Mechanisms of immunosuppression by glucocorticoids

Glucocorticoids are of great clinical importance in the treatment of autoimmune diseases. However, their immunosuppressive action is associated with many potentially serious side effects, such as hypertension, hyperglycemia, osteoporosis, weight gain and predisposition to infections. So far, it has been impossible to separate the immunomodulatory action of glucocorticoid analogs from their untoward effects, reflecting the fact that most, if not all, cortisol effects are mediated through a single nuclear receptor molecule. Hence, the better understanding of the molecular basis of steroids on the inflammatory response are pivotal for the potential development of more selective immunosuppressive agents.