Glucocorticoids: What are they? How Do These Hormones Work? Medical Uses, Types, Side Effects and Risks

These hormones help the process of flow of carbohydrates consumed, because of this, they are of great importance in the human being.

Glucocorticoids are essential hormones for life, since their main action is to help the metabolic process of the human being.

How do these hormones work?

The secretion of these hormones is controlled by the hypothalamic-pituitary-adrenal axis. The corticotropin-releasing hormone (CRH), which acts on the anterior pituitary to stimulate the pituitary secretion of adrenocorticotropic hormone (ACTH by its acronym in English).

ACTH is another hormone that acts on the adrenal cortex to stimulate the production and secretion of glucocorticoids, thus forming a dependence on one hormone with the other for its functioning.

In most cases, people suffering from body depression, the glucocorticoid works to maintain homeostasis, both in response to changes in normal metabolism, and in unpleasant disturbances.

Glucocorticoid hormones regulate physiological procedures including metabolism and cardiovascular function .

They are also involved with the red blood cells that are found in the body. They also have familiarity with CRH, which is another hormone that is responsible for the release of stress in the human being.

That is, we note a hormone close to another for its functioning, in general most organs work under this methodology or system for the benefit of the daily functioning of the human body.

Medical uses

Glucocorticoids are powerful medications that fight inflammation and work with your immune system to treat a wide range of health problems.

Your body actually produces its own glucocorticoids. Sometimes, however, they are not enough. That’s when the man-made versions can help.

How do they work?

Inflammation is the response of your immune system to an injury or infection. It causes your body to produce more white blood cells and chemicals to help it heal. Sometimes, however, that response is too strong and can even be dangerous.

The asthma , for example, is an inflammation of the airways that can prevent breathing.

If you have an autoimmune disease, your body triggers inflammation by mistake. That means that your immune system attacks healthy cells and tissues as if they were viruses or bacteria.

Glucocorticoids prevent your body from pumping many of the chemicals involved in inflammation. They can also turn back the response of their immune system by changing the way white blood cells work.

Conditions that treat

Glucocorticoids treat many conditions that are caused by inflammation, such as:

  • Asthma .
  • Chronic obstructive pulmonary disease (COPD).
  • Allergies
  • Rheumatoid arthritis .
  • Osteoarthritis.
  • Crohn’s disease and other types of inflammatory bowel disease.
  • Eczema and other skin conditions.
  • Multiple sclerosis.
  • Tendinitis.
  • Lupus.

Doctors also prescribe glucocorticoids for people who undergo organ transplants .

After the procedure, your immune system sees the new organ as an invader and attacks it. Drugs that lower your immune system, such as glucocorticoids, can prevent your body from rejecting the new organ.

Types of glucocorticoids

A glucocorticoid is a type of steroid. The type you need depends on the specific health condition you have.

Among the most common are:

Side effects

How glucocorticoids affect you will depend on the specific medication or dose you take. For example, if you only take one once in a while for outbreaks of joint inflammation, it may not have any side effects.

Common problems include:

  • Weight gain.
  • Feeling very hungry
  • Water retention or swelling
  • Humor changes.
  • Blurry vision.
  • Nervousness or restlessness
  • Problems to sleep.
  • Muscular weakness.
  • Acne .
  • Stomach irritation

What are the risks?

In general, it is safe for most people to take glucocorticoids for a while. But using them for a long time can cause health problems, which include:

  • Osteoporosis, when bones weaken and break easily.
  • High blood pressure
  • Diabetes

If you notice any change in how you feel while taking these medications, be sure to tell your doctor.

If you are pregnant or breast-feeding, talk with your doctor about the risks and benefits of prednisone and other glucocorticoids.

These medications can be a slight risk to your baby. However, if you take them because you have a serious health problem or a life-threatening illness, continuing with your treatment may be preferable compared to the possibility of medications hurting your baby.

