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Brain Behav Immun. 2010 Oct;24(7):1035-42. doi: 10.1016/j.bbi.2010.06.010. Epub 2010 Jun 25.

Classic glucocorticoids versus non-steroidal glucocorticoid receptor modulators: survival of the fittest regulator of the immune system?

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Laboratory of Eukaryotic Gene Expression & Signal Transduction, Department of Physiology, Ghent University, K.L. Ledeganckstraat 35, Gent, Belgium.


The search for novel glucocorticoid receptor (GR) modulators with similar anti-inflammatory properties as conventional steroids, but with a reduction in the number or severity of the side effects has been a long-standing goal, and still remains a challenge today. The quest for these so-called 'dissociated GR ligands' is mainly based on the hypothesis that the occurrence of undesirable side effects is mostly associated with GR-mediated transactivation, whereas transrepression of many pro-inflammatory genes (e.g. cytokines and enzymes involved in inflammatory processes) is more involved in GR-mediated anti-inflammatory effects. As glucocorticoids (GCs) can also enhance the transcription of anti-inflammatory genes, the GR-mediated activation-repression dissociation hypothesis has to be nuanced. However, an enhanced selectivity of GR-affected genes, while upholding the desired anti-inflammatory potential, is still believed to contribute to a more beneficial therapeutic profile with fewer side effects. The initial pharmacological focus on steroidal scaffolds as a basis to dissociate the functionalities of GR has, due to a lack of success, recently been shifted to a focus on non-steroidal ligands. The current work reviews recent advances on the characterization of a generation of novel non-steroidal GR ligands.

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