The Ubiquity and Limitations of Cortisone
Cortisone and related drugs are frequently used to treat various acute and chronic inflammatory conditions, ranging from sports injuries to asthma and diabetes.
Despite their rapid anti-inflammatory effects, the efficacy of these drugs wanes over time, and they are not without side effects such as osteoporosis, increased susceptibility to infections, and metabolic disorders.
A recent study led by Prof. Oliver Werz and Dr. Markus Werner, in collaboration with researchers from the University of Jena, Jena University Hospital, and Harvard Medical School, reveals crucial biochemical mechanisms that could optimize the use of cortisone.
The research, published in the journal PNAS, focuses on how cortisone affects human immune cells.
Two Phases of Inflammation
During an inflammatory reaction, pro-inflammatory M1 macrophages appear first, triggering symptoms like fever and pain through the release of substances like prostaglandins and leukotrienes.
Eventually, the body shifts to an inflammation-resolving phase, dominated by M2 macrophages that produce inflammation-resolving messengers, called resolvins.
The researchers found that cortisone influences enzymes, specifically 15-lipoxygenase-1 and 15-lipoxygenase-2, which regulate the activity of these macrophages.
Cortisone enhances the formation of resolvins in the early phase by upregulating 15-lipoxygenase-2 in M1 macrophages.
Conversely, it suppresses this formation in the later phase by inhibiting 15-lipoxygenase-1 in M2 macrophages.
The team confirmed these findings in patient samples, including those with Crohn’s disease, ulcerative colitis, and COVID-19-related inflammation, who were treated with cortisone. They found similar enzyme activity regulation, validating the cell culture results.
Future Directions
According to the study, understanding this enzyme regulation opens the door for time-limited cortisone use and new therapies based on 15-lipoxygenase, potentially reducing cortisone-related side effects.
This research brings us closer to personalized, more effective treatments for various inflammatory conditions.
“In essence, our findings could revolutionize the way we use cortisone, making treatments more effective and less harmful,” says Prof. Werz.
With more targeted use based on the phases of inflammation, cortisone therapy could see significant improvements in both efficacy and safety.
If you care about inflammation, please read studies that diabetes drug metformin may reverse liver inflammation, and aspirin and other drugs for inflammation could help prevent COVID-19 deaths.
For more information about inflammation, please see recent studies about the cause of severe inflammation in COVID-19, and results showing vitamin D can help reduce inflammation.
The study was published in PNAS.
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