Cortisone

Added by Robert Hill on June 10, 2012.
Saved under Medications, Ulcerative Colitis Medications
Tags: adrenal cortex, adrenal gland, chemical structure, corticotropin releasing hormone, dehydrocorticosterone, EBV infectious mononucleosis, glucocorticoids, hormone cortisol, inactive metabolite, inflammation, precursor molecule, steroid hormone, steroid hormones, zona fasciculata

Cortisone

Nutrient Deficiencies,

Depending on the part of the intestine involved in Crohn’s disease, patients can develop specific nutrient deficiencies. For example, the last part of the small intestine (terminal ileum) is commonly affected in Crohn’s disease; this is also where vitamin B12 deficiency can develop in patients with Crohn’s disease of the terminal ileum.

17-hydroxy-11-dehydrocorticosterone is a steroid hormone. It is one of the main hormones released by the adrenal gland in response to stress. In chemical structure, it is a corticosteroid closely related to corticosterone.

It is used to treat a variety of ailments and can be administered intravenously, orally, intraarticularly, or transcutaneously. Cortisone suppresses the immune system, thus reducing inflammation and attendant pain and swelling at the site of the injury. Risks exist, in particular in the long-term use of cortisone.

Cortisone

Production

Cortisone is one of several end-products of a process called steroidogenesis. This process starts with the synthesis of cholesterol, which then proceeds through a series of modifications in the adrenal gland (suprarenal) to become any one of many steroid hormones.

One end-product of this pathway is cortisol. For cortisol to be released from the adrenal gland, a cascade of signaling occurs.

Corticotropin-releasing hormone released from the hypothalamus stimulates corticotrophs in the anterior pituitary to release ACTH, which relays the signal to the adrenal cortex. Here, the zona fasciculata and zona reticularis, in response to ACTH, secrete glucocorticoids, in particular cortisol.

In the peripheral tissues, cortisol is converted to cortisone by the enzyme 11-beta-steroid dehydrogenase. Cortisol has much greater glucocorticoid activity than cortisone, and, thus, cortisone can be considered an inactive metabolite of cortisol. However, 11-beta-steroid dehydrogenase can catalyze the reverse reaction as well, and, thus, cortisone is also the inactive precursor molecule of the active hormone cortisol.

Cortisone is activated through hydrogenation of the 11-keto-group, and cortisol is, thus, sometimes referred to as hydrocortisone.

Effects and uses

Cortisone, a glucocorticoid, and adrenaline are the main hormones released by the body as a reaction to stress. They elevate blood pressure and prepare the body for a fight or flight response.
A cortisone injection can also be used to give short-term pain relief and reduce the swelling from inflammation of a joint, tendon, or bursa in, for example, the joints of the knee, elbow, and shoulder.

Cortisone may also be used to deliberately suppress immune response in persons with autoimmune diseases or following an organ transplant to prevent transplant rejection. The suppression of the immune system may also be important in the treatment of inflammatory conditions such as severe IgE-mediated allergies.

Last, cortisone is a common treatment for a severe sore throat that occurs commonly with EBV infectious mononucleosis. It is important to note that cortisone does not help lessen the duration of the virus, and is used purely to increase the comfort of a patient with trouble speaking or swallowing as a result of the mononucleosis-induced swollen throat.