocorticoid released in humans is cortisol (also known as hydrocortisone). Cortisol synthesis and secretion are under the control of specific hypothalamic and pituitary hormones.7,24 31 Corticotropinreleasing hormone (CRH) from the hypothalamus stimulates the release of adrenocorticotropic hormone (ACTH) from the anterior pituitary. ACTH travels in the systemic circulation to reach the adrenal cortex, where it stimulates cortisol synthesis. Cortisol then travels in the bloodstream to various target tissues to exert a number of physiologic effects (see Physiologic Effects of Glucocorticoids, later). 

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