Topical glucocorticosteroids: modern options
It is difficult to imagine the treatment of a number of inflammatory dermatoses without the use of external medications that contain corticosteroid hormones (glucocorticoids). Let's talk about the possibilities of steroid drugs.
Anti-inflammatory effect
The anti-inflammatory effect of topical glucocorticoids in the skin is achieved through various pathways, but the most important is the mechanism mediated by cytosolic glucocorticoid receptors. The essence of the mechanism is that the hormone-receptor complex, penetrating the nucleus of the target skin cell, increases the expression of genes encoding lipocortin synthesis, which suppress the activity of lysosomal phospholipase A2. This leads to a decrease in the release of arachidonic acid from membrane phospholipids and the formation of inflammatory mediators - prostaglandins and leukotrienes. GCS inhibit the synthesis of several cytokines, including interleukins 1, 2, 6, 10, tumor necrosis factor in various cell types by interacting with the nuclear receptor for corticosteroids, which causes repression of cytokine gene transcription.
Another important mechanism of anti-inflammatory action of steroids is a decrease in the stability of mRNA cytokines and an increase in susceptibility to apoptosis. Topical glucocorticosteroids have a pronounced antiallergic effect by inhibiting the migration of lymphocytes, granulocytes, Langerhans cells and inhibiting their function in areas of inflammation due to the suppression of the expression of adhesion molecules. The cessation of the synthesis of inflammatory mediators quickly leads to the restoration of impaired permeability of the vessel walls, their narrowing, and a decrease in exudation.
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