Udi Nussinovitch, Jozelio Freire de Carvalho, Rosa Maria R. Pereira and Yehuda Shoenfeld Pages 3574 - 3585 ( 12 )
Glucocorticoids (GC) are drugs commonly used, by approximately 1% of the total adult population as anti-inflammatory and immunosuppressive therapies for asthma, inflammatory bowel disease, dermatological, ophthalmic, neurological, and rheumatic autoimmune diseases. Supporting evidence exists of GC use in both immune mediated and non-immune mediated heart disease. The molecular mechanisms by which GC induces immune-modulation and direct cardioprotection, are complex and not fully understood. We review herein, the current knowledge of GC use in various immune-mediated or non-immune mediated cardiovascular conditions. GC have been investigated in autoimmune, inflammatory and idiopathic heart diseases such as atrio-ventricular conduction abnormalities, rheumatic fever, myocarditis, dilated cardiomyopathy, Churg-Strauss syndrome, Kawasaki disease and sarcoidosis. GC therapy has been studied in non-autoimmune and non-inflammatory indications such as acute myocardial infarction, angina, postpericardiotomy syndrome and other pericardial diseases, endocarditis and cardiac amyloidosis, as well as in invasive cardiology, coronary interventions, and cardiopulmonary- bypass surgery. Despite GCs role as natural, physiologic regulators of the immune system, cardiovascular adverse outcomes may occur. Some of the well-known side effects of GC therapy involve bone, metabolic, and cardiovascular systems and include osteoporosis, fractures, dyslipidemia, diabetes, obesity, and hypertension.
Cardiovascular disease,glucocorticoid,myocardial infarction,cardiopulmonary bypass,vasospastic angina,Kawasaki disease,Churg-Strauss syndrome,rheumatic fever,Glucocorticoids,Cardiovascular System,autoimmune diseases,immune-modulation,cardioprotection,idiopathic heart diseases,myocarditis,dilated cardiomyopathy,sarcoidosis,pericardial diseases,endocarditis,cardiac amyloidosis,cardiopulmon,dyslipidemia,diabetes,cytosolic glucorticoid receptor,interferon regulator factor 3,membrane-bound GC receptor,cyclooxygenase,CD95 expression,macrophages,T-lymphocytes,tumor suppressors,cytokines,annexins,ischemia,NF-B,Endogenous peroxynitrite,myocardium,vascular cell adhesion molecule,granulocyte,–,macrophage colony-stimulating factor,calpain 6,caspase 11,S6 kinase,Acute Myocardial Infarction,beclomethasone,Angina,Tuberculosis,NSAIDs,pericarditis,Staphylococcus aureus,troponin I,dexamethasone,Atrio-Ventricular Conduction Abnormalities,pregnancy,Pulse Therapy
, , , Department of Medicine ‘B’ and Center for Autoimmune Diseases, Sheba Medical Center (Affiliate to Tel-Aviv University) Tel-Hashomer 52621, Israel.