Article ; Online: Fresh insights into glucocorticoid-induced diabetes mellitus and new therapeutic directions.
2022 Volume 18, Issue 9, Page(s) 540–557
Abstract: Glucocorticoid hormones were discovered to have use as potent anti-inflammatory and immunosuppressive therapeutics in the 1940s and their continued use and development have successfully revolutionized the management of acute and chronic inflammatory ... ...
Abstract | Glucocorticoid hormones were discovered to have use as potent anti-inflammatory and immunosuppressive therapeutics in the 1940s and their continued use and development have successfully revolutionized the management of acute and chronic inflammatory diseases. However, long-term use of glucocorticoids is severely hampered by undesirable metabolic complications, including the development of type 2 diabetes mellitus. These effects occur due to glucocorticoid receptor activation within multiple tissues, which results in inter-organ crosstalk that increases hepatic glucose production and inhibits peripheral glucose uptake. Despite the high prevalence of glucocorticoid-induced hyperglycaemia associated with their routine clinical use, treatment protocols for optimal management of the metabolic adverse effects are lacking or underutilized. The type, dose and potency of the glucocorticoid administered dictates the choice of hypoglycaemic intervention (non-insulin or insulin therapy) that should be provided to patients. The longstanding quest to identify dissociated glucocorticoid receptor agonists to separate the hyperglycaemic complications of glucocorticoids from their therapeutically beneficial anti-inflammatory effects is ongoing, with selective glucocorticoid receptor modulators in clinical testing. Promising areas of preclinical research include new mechanisms to disrupt glucocorticoid signalling in a tissue-selective manner and the identification of novel targets that can selectively dissociate the effects of glucocorticoids. These research arms share the ultimate goal of achieving the anti-inflammatory actions of glucocorticoids without the metabolic consequences. |
---|---|
MeSH term(s) | Anti-Inflammatory Agents/adverse effects ; Diabetes Mellitus, Type 2/drug therapy ; Glucocorticoids/adverse effects ; Humans ; Immunosuppressive Agents/pharmacology ; Receptors, Glucocorticoid/metabolism |
Chemical Substances | Anti-Inflammatory Agents ; Glucocorticoids ; Immunosuppressive Agents ; Receptors, Glucocorticoid |
Language | English |
Publishing date | 2022-05-18 |
Publishing country | England |
Document type | Journal Article ; Review ; Research Support, Non-U.S. Gov't |
ZDB-ID | 2489381-X |
ISSN | 1759-5037 ; 1759-5029 |
ISSN (online) | 1759-5037 |
ISSN | 1759-5029 |
DOI | 10.1038/s41574-022-00683-6 |
Database | MEDical Literature Analysis and Retrieval System OnLINE |
More links
Kategorien
In stock of ZB MED Cologne/Königswinter
Zs.A 6336: Show issues | Location: Je nach Verfügbarkeit (siehe Angabe bei Bestand) bis Jg. 2021: Bestellungen von Artikeln über das Online-Bestellformular ab Jg. 2022: Lesesaal (EG) |
|||
Zs.MG 93: Show issues |
Order via subito
This service is chargeable due to the Delivery terms set by subito. Orders including an article and supplementary material will be classified as separate orders. In these cases, fees will be demanded for each order.