Papers of The 11th Japan Scar Workshop

4. Pharmacological activities of glucocorticoids

Norihisa Inazu
Faculty of Pharmaceutical Sciences, Teikyo Heisei University, Tokyo, Japan

Glucocorticoids have an 11β-hydroxy group in their steroid structure and have strong anti-inflammatory properties. In particular, they significantly inhibit the biosynthesis of prostaglandins and leukotrienes by reducing the levels of cyclooxygenase 2 and phospholipase A2. They also reduce the expression of proinflammatory cytokines such as interleukins and tumor necrosis factor-α. Moreover, they induce the expression of lipocortin, α2-adrenoreceptor, and angiotensin-converting enzyme. Furthermore, glucocorticoids inhibit the exudation of plasma fluids from arterioles. Side effects of externally or locally administered glucocorticoids include inhibition of cellular proliferation, hormone activities such as acne and hirsutism, immunosuppression that promotes bacterial, fungal, and viral infections, and glaucoma and cataract. However, externally or locally administered glucocorticoids never induce the moon face and central obesity that are well-known side effects of orally or intravenously administered glucocorticoids. Plastic surgeons and dermatologists should be aware of the significant adverse side effects that associate with long-term glucocorticoid therapy and should consider alternative therapies that have fewer side effects.
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