Overview of Newer Glucocorticosteroid Preparations for Inflammatory Bowel Disease

Because the glucocorticosteroid receptor seems to be uniform in the human body, there is currently no support for a possibility of separating the therapeutic and adverse glucocorticosteroid actions at the receptor level. However, based on a new generation of glucocorticosteroids characterized by a h...

Full description

Saved in:
Bibliographic Details
Main Author: R Brattsand
Format: Article
Language:English
Published: Wiley 1990-01-01
Series:Canadian Journal of Gastroenterology
Online Access:http://dx.doi.org/10.1155/1990/708916
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1832547479444258816
author R Brattsand
author_facet R Brattsand
author_sort R Brattsand
collection DOAJ
description Because the glucocorticosteroid receptor seems to be uniform in the human body, there is currently no support for a possibility of separating the therapeutic and adverse glucocorticosteroid actions at the receptor level. However, based on a new generation of glucocorticosteroids characterized by a high first pass metabolism in the liver, it seems possible today co reach a more selective topical therapy of inflammatory bowel disease. The properties of three new glucocorticosteroids are presented: the highly potent budesonide, fluticasone propionate and tixocortol pivalate - the latter with only low topical potency. Their properties can be exemplified by budesonide, which is currently the best documented compound. The topical potency of budesonide is 200 and 15 times higher than chose of hydrocortisone and prednisolone, respectively. This means that there is a high potential for anti-inflammatory and immunosuppressive actions on rectal and bowel mucosa. The compound is metabolically stable in the bowel compartment, which allows full retention of glucocorticosteroid activity in the target organ. However, when absorbed and distributed to the liver, there is a 90% first pass hepatic metabolism co metabolites of very low potency. This suggests that after topical application to rectal or bowel mucosa, glucocorticosteroid activity in the systemic circulation is low. This is in contrast to prednisolone, which has a hepatic first pass metabolism of just 20%.
format Article
id doaj-art-0a37cf563c5f49a783ecb1e26cd4c2f3
institution Kabale University
issn 0835-7900
language English
publishDate 1990-01-01
publisher Wiley
record_format Article
series Canadian Journal of Gastroenterology
spelling doaj-art-0a37cf563c5f49a783ecb1e26cd4c2f32025-02-03T06:44:29ZengWileyCanadian Journal of Gastroenterology0835-79001990-01-014740741410.1155/1990/708916Overview of Newer Glucocorticosteroid Preparations for Inflammatory Bowel DiseaseR BrattsandBecause the glucocorticosteroid receptor seems to be uniform in the human body, there is currently no support for a possibility of separating the therapeutic and adverse glucocorticosteroid actions at the receptor level. However, based on a new generation of glucocorticosteroids characterized by a high first pass metabolism in the liver, it seems possible today co reach a more selective topical therapy of inflammatory bowel disease. The properties of three new glucocorticosteroids are presented: the highly potent budesonide, fluticasone propionate and tixocortol pivalate - the latter with only low topical potency. Their properties can be exemplified by budesonide, which is currently the best documented compound. The topical potency of budesonide is 200 and 15 times higher than chose of hydrocortisone and prednisolone, respectively. This means that there is a high potential for anti-inflammatory and immunosuppressive actions on rectal and bowel mucosa. The compound is metabolically stable in the bowel compartment, which allows full retention of glucocorticosteroid activity in the target organ. However, when absorbed and distributed to the liver, there is a 90% first pass hepatic metabolism co metabolites of very low potency. This suggests that after topical application to rectal or bowel mucosa, glucocorticosteroid activity in the systemic circulation is low. This is in contrast to prednisolone, which has a hepatic first pass metabolism of just 20%.http://dx.doi.org/10.1155/1990/708916
spellingShingle R Brattsand
Overview of Newer Glucocorticosteroid Preparations for Inflammatory Bowel Disease
Canadian Journal of Gastroenterology
title Overview of Newer Glucocorticosteroid Preparations for Inflammatory Bowel Disease
title_full Overview of Newer Glucocorticosteroid Preparations for Inflammatory Bowel Disease
title_fullStr Overview of Newer Glucocorticosteroid Preparations for Inflammatory Bowel Disease
title_full_unstemmed Overview of Newer Glucocorticosteroid Preparations for Inflammatory Bowel Disease
title_short Overview of Newer Glucocorticosteroid Preparations for Inflammatory Bowel Disease
title_sort overview of newer glucocorticosteroid preparations for inflammatory bowel disease
url http://dx.doi.org/10.1155/1990/708916
work_keys_str_mv AT rbrattsand overviewofnewerglucocorticosteroidpreparationsforinflammatoryboweldisease