What does cortisone do
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The Multifaceted Effects of Cortisone
Introduction to Cortisone
Cortisone, a steroid hormone, has been a significant medical discovery since its introduction in the late 1940s. Initially known as "compound E," cortisone quickly gained attention for its potential therapeutic benefits, particularly in treating rheumatoid arthritis (RA) 16. This article explores the various physiological effects of cortisone, its therapeutic applications, and its impact on infections and immune responses.
Anti-Inflammatory and Immunosuppressive Properties
Suppression of Inflammation and Pain
Cortisone is widely recognized for its potent anti-inflammatory properties. It diminishes fibroblastic proliferation, suppresses fever, local inflammatory manifestations, and pain . These effects make cortisone a valuable treatment for conditions characterized by inflammation, such as rheumatoid arthritis and other chronic inflammatory diseases 16.
Inhibition of Allergic Processes
Cortisone also inhibits certain allergic processes, which contributes to its effectiveness in treating allergic conditions like phlyctenular keratoconjunctivitis and vernal conjunctivitis 210. This inhibition helps reduce symptoms and improve patient outcomes in allergic reactions.
Therapeutic Applications
Treatment of Rheumatoid Arthritis
One of the most notable uses of cortisone is in the treatment of rheumatoid arthritis. Early studies demonstrated that cortisone could provide remarkable relief from the symptoms of RA, leading to its widespread adoption in clinical practice 16. Despite its effectiveness, the long-term use of cortisone in chronic diseases requires careful management due to potential side effects .
Management of Viral Infections
Cortisone has shown mixed results in the management of viral infections. For instance, in chick embryos infected with influenza B virus, cortisone administration prolonged survival and suppressed inflammation when injected 24-42 hours post-infection . However, its overall impact on viral infections varies depending on the timing and dosage of administration.
Influence on Tumor Growth
Research on cortisone's effect on tumors has revealed complex outcomes. While cortisone temporarily inhibited the growth rate of transplanted adenocarcinomas in mice, it also increased the metastatic spread of experimental tumors . These findings highlight the need for cautious application of cortisone in cancer treatment.
Impact on Infections and Immune Response
Enhanced Susceptibility to Infections
Cortisone significantly affects the host's immune response, often enhancing susceptibility to various infections. It disrupts the natural host-parasite relationship, favoring the parasite and leading to increased infection rates with agents like pneumococci, tubercle bacilli, and influenza viruses . This immunosuppressive effect is a critical consideration in cortisone therapy, especially in patients with compromised immune systems.
Effects on Phagocytosis and Reticuloendothelial System
Cortisone has been shown to reduce the resistance of mammals to bacteria, viruses, and fungi by depressing the functions of the reticuloendothelial system (RES) . This reduction in RES activity impairs the body's ability to clear infections, further contributing to the increased risk of infections during cortisone therapy.
Conclusion
Cortisone is a powerful anti-inflammatory and immunosuppressive agent with a wide range of therapeutic applications. Its ability to suppress inflammation and pain makes it invaluable in treating conditions like rheumatoid arthritis and allergic reactions. However, its immunosuppressive properties also increase the risk of infections, necessitating careful management and monitoring during therapy. Understanding the multifaceted effects of cortisone is crucial for optimizing its use in clinical practice while minimizing potential adverse effects.
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