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Glucocorticoid Excess in Bone and Muscle

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Abstract

Glucocorticoids (GC), produced and released by the adrenal glands, regulate numerous physiological processes in a wide range of tissues. Because of their profound immunosuppressive and anti-inflammatory actions, GC are extensively used for the treatment of immune and inflammatory conditions, the management of organ transplantation, and as a component of chemotherapy regimens for cancers. However, both pathologic endogenous elevation and long-term use of exogenous GC are associated with severe adverse effects. In particular, excess GC has devastating effects on the musculoskeletal system. GC increase bone resorption and decrease formation leading to bone loss, microarchitectural deterioration, and fracture. GC also induce loss of muscle mass and strength leading to an increased incidence of falls. The combined effects on bone and muscle account for the increased fracture risk with GC. This review summarizes the advance in knowledge in the last two decades about the mechanisms of action of GC in bone and muscle and the attempts to interfere with the damaging actions of GC in these tissues with the goal of developing more effective therapeutic strategies.

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Funding

This research was supported by the National Institutes of Health (grants AR059357, AT008754, AT008754-O2S1, and CA209882 to TB) and the United States Department of Veterans Affairs (I01BX002104-01 to TB). AYS was partially supported by T32-AR065971.

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  1. Department of Anatomy and Cell Biology, Indiana University School of Medicine, 635 Barnhill Drive, MS5045A, Indianapolis, IN, 46202, USