Q. We heard in class today that steroids are used for autoimmune diseases, and I’ve heard this before but never understood why. What is it about steroids that make them effective as immunosuppressants?
A. There are lots of mechanisms by which steroids dampen the immune response. Here are a few of them:
1. Suppression of T cells. Steroids interfere with production of cytokines (like interleukins), which are critical in the proliferation and interaction of T cells.
2. Suppression of B cells. Steroids interfere with the binding of interleukins to B cells, which means that the B cells have a hard time proliferating and making antibodies.
3. Suppression of neutrophils. Steroids inhibit just about everything that neutrophils do: adhesion, chemotaxis, phagocytosis, and the release of toxic substances.
4. Suppression of macrophages. Steroids down-regulate the expression of Fc receptors on macrophages – so macrophages are less able to phagocytose opsonized things.
5. Diminished production of prostaglandins and leukotrienes. Steroids inhibit cyclooxygenase and phospholipase A2, which decreases the production of pro-inflammatory arachadonic acid metabolites.
Steroids are used in a ton of different immune and inflammatory disorders, like asthma, vasculitis, arthritis, gout, multiple sclerosis, sarcoidosis, alopecia areata…the list goes on and on.
- Kristine said Hi Cynthia – Yes!! I totally agree. I remember learning that if you see any secondary granulat...
- Cynthia said I’m going to have agree with the granules being the most important. I’m also MT and I...
- AG said Thanks Kristine, very helpful!
- Frank MD said Succinctly explained. Excellent! Thank you so much!!
- kartik said Thanks,i am learner,when i think hypothtically,i think i may find confusing beetween promyelocyte an...
- Carol said Thanks…. Well explained
- Ulyses Yakovlevich said This looks like an awesome tool for future Pathologists to learn from :).
- Chief said Amazing explanation. No other website teaches this interesting and important medical lesson. Not eve...
- Dr.Kisor Kumar Pal said Very helpful and practical discussion.I learned a lot.
- Cheri said Thank you ! I’m a traveler in Pathology/Histology
- Dr. Syed Mahbub Baksh said During my residency years, I have read only two books: Robbins Pathology and Henry’s Clinical...
- Theresa said Thanks for breaking this down in a simple way to understand it. Well done.