Where do the side effects with cortisone come from? Cause research successfully completed

Researchers have clarified the cause of side effects with cortisone preparations

Although cortisone is used successfully in numerous diseases, it often causes unwanted side effects, including in the metabolism. Why this is so, was now an international research team enlighten.

Drug with a wide range of applications

Cortisone is prescribed by doctors for many different conditions. Often it is used for inflammation and allergic reactions. Among other things, it is also administered for skin diseases, rheumatism, asthma bonchiale, intestinal diseases or multiple sclerosis. Although hardly any other drug has such a range of applications, many patients have reservations or fear of the side effects of cortisone. Researchers were now able to elucidate the cause of certain side effects with cortisone preparations.

Patients treated with cortisone preparations may have unwanted side effects. Researchers have now elucidated the cause of certain side effects. (Image: eenevski / fotolia.com)

Side effects in the metabolism

In patients who are long term with anti-inflammatory steroids, side effects may occur in the metabolism.

Researchers at the Helmholtz Zentrum München and the Ludwig-Maximilians-Universität München (LMU), members of the German Center for Diabetes Research (DZD), have now been able to elucidate a mechanism with international colleagues that leads to this so-called steroid diabetes.

The results have been published in the journal "Nature Communications".

Steroid diabetes

"Glucocorticoids such as cortisone have been used for many decades for the treatment of inflammatory diseases such as asthma or rheumatism and are the most prescribed preparation for anti-inflammatory treatment," explains Prof. Dr. med. Henriette Uhlenhaut in a message.

"But they are also used for autoimmune diseases, organ transplants or cancer," says the group leader at the Institute for Diabetes and Obesity at Helmholtz Zentrum München (IDO) and at the Gene Center of the LMU.

"According to estimates, between one and three percent of people in the Western world are treated with it, which would currently correspond to over one million people in Germany."

However, their versatility is limited by various side effects that can occur during therapy. These include undesirable effects on the metabolism.

Because after the glucocorticoids have bound to their receptor in the body's cells, it begins to turn numerous genes on and off.

"This includes various metabolic genes, which in consequence can lead to so-called steroid diabetes," explains Henriette Uhlenhaut.

New therapeutic intervention options

In the current study, her team, together with colleagues from the Max Delbrück Center for Molecular Medicine in Berlin, the Salk Institute in San Diego and the University of Freiburg, investigated the exact mechanisms that follow the binding of steroids to the receptor.

"We were particularly struck by the transcription factor E47, which together with the glucocorticoid receptor provides for the altered gene activities, especially in liver cells," says Charlotte Hemmer, PhD student at the IDO and first author of the current work.

"We were able to work out this connection through genome-wide analyzes and genetic experiments."

To substantiate their findings, the scientists also examined the relationships in a preclinical model.

"In fact, the absence of E47 in this case protected against the negative effects of glucocorticoids, while steroid administration in intact E47 was associated with metabolic changes such as hypoglycaemia, elevated blood lipids or fatty liver," explains Charlotte Hemmer.

Since the components of the newly found mechanism also exist in humans, Uhlenhaut and her team, together with clinical cooperation partners, want to find out in future whether the results will be confirmed there.

"In this case, new therapeutic intervention options could be offered to counteract the side effects of steroid therapy with safer immunosuppressive drugs," hopes Henriette Uhlenhaut. (Ad)