Immune Monitoring of Glucocorticoid Therapy
Glucocorticoids (GC) are broadly used to inhibit undesired immune reactions. They are applied both topically (inhalation, ointment) and systemically (per os, i.v.). Although they have been therapeutically used for decades now, the molecular mechanism of action has continued to be obscure. Recently we have learned more about the molecular targets of GC. Following binding to the intracellular GC receptor complex, the ligand/receptor/heat shock protein complex translocates into the nucleus and interacts with both transcription factors (like NFκB) and DNA (via GC responsive elements in various promoter regions) mediating transactivating or transrepressing mechanisms (Table 1). Both pathways mediate the anti-inflammatory properties of GC, whereas the side effects are mainly induced via the transactivating mechanisms. Recent results (this volume) suggest that it might be possible to separate the transactivating and transrepressing effects of GC in order to promote anti-inflammatory properties in absence of most of the side effects.
KeywordsOptic Neuritis Glucocorticoid Therapy Immune Monitoring Tumour Necrosis Factor Release Healthy Proband
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