Tell your doctor if you have any of these medical problems before you start taking a glucocorticoid:

  • Cataracts or glaucoma .
  • Heart attack or congestive heart failure.
  • High blood pressure
  • Thyroid disease
  • Peptic Ulcer .
  • Diabetes.
  • Depression or other mood disorders.
  • Kidney disease
  • Problems of the adrenal gland .

Glucocorticoids and cancer

Glucocorticoids have been used in clinical oncology for more than half a century.

The clinical applications of glucocorticoids in oncology depend mainly on their proapoptotic action to treat lymphoproliferative disorders , and also to alleviate the side effects induced by chemotherapy or radiotherapy in non-haematological types of cancer.

Research in recent years has begun to reveal the profound complexity of glucocorticoid signaling and has contributed significantly to therapeutic strategies.

However, it remains striking and puzzling how glucocorticoids use different mechanisms in different types of cancer and different targets to promote or inhibit tumor progression.

Currently studies are being conducted on the actions of glucocorticoid signaling during tumor progression and metastasis .

Glucocorticoids have been used as anticancer agents since the 1940s, with activity reported in a wide variety of solid tumors, including breast and prostate cancer, and malignant lymphoid hematologic tumors.

They are commonly found in regimens of acute lymphocytic leukemia, Hodgkin’s and non-Hodgkin’s lymphoma , myeloma, and chronic lymphocytic leukemia.

Multiple myeloma

Several studies suggesting a benefit of the use of glucocorticoids in refractory multiple myeloma have been reported.

Alexanian et al. They reported the use of pulse therapy with prednisone in patients with myeloma refractory to melphalan (Alkeran). Prednisone was administered at 60 mg / m 2 / day for 5 of 8 days, for three pulses, followed by a 3-week rest, with the cycle repeated.

The researchers noticed a reduction of more than 50% in the tumor mass in 5 of 16 patients, and found that the patients who responded benefited clinically with less pain, better performance status and increased hemoglobin.

Non-Hodgkin lymphoma

In 1996, Newcom reported the outcome of two patients with refractory and poorly differentiated lymphocytic lymphoma who had been treated with continuous glucocorticoids (prednisone, 60 to 100 mg / day).

Both patients improved within 3 weeks after the start of prednisone as a single agent and reportedly experienced regression of the nodes and organomegaly, as well as an improvement in function.

However, patients died 14 and 15 months after the start of prednisone therapy.

Breast cancer

They have been used in the primary treatment of breast cancer in elderly women after the failure of first-line hormone therapy.

Minton et al. They followed 91 women aged 65 or older in whom the disease progressed after initial hormone therapy with estrogens , tamoxifen (Nolvadex) or androgens.

A 1 month untreated period was recommended to control an abstinence response.

The majority of patients received prednisolone, 15 mg daily, and 10 patients received hydrocortisone acetate, 75 mg daily.

Objective responses were observed in 13 patients (14%). Another (21%) achieved stable disease for at least 6 months.

There was no correlation with any previous response to endocrine therapy, and the toxicity was considered acceptable. Unfortunately, the authors did not report a clinical benefit as patients reported subjectively.

Prostate cancer

Hormone therapy is well established in the treatment of prostate cancer. However, progressive disease after the failure of hormone therapy is a difficult problem for patients in this context.

Tannock and his colleagues at Princess Margaret Hospital in Toronto have reported their experience with prednisone in the treatment of hormone-refractory disease.

In an informative study, these investigators prospectively treated 37 men with symptomatic bone metastases with 7.5 to 10 mg of prednisone daily.

Pain scores were assessed by three different measures at monthly intervals.

An improvement was reported in the three pain scales without an increase in opioid doses for a minimum of 1 month in 14 (38%) patients.

The responses did not correlate with alkaline or acid phosphatase measurements, but they did seem to correlate with the suppression of adrenal androgens .

Although the average duration of the response was only slightly longer than 4 months, the researchers concluded that there was an improvement in the quality of life with little toxicity or expense.

These investigators have now reported the superiority of the combination of mitoxantrone (Novantrone) and prednisone as a palliative for a similar group of patients; however, this therapy was not associated with a survival advantage.