Corticosteroid

Asthma inhaler
An asthma inhaler. Getty Images

Synonyms: Steroids

Medical Specialties: Allergy/immunology, Internal medicine, Family medicine

Clinical Definition: Corticosteroids are synthetic compounds that produce physiological effects similar to the chemicals produced by the human adrenal cortex, an organ which sits atop each kidney. Corticosteroids decrease the inflammatory process and the immune system response, which may have a therapeutic effect on a variety of diseases.

In Our Own Words

Corticosteroids are a type of medication made to induce some of the same effects as the hormone, cortisol, which is produced naturally by the human adrenal gland. These medications are anti-inflammatory, meaning they reduce the production of inflammatory chemicals and decrease certain activities in immune cells. Although inflammation is part of the body’s natural system of defenses, it can also be excessive and lead to tissue injury.

Corticosteroids are commonly prescribed by doctors to treat a variety of medical conditions that involve destructive inflammation like arthritis, asthma, and lupus.

Clinical Uses of Corticosteroids

Asthma and COPD. Corticosteroids are used to relieve airway obstruction in conditions such as asthma. Steroids help people with asthma breathe easier and avoid future asthma attacks as well as live better quality lives. To a lesser extent, corticosteroids have proven useful when treating chronic obstructive pulmonary disease (COPD) — emphysema and chronic bronchitis — which is usually caused by smoking.

Corticosteroids have no direct effect on the smooth muscles that contract during airway obstruction and instead they reduce inflammation (and thus decrease the immune response).

Arthritis. With respect to rheumatoid arthritis, the more inflammation, the more severe the disease. Steroids help reduce inflammation in those with rheumatoid arthritis and are give orally.

With less inflammation, the pain of rheumatoid arthritis decreases. Other treatments for rheumatoid arthritis include methotrexate (an immunomodulator) and NSAIDs (think ibuprofen or naproxen) for pain relief. Alternatively, corticosteroid injections can be given into the joint in order to help with pain. Of note, with respect to osteoarthritis, oral or systemic corticosteroids don't help because osteoarthritis isn't inflammatory in nature. Instead, osteoarthritis is "wear and tear" of the joint cartilage that is exacerbated by excess weight, overuse, and injury. However, corticosteroid injections into joint spaces may help with pain.

Topical corticosteroids.Topical corticosteroids in the form of creams help with a variety of inflammatory skin conditions including acne, psoriasis, eczema, dermatitis, and rosacea.

Autoimmune disease. In addition to rheumatoid arthritis, oral or systemic corticosteroids are used to treat a variety of autoimmune diseases including the following:

  • Glomerulonephritis (kidney disease)
  • Grave's disease (thyroid disease)
  • Myasthenia gravis
  • Multiple sclerosis
  • Polymyositis

The immune system is the collection of cells and tissues that protect your body from infection. Sometimes your immune system turns on itself and attacks your body's healthy cells using anitibodies and immune cells. Corticosteroids help to dampen this pathological immune response.

Sources:

The Cleveland Clinic. Health Library. clevelandclinic.org. Accessed July 2013.

Gardenhire, Douglas S. EdD(C) RRT. Rau’s Respiratory Care Pharmacology. Mosby 2011. Accessed July 2013.

Harvard Medical School. Medical Dictionary of Health Terms. Harvard Health publications. Accessed July 2013.

The Cleveland Clinic. Health Library. Accessed July 2013.

The John Hopkins Lupus Center. Steroids. Accessed July 2013.

Continue Reading