Scleroderma is a chronic autoimmune disease that can affect the skin as well as such internal organs as the heart, kidneys, lungs, and gastrointestinal tract. It can also affect blood vessels and muscles, causing the formation of scar tissue that can interfere with how well these organs and tissues work.
While scleroderma currently has no cure, treatments can help to reduce its symptoms and delay disease progression. One of the major classes of therapies used to treat scleroderma is corticosteroids.
What are corticosteroids?
Corticosteroids are immune-suppressing medications that reduce the inflammation present in active scleroderma lesions, and slow the progression of scar tissue formation by preventing the immune system from mistaking healthy tissue as foreign and attacking it.
Corticosteroids resemble a steroid hormone normally secreted by the body called cortisol. Cortisol is normally secreted by the adrenal glands, situated over the kidneys. Once secreted, cortisol binds to a receptor protein called the glucocorticoid receptor, which is present in almost every cell in the body. When bound to cortisol (or another corticosteroid), the glucocorticoid receptor moves inside the cell nucleus and and changes how a gene is expressed, meaning whether or not it can produce its related protein.
When bound to corticosteroids, the glucocorticoid receptor “turns off” the genes that promote inflammation and “turns on” those that block inflammation. Corticosteroids may also stop or slow the growth of certain immune cells, called T-cells. Together, these changes make the immune system less sensitive.
Types of corticosteroids
Corticosteroids can be applied topically to scleroderma skin lesions to reduce active inflammation, or taken as oral tablets or via injections to treat the symptoms of systemic scleroderma.
The most common corticosteroid treatment used in scleroderma is prednisone, but other corticosteroid preparations exist, including:
- betamethasone, (Celestone)
- prednisolone (Orapred, Prelone)
- triamcinolone (Kenalog)
- methylprednisolone (Medrol)
Other information
Side effects of corticosteroids can be serious and patients should be monitored while using them. Such side effects include weight gain; elevated blood pressure in the eyes (glaucoma); fluid retention, which can cause swelling in the legs; high blood pressure; and problems with mood, memory, and behavior.
Long-term corticosteroid use is also linked to side effects that include clouding of the lens in one or both eyes (cataracts); high blood sugar, which can trigger or worsen diabetes; increased risk of infections; thinning bones (osteoporosis) and fractures; thinner skin; bruising; and slower wound healing.
Specific to this disease, corticosteroid use can lead to renal crisis (kidney failure) in scleroderma patients.
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Scleroderma News is strictly a news and information website about the disease. It does not provide medical advice, diagnosis, or treatment. This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this website.