Central nervous system effects of natural and synthetic glucocorticoids

Abstract

Natural glucocorticoids (NGC) physiologically modulate body homeostasis and coordinate adaptive responses to stress, involving almost all organs and tissues, including brain. Since their therapeutic availability, synthetic GC (SGC) have been successfully prescribed for a variety of diseases. Mounting evidence, however, demonstrated pleiotropic adverse effects (AE), including central nervous system (CNS) disturbances, which are often misdiagnosed or underestimated. The aim of the present study was therefore to review and discuss the CNS effects of both NGC and SGC. A detailed search was carried out of the available literature using the PubMed (US National Library of Medicine) database. Cortisolemia plays a crucial role in control of behavior, cognition, mood, and early life programming of stress reactivity. Hypercortisolemia or SGC treatments may induce behavioral, psychic and cognitive disturbances, due to functional and, over time, structural alterations in specific brain target areas. These AE are generally dose and time dependent (infrequent at prednisone-equivalent doses <20 mg/day) and usually reversible. Pediatric patients are particularly susceptible. Behavioral changes, including feeding and sleeping modifications, are common. Psychic AE are unpredictable and heterogeneous, usually mild/ moderate, severe in 5-10% of cases. Manic symptoms have been mostly associated with short SGC courses, and depressive disorder with long-term treatments. Suicidality has been reported. Cognitive AE peculiarly affect declarative memory performance. Physiologic levels of NGC are essential for efficient brain functions. Otherwise, hypercortisolemia and SGC treatments may cause dose-/time-dependent neuropsychic AE and, over time, structural alterations in brain target areas. Clinicians should carefully monitor patients, especially children and/or when administering high doses SGC.

Negative illness perceptions are associated with impaired quality of life in patients after long-term remission of Cushing's syndrome

“…Following successful treatment of hypercortisolism, signs and symptoms improve substantially. However, prolonged, excessive exposure to glucocorticoids may have long-lasting adverse effects on behavioral and cognitive functions, due to functional and structural alterations in specific brain target areas (1)(2)(3)(4). Furthermore, these patients do not completely return to their premorbid level of functioning, and quality of life (QoL) is persistently impaired despite long-term cure of CS (5).…”

CXCL8, IL-1β and sCD200 are pro-inflammatory cytokines and their levels increase in the circulation of breast carcinoma patients

“…However, the groups in the present study consisted of overweight subjects, not obese. Adipose tissue functions as an endocrine organ and secretes bioactive molecules (33,34), and several epidemiological studies have established a consistent association between obesity and cancer (31). One study found a positive association between CRP levels and postmenopausal breast cancer risk, which was restricted to women with excess adiposity (35).…”

Оментин-1 У Хворих На Цукровий Дiабет 2 Типу: Зв'язок З Атерогенезом

“…Виявлення кореляцiйних зв'язкiв цирку-ляторних рiвнiв оментину-1 з iншими гормо-нально-метаболiчними або iнструментальни-ми показниками не довело асоцiацiї цього адипокiну з параметрами iнсулiнорезистен-тностi та ожирiння. Останнє спiвпадає з лi-тературними даними щодо вiдсутностi зале-жностi рiвнiв оментину-1 вiд загальної маси жирової тканини тiла та, зокрема, маси бiлої жирової тканини [21]. Однак оментин-1 був обернено зв'язаний з таким прозапальним чинником, як IЛ-1β (r = -0,312; Р = 0,008), що може вiддзеркалювати гальмiвний вплив процесiв запалення на синтез та/або секре-цiю оментина-1.…”