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MECHANISMS IN ENDOCRINOLOGY: Tissue-specific activation of cortisol in Cushing’s syndrome
- Source :
- European Journal of Endocrinology. 175:R81-R87
- Publication Year :
- 2016
- Publisher :
- Oxford University Press (OUP), 2016.
-
Abstract
- Glucocorticoids are widely prescribed for their anti-inflammatory properties, but have ‘Cushingoid’ side effects including visceral obesity, muscle myopathy, hypertension, insulin resistance, type 2 diabetes mellitus, osteoporosis, and hepatic steatosis. These features are replicated in patients with much rarer endogenous glucocorticoid (GC) excess (Cushing’s syndrome), which has devastating consequences if left untreated. Current medical therapeutic options that reverse the tissue-specific consequences of hypercortisolism are limited. In this article, we review the current evidence that local GC metabolism via the enzyme 11β-hydroxysteroid dehydrogenase type 1 (11β-HSD1) plays a central role in mediating the adverse metabolic complications associated with circulatory GC excess – challenging our current view that simple delivery of active GCs from the circulation represents the most important mode of GC action. Furthermore, we explore the potential for targeting this enzyme as a novel therapeutic strategy for the treatment of both endogenous and exogenous Cushing’s syndrome.
- Subjects :
- 0301 basic medicine
medicine.medical_specialty
Hydrocortisone
Endocrinology, Diabetes and Metabolism
Osteoporosis
030209 endocrinology & metabolism
Cushingoid
Endogeny
03 medical and health sciences
0302 clinical medicine
Endocrinology
Insulin resistance
Internal medicine
11-beta-Hydroxysteroid Dehydrogenase Type 1
medicine
Humans
Muscle, Skeletal
Myopathy
Cushing Syndrome
business.industry
Type 2 Diabetes Mellitus
General Medicine
medicine.disease
030104 developmental biology
Adipose Tissue
Liver
Organ Specificity
Steatosis
medicine.symptom
business
Glucocorticoid
medicine.drug
Subjects
Details
- ISSN :
- 1479683X and 08044643
- Volume :
- 175
- Database :
- OpenAIRE
- Journal :
- European Journal of Endocrinology
- Accession number :
- edsair.doi.dedup.....c32e676a48a40766cee4000f9a234125