glucocorticoid

Overview

Glucocorticoids are a class of steroid hormones and widely used anti-inflammatory and immunosuppressive agents that act primarily through the glucocorticoid receptor. Endogenously, they are central regulators of metabolism, stress responses, and immune homeostasis; pharmacologically, they are among the most important therapies for inflammatory, autoimmune, allergic, and transplant-related conditions. Their effects are pleiotropic: they can suppress proinflammatory cytokine production, alter leukocyte trafficking and activation, and influence tissue repair and metabolic pathways.

In biomedical research, glucocorticoids are studied both as therapeutic agents and as biologically active signals within disease microenvironments. Recent work has highlighted their role in rheumatoid arthritis, Sjögren’s disease, inflammatory bowel and kidney disorders, cancer immunotherapy toxicity, and T-cell differentiation. At the same time, studies continue to examine glucocorticoid-related adverse effects, including infection risk, cardiovascular associations, and steroid resistance, as well as mechanisms of local glucocorticoid metabolism and receptor signaling.

Focus of Latest Publications

Recent publications have focused on glucocorticoids in both clinical and mechanistic settings, with several studies examining whether adding glucocorticoids improves outcomes when combined with other therapies. In ANCA-associated vasculitis, a longitudinal cohort study found no benefit from adding low-dose glucocorticoids to maintenance treatment for reducing major relapses, hospitalisation, or damage accumulation risk. In rheumatoid arthritis, a cohort study of newly diagnosed patients described glucocorticoid use during the first year after treatment initiation and reported that use was common, with doses highest early in the disease course and declining substantially after the initial visit; the one-year infection analysis yielded a relative risk compatible with both benefit and harm.

Other studies evaluated glucocorticoids as part of combination regimens in immune-mediated kidney and vascular disease. In IgA nephropathy, telitacicept plus glucocorticoids was associated with a greater reduction in 24-hour proteinuria at 6 months than telitacicept alone, while estimated glomerular filtration rate was preserved and no serious adverse events were reported. In severe cerebral venous thrombosis, a human mechanistic exploratory study examined glucocorticoids combined with anticoagulation and proposed that the combination may improve outcomes by modulating the central NLRP3/NETosis inflammatory process.

Mechanistic work also highlighted an intrinsic role for glucocorticoid signaling in immune-cell homeostasis. A study of Th17 cells identified a cell-intrinsic glucocorticoid biosynthesis and sensing circuit in homeostatic Th17 cells, involving CYP11A1, glucocorticoid receptor signaling, and regulation by TGF-β1 and IL-6. This circuit distinguished homeostatic from pro-inflammatory Th17 states and suggested implications for treating Th17-mediated autoimmunity.

Additional publications described glucocorticoid-sparing or glucocorticoid-enhancing contexts. In heavily pretreated chronic graft-versus-host disease, belumosudil was associated with clinical responses and a marked reduction in glucocorticoid dose in real-world practice. In asthma, a study of the herbal pair Epimedium brevicornum Maxim and Ligustrum lucidum Ait reported that these agents may enhance glucocorticoid-associated anti-inflammatory effects via the cAMP/PKA/CREB signaling pathway. A case report of recurrent IgA1-λ-type PGNMID also noted complete remission with glucocorticoid monotherapy before later relapse and response to additional conventional immunosuppressive therapy.

Key Publications

NEWJun No benefit of adding glucocorticoids to maintenance treatment in reducing the risk of major relapses in ANCA-associated vasculitis: real life data from a longitudinal cohort study. (RMD open, 2026, PMID 42342286): "To examine the role of low-dose glucocorticoids (GCs) in major relapse, hospitalisation and damage accumulation risk during maintenance therapy in anti-neutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAVs)."
NEWJun Glucocorticoid use among patients with rheumatoid arthritis during the first year of treatment-a cohort study. (Rheumatology international, 2026, PMID 42283855): "Glucocorticoid treatment for patients with rheumatoid arthritis (RA) is widely used as fast-acting bridging therapy to reduce disease activity."
NEWJun A cell-intrinsic glucocorticoid biosynthesis and sensing circuit maintains a homeostatic Th17 cell state. (Immunity, 2026, PMID 42285103): "Th17Hom cell-derived GC signaled through the glucocorticoid receptor (GR), which was higher in Th17Hom cells compared with Th17Inf cells, thereby forming a circuit that maintained the homeostatic state."
Jul Belumosudil in the Management of Heavily Pretreated Prolonged Chronic GVHD: A Retrospective Multicenter Real-World Study. (Hematological oncology, 2026, PMID 42198791): "A significant reduction in the glucocorticoid dosage was observed, with the median dose decreasing from 0.29 mg/kg/day at baseline to 0.02 mg/kg/day at the last follow-up."
Apr Glucocorticoids combined with anticoagulation modulate the central NLRP3/NETosis inflammatory process in patients with severe cerebral venous thrombosis: a human mechanistic exploratory study. (Inflammation research : official journal of the European Histamine Research Society ... [et al.], 2026, PMID 42050165): "Although previous studies have reported that the combination of glucocorticoids (GCs) and anticoagulation is associated with improved clinical outcomes, its mechanism remains unknown."
May Telitacicept Add Glucocorticoids Versus Telitacicept Alone in the Treatment of IgA Nephropathy: A Real-World Study. (FASEB journal : official publication of the Federation of American Societies for Experimental Biology, 2026, PMID 41964393): "However, the efficacy and safety of telitacicept combined with glucocorticoids (GCs) in the treatment of immunoglobulin A nephropathy (IgAN) remain unclear."
May Epimedium brevicornum Maxim and Ligustrum lucidum Ait enhance glucocorticoid-associated anti-inflammatory effects in asthma via the cAMP/PKA/CREB signaling pathway. (Journal of ethnopharmacology, 2026, PMID 41690429): "Emerging evidence suggests that EL and its active constituents, icariin and oleanolic acid (IO), can enhance glucocorticoid-associated anti-inflammatory effects; however, the underlying molecular mechanism remains incompletely understood."
Jun Recurrent IgA1-λ-Type PGNMID Achieving Remission with Conventional Immunosuppressive Therapy. (Internal medicine (Tokyo, Japan), 2025, PMID 41192914): "Complete remission was achieved with glucocorticoid monotherapy in December 2013."