Whether you have a sports injury, repetitive strain injury or pain in the knee, cortisone preparations are often used to treat acute inflammations. Chronic inflammatory diseases such as asthma, diabetes and chronic inflammatory bowel diseases are also treated with drugs containing cortisone or derived drugs. This is because these drugs usually have a rapid anti-inflammatory effect.
appear first, including M1 macrophages. They produce pro-inflammatory messenger substances , which trigger the typical symptoms, such as fever and pain. After a few days, the second phase follows, in which the inflammation subsides. At that point, macrophages of the"M2" type are increasingly active, which produce inflammation-resolving messenger substances .
This effect is regulated by the 15-lipoxygenase enzymes, which occur in two forms in immune cells: 15-lipoxygenase-1 and 15-lipoxygenase-2."We found that cortisone upregulates 15-lipoxygenase-2 in pro-inflammatory M1 macrophages of the early inflammatory phase. This enzyme catalyzes the formation of resolvins, thereby stopping and resolving inflammatory processes, which is partly responsible for the positive effects of cortisone," says Dr. Werner.
At the same time, the experiments also showed that cortisone suppresses this resolvin formation in inflammation-resolving M2 macrophages, which is important for healing, by virtually"switching off" 15-lipoxygenase-1."This explains why the use of cortisone in the later phase of inflammatory diseases no longer leads to symptom relief, and can even be counterproductive and inhibit regeneration processes," adds Prof. Werz.
"As in the experiments on cell cultures, we were able to detect a clear upregulation of 15-lipoxygenase-2 in the patient groups treated with cortisone," notes Dr. Benjamin Giszas, a doctor at the Clinic for Internal Medicine IV. Giszas supervised the studies as part of his Clinician Scientist project.
According to the researchers, their results imply that treatment of inflammatory diseases could be improved by a time-limited use of cortisone and by new 15-Lipoxygenase-based therapy principles, with fewerRao, Zhigang et al, Glucocorticoids regulate lipid mediator networks by reciprocal modulation of 15-lipoxygenase isoforms affecting inflammation resolution,
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