Man made (synthetic) corticosteriods are used to treat a large number of conditions and symptoms. Corticosteriods are used as a replacement therapy when the body is not naturally producing enough of its own of natural corticosteriods. They are also used to treat conditions where there is inflammation, autoimmune conditions or allergy symptoms. Corticosteriod can be taken orally as a systemic treatment to treat the body as a whole or it can be applied to the affected area for a local effect as creams, inhalations, nasal sprays, eye drops, ear drops or injections. Examples of conditions they treat are allergies, asthma, COPD, dermatitis, ulcerative colitis, Crohn’s disease, multiple sclerosis, nephrotic syndrome, adrenal insufficiency, inflammation, Addison’s disease, rheumatic conditions such as arthritis, fibromyalgia and lupus.
“Most of the known effects of the glucocorticoids are mediated by widely distributed glucocorticoid receptors. These proteins are members of the superfamily of nuclear receptors that includes steroid, sterol (vitamin D), thyroid, retinoic acid, and many other receptors with unknown or nonexistent ligands (orphan receptors). All these receptors interact with the promoters of and regulate the transcription of target genes . In the absence of the hormonal ligand, glucocorticoid receptors are primarily cytoplasmic, in oligomeric complexes with heat shock proteins (Hsp). The most important of these are two molecules of Hsp90, although other proteins are certainly involved. Free hormone from the plasma and interstitial fluid enters the cell and binds to the receptor, inducing conformational changes that allow it to dissociate from the heat shock proteins. The ligand-bound receptor complex then is actively transported into the nucleus, where it interacts with DNA and nuclear proteins. As a homodimer, it binds to glucocorticoid receptor elements (GRE) in the promoters of responsive genes. The GRE is composed of two palindromic sequences that bind to the hormone receptor dimer.