The long-term use of glucocorticoids is associated with several deleterious effects. Attempts to separate the beneficial from the adverse effects of these compounds have met with varying degrees of difficulty. The discovery of distinct modes of action of the glucocorticoid receptor, the protein that mediates glucocorticoid action has opened up many possibilities for improving glucocorticoid therapy. This book provides an in-depth overview of the molecular actions of the glucocorticoid receptor and discusses the chances of an imminent identification of selective glucocorticoid agonists. Such componds should fulfill all the criteria of a glucocorticoid but should lack the sideeffects so far linked with classical glucocorticoids.
This timely volume provides a comprehensive overview of glucocorticoids and their role in regulating many aspects of physiology and their use in the treatment of disease. The book is broken into four sections that begin by giving a general introduction to glucocorticoids and a brief history of the field. The second section will discuss the effects of glucocorticoids on metabolism, while the third section will cover the effects of glucocorticoids on key tissues. The final section will discuss general topics, such as animal models in glucocorticoid research and clinical implications of glucocorticoid research. Featuring chapters from leaders in the field, this volume will be of interest to both researchers and clinicians.
Glucocorticoids regulate multiple metabolic and developmental processes and play a vital role in the maintenance of basal and stress-related homeostasis. For the last 50 years, pharmacologic doses of glucocorticoids have been used in the treatment of inflammatory, autoimmune, and lymphoproliferative diseases and in the prevention of allograft rejection, while substitution doses have been employed in the management of adrenocortical insufficiency. aspects of glucocorticoid action, in particular, (i) the impact of maternal and early life stress on stress-related gene regulation in the offspring; (ii) the importance of glucocorticoids and their receptors; (iii) further understanding of the mechanisms of GR action, including its effect on chromatin modulation, its interaction with coactivators and corepressors, and the genetic dissection of GR function in mice; (iv) The interaction of hGR with other transcription factors, such as NF-kappa-B, p53, transforming growth factor beta (TGF-beta) and the chicken ovalbumin upstream promoter transcription factor II (COUP-TFII); recycling, ubiquitination and degradation of the receptor, actions of the GR-beta isoform, a novel synthetic nonsteroidal target gene-specific agonist, the importance of target tissue activity of 11-beta-hydroxysteroid dehydrogenase type 1 in glucocorticoid action in health and disease, the interaction of the receptor with the nutrient carnitine, the anthrax products protective antigen (PA) and lethal factor (LF), and the human immunodeficiency virus type-1 (HIV-1)-encoded molecules Vpr and Tat; (vi) an update on the effects of glucocorticoids on the immune system; and (vii) the clinical implications of glucocorticoid action, including glucocorticoid resistance/hypersensitivity, familial and sporadic glucocorticoid resistance, and the effects of stress and depression.
Osteoporosis is one of the most clinically relevant disabling chronic disease encountered in clinical practice. A common cause of osteoporosis is glucocorticoid excess, as glucocorticoids may increase bone resorption, inhibit bone formation, have indirect actions on bone by decreasing intestinal calcium absorption and induce hypercalciuria. This book presents a comprehensive overview of the effects of glucocorticoids on bone metabolism and structure and on the diagnosis and treatment of glucocorticoid-induced osteoporosis. It aims at providing updated information on the pathogenesis, diagnosis and treatment of this often dramatic complication of glucocorticoid excess. Being one of the few publications completely devoted to glucocorticoid-induced osteoporosis it will heighten the awareness of specialists who prescribe glucocorticoids of the clinical relevance of this treatment complication. 'Glucocorticoid-Induced Osteoporosis' is addressed to clinical experts as well as to general practitioners who will both benefit from the comprehensive and integrative view of the management of patients exposed to glucocorticoids.
Nuclear Receptors in Development and Disease, Volume 125, the latest volume in the Current Topics in Developmental Biology series, covers nuclear receptors in development and disease, and includes contributions from an international board of authors. New chapters in this release cover the Evolution of Nuclear Receptors and Ligand Signaling: Towards a Soft Key–Lock Model?, The Function and Evolution of Nuclear Receptors in Insect Embryonic Development, Nuclear Receptors in Skeletal Homeostasis, Estrogen Hormone Biology, and the Mechanisms of Glucocorticoid Action During Development. The book's chapters provide a comprehensive set of reviews that cover such topics as nuclear differentiation and remodeling, evolution of receptors, ligand signaling and neural development. - Covers the area of nuclear receptors in development and disease - Includes contributions from an International board of authors - Provides a comprehensive set of reviews on topics as nuclear differentiation and remodeling, evolution of receptors, ligand signaling and neural developments
Written by world experts, this books follows upon the monumental success of the first edition of The Parathyroids, which was universally acclaimed as the best text on the subject. An authoritative reference that spans the basic science of parathyroid hormone treatment to major clinical disorders in a superb, single compendium, The Parathyroids offers an objective and authoritative view on controversial clinical issues in this rapidly changing field. Every medical school library and virtually every major hospital library will need this book as a reference for students and clinicians.Key Features* Offers objective and authoritative reviews on controversial clinical issues* Written by world experts on parathyroid hormone and its disorders* Superb, state-of-the-art compendium in one convenient volume* Bridges basic science of parathyroid hormone to major clinical disorders* Practical information on clinical management of parathyroid hormone disorders
The hypothalamic-pituitary-adrenal axis controls reactions to stress and regulates various body processes such as digestion, the immune system, mood and sexuality, and energy usage. This volume focuses on the role it plays in the immune system and provides substantive experimental and clinical data to support current understanding in the field, and potential applications of this knowledge in the treatment of disease. - Evidence presented in this book suggests that the nervous, endocrine, and immune systems form the Neuroendoimmune Supersystem, which integrates all the biological functions of higher organisms both in health and disease for their entire life cycle - Contributors include both the scientists who initiated the work on the HPA axis and on the autonomic nervous system, and those who joined the field later
Core Topics in Endocrinology in Anesthesia and Critical Care provides a comprehensive, practical overview of the perioperative management of patients with endocrine disorders, giving clear diagnostic advice and management guidelines. This book considers the management of patients with endocrine disorders of the pituitary, thyroid, parathyroid and adrenal glands, including rarer disorders such as MEN syndrome. It then considers all aspects of the perioperative management of diabetic patients, including paediatric, obstetric and ambulatory patients. Finally it discusses endocrine disorders in the critically ill patient, covering such issues as the topical conundrum of glucose control and the management of diabetic metabolic acidosis, thyroid storm and myxoedema coma. Every chapter reviews the relevant anatomy and pathophysiology and the latest developments in defining the genetic causes are also considered where appropriate. Core Topics in Endocrinology in Anesthesia and Critical Care is an invaluable tool for all anaesthetists and intensivists in their daily clinical practice.
Recent years have seen spectacular advances in the field of circadian biology. These have attracted the interest of researchers in many fields, including endocrinology, neurosciences, cancer, and behavior. By integrating a circadian view within the fields of endocrinology and metabolism, researchers will be able to reveal many, yet-unsuspected aspects of how organisms cope with changes in the environment and subsequent control of homeostasis. This field is opening new avenues in our understanding of metabolism and endocrinology. A panel of the most distinguished investigators in the field gathered together to discuss the present state and the future of the field. The editors trust that this volume will be of use to those colleagues who will be picking up the challenge to unravel how the circadian clock can be targeted for the future development of specific pharmacological strategies toward a number of pathologies.
