Chapter 4. Dissociated Glucocorticoids

  1. Ian M. Adcock and
  2. Kian Fan Chung
  1. Ian M. Adcock

Published Online: 18 MAR 2008

DOI: 10.1002/9780470985731.ch4

Overcoming Steroid Insensitivity in Respiratory Disease

Overcoming Steroid Insensitivity in Respiratory Disease

How to Cite

Adcock, I. M. (2008) Dissociated Glucocorticoids, in Overcoming Steroid Insensitivity in Respiratory Disease (eds I. M. Adcock and K. F. Chung), John Wiley & Sons, Ltd, Chichester, UK. doi: 10.1002/9780470985731.ch4

Editor Information

  1. Airways Disease Section, National Heart and Lung Institute, Imperial College London, London, UK

Author Information

  1. Airways Disease Section, National Heart and Lung Institute, Imperial College London, London, UK

Publication History

  1. Published Online: 18 MAR 2008
  2. Published Print: 14 MAR 2008

ISBN Information

Print ISBN: 9780470058084

Online ISBN: 9780470985731

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Keywords:

  • glucocorticoid receptor;
  • side effects;
  • gene expression;
  • Inflammation;
  • dissociated steroids;
  • COPD

Summary

Since the discovery of the therapeutic utility of glucocorticoids in the 1950's they have been the mainstay of treatment for chronic inflammatory diseases. However, their debilitating side effects have tempered their use. Both the beneficial and detrimental effects of glucocorticoids are mediated through the same receptor (glucocorticoid receptor, GR). The improved understanding of the molecular mechanisms of GR action along with the description of the GR-ligand crystal structure has enabled significant progress to be made toward minimizing side effects through the use of increasingly selective molecules. These discoveries are likely to generate significant new opportunities for the enhancement of the therapeutic index by dissociating the ability of GR to mediate its beneficial effects from its detrimental side-effects.