Corticosteroids

Kapugi, Michelle; Cunningham, Kathleen Gallagher

doi:10.1097/nor.0000000000000595

Cited by 95 publications

(79 citation statements)

References 6 publications

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“…Based on its biological half-life in vivo , glucocorticoids could be further classified based on its length of effect, i.e., short-duration (8 to 12 h), medium-duration (12 to 36 h), and long-duration (36 to 72 h) drugs. For example, cortisone (hydrocortisone) has a biological half-life of 8 to 12 h. Prednisolone, methylprednisolone, or triamcinolone have a biological half-life of 12 to 36 h, whereas that of dexamethasone is 36 to72 h 24 , 25 . Although triamcinolone, prednisolone, and methylprednisolone are medium-duration drugs, methylprednisolone is preferred for the treatment of lung diseases because it achieves higher concentrations in the lung.…”

Section: Discussionmentioning

confidence: 99%

Glucocorticoids improve severe or critical COVID-19 by activating ACE2 and reducing IL-6 levels

Xiang¹,

Liu²,

Shi³

et al. 2020

Int. J. Biol. Sci.

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COVID-19 is a public health emergency that has rapidly spread to over 200 countries and regions, and no effective treatment has been established to date. Severe and critical cases have been associated with higher mortality due to acute respiratory distress syndrome (ARDS) and cytokine storm. Based on the novelty and recent emergence of COVID-19, no effective treatment regimen has been identified, thus prompting clinicians to engage in drug repurposing to address the immediate therapeutic need. This study focused on the molecular target angiotensin-converting enzyme 2 (ACE2) of SARS-CoV-2 and screened a group of ACE2 agonists by bioinformatics. Glucocorticoids are a type of ACE2 activator. We verified the efficacy of nine chemicals on regulating ACE2 expression in human GES-1, an upper digestive tract epithelial cell line, and THP-1, a human monocyte cell line, and found that several glucocorticoids imparted activating effects on ACE2 in both cell lines. The drugs triciribine and kinetin riboside activate ACE2 expression or inhibit IL-6 production in macrophages to some extent. In addition, we compared the efficacies of several glucocorticoids. Hydrocortisone showed the strongest effect on ACE2 activation, followed by prednisolone, dexamethasone, and methylprednisolone. We retrospectively analyzed the therapeutic efficacy of nine severe or critical patients from a cohort of 90 COVID-19 cases, who received medium to small doses of glucocorticoids from our integrated medical team in Wuhan. Seven out of nine patients revealed significant improvement in clinical parameters and chest CT images. This study provides experimental and clinical evidence that medium-to-low-dose glucocorticoids may play a protective role in the respiratory and digestive systems by activating ACE2 and suppressing cytokine storm.

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Section: Discussionmentioning

confidence: 99%

Glucocorticoids improve severe or critical COVID-19 by activating ACE2 and reducing IL-6 levels

Xiang¹,

Liu²,

Shi³

et al. 2020

Int. J. Biol. Sci.

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“…2,6,7 Esta classe farmacológica está associada a efeitos adversos metabólicos, musculoesqueléticos, infeciosos, cardiovasculares, dermatológicos e oftalmológicos, sendo por isso importante considerar a sua utilização de forma criteriosa. 12 O tratamento sintomático da dor também deve ser considerado, dado ser um sintoma frequente e, neste caso, a principal queixa do doente, tendo sido administrado um anti-inflamatório não esteroide. 5 Após o tratamento de fase aguda, muitos doentes necessitam de reabilitação motora e de vigilância a longo prazo, 6,9 sendo necessária uma articulação de cuidados multidisciplinar, nomeadamente entre CSP e secundários.…”

Section: Discussionunclassified

Síndrome de Ramsay Hunt: Um Caso Raro de Otalgia

Duarte¹,

Rebelo²,

Ferreira³

et al. 2020

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A síndrome de Ramsay Hunt é uma causa incomum de otalgia, caracterizada por uma tríade de otalgia, paralisia facial periférica ipsilateral e rash vesicular no ouvido externo ou orofaringe, causada pela reativação do vírus Varicella-Zoster.Descreve-se o caso de um homem de 21 anos que recorre aos Cuidados de Saúde Primários por otalgia como “picadas” à direita, com uma semana de evolução, diagnosticado com otite externa e medicado com antibioterapia tópica. Posteriormente desenvolve paralisia facial periférica direita, mantendo a otalgia e é diagnosticado com síndrome de Ramsay Hunt.Esta síndrome é uma condição médica emergente e potencialmente grave, que requer uma abordagem e tratamento precoces. O seu diagnóstico é clínico e o seu tratamento inclui fármacos antivíricos e corticosteroides. Este é muitas vezes protelado, estando associado a pior prognóstico e a possíveis complicações, como a nevralgia pós-herpética, úlceras da córnea de exposição e sequelas neurológicas.

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“…Steroids are commonly used to treat inflammation (Rafieian-kopaei et al 2017). However, they are also associated with adverse effects such as cardiovascular effects (fluid retention, hypertension), hyperglycaemia, insomnia, irritability, psychotic-like symptoms, rashes, gastric and oesophageal ulcerations, weight gain, immunosuppression, increased risk of osteoporosis, impaired wound healing and many more (Kapugi and Cunningham 2019).…”

Section: Introductionmentioning

confidence: 99%

The effect of ethanolic leaves extract of Hymenodictyon floribundun on inflammatory biomarkers: a data-driven approach

et al. 2021

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Background Medicinal plants are used to manage pain and inflammatory disorders in traditional medicine. A scientific investigation could serve as a basis for the determination of molecular mechanisms of antinociceptive and antiinflammatory actions of herbal products. In this work, we used both artificial intelligence (AI) based models inform of adaptive neuro-fuzzy inference system and artificial neural network (ANN) as well as a linear model, namely; stepwise linear regression in modelling the performance of four different inflammatory biomarkers namely; interleukin (1L)-1β, 1L-6, tumour necrosis factor (TNF)-α and prostaglandin E2 (PGE2). This modelling was done using number of abdominal writes, the reaction time of paw licking in mice and paw oedema diameter as the input variables. Results Four different performance indices were employed, which are determination coefficient (DC), root mean squared error (RMSE), mean square error (MSE) and correlation co-efficient (CC). The results have shown the superiority of the AI-based models over the linear model. Conclusions The overall quantitative and visualized comparison of the results showed that adaptive neuro-fuzzy inference system outperformed the ANN and SWLR models in modelling the performance of the four inflammation biomarkers in both the calibration and verification phases.

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Corticosteroids

Cited by 95 publications

References 6 publications

Glucocorticoids improve severe or critical COVID-19 by activating ACE2 and reducing IL-6 levels

Glucocorticoids improve severe or critical COVID-19 by activating ACE2 and reducing IL-6 levels

Síndrome de Ramsay Hunt: Um Caso Raro de Otalgia

The effect of ethanolic leaves extract of Hymenodictyon floribundun on inflammatory biomarkers: a data-driven approach

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