Corticosteroids

Corticosteroids are a group of steroid hormones synthesized by the adrenal cortex from cholesterol. They are a key link in the body’s adaptation to stress, regulating energy metabolism, inflammatory responses, immune activity, and water-electrolyte balance.

In clinical practice, both endogenous hormones and their synthetic analogs, which mimic or enhance physical effects, are used.

Types of corticosteroids

Corticosteroids are divided into two main groups, differing in functions and targets:

• glucocorticoids: regulate carbohydrate, protein, and fat metabolism, participate in stress adaptation and control inflammation;
• mineralocorticoids: responsible for maintaining blood volume, blood pressure, and the balance of sodium, potassium, and water.

The main physiological glucocorticoid is cortisol, while the key mineralocorticoid is aldosterone.

Physiological role in the body

Corticosteroids are essential for the survival and normal functioning of all body systems. Their functions include:

• maintaining blood glucose levels by stimulating gluconeogenesis;
• mobilization of fatty acids and amino acids under stress;
• limiting excessive inflammatory response;
• modulating immune system activity;
• regulating vascular tone and blood pressure.

In the case of corticosteroid deficiency, the body’s ability to adapt to stress, infections, and injuries is impaired.

Mechanism of action

Corticosteroids penetrate the cell and bind to intracellular receptors. The formed complex interacts with DNA, altering protein synthesis. As a result:

• the production of pro-inflammatory cytokines decreases;
• the activity of immune cells is reduced;
• the metabolism of carbohydrates, fats, and proteins is altered.

These effects develop gradually, which explains the delay in the clinical action of hormones.

Indications for use

Synthetic corticosteroids are used in conditions accompanied by inflammation, autoimmune reactions, or hormonal deficiency:

• bronchial asthma and chronic inflammatory diseases of the respiratory tract;
• allergic reactions of varying severity;
• autoimmune and systemic inflammatory diseases;
• joint and connective tissue diseases;
• adrenal insufficiency.

Side effects and risks

With prolonged or uncontrolled use, corticosteroids can disrupt the body’s natural regulatory mechanisms:

• weight gain and redistribution of adipose tissue;
• increased blood glucose levels and insulin resistance;
• decreased bone density;
• suppression of immune defense;
• suppression of the adrenal glands’ own function.

Sudden withdrawal of the drugs can lead to withdrawal syndrome and acute hormonal deficiency.

Conclusion

Corticosteroids are fundamental hormones that ensure the body’s adaptation to stress and maintenance of internal balance. In medicine, they remain one of the most effective anti-inflammatory agents, but require a balanced and individualized approach. Optimal dosages, duration of use, and gradual withdrawal are crucial for preserving health and minimizing side effects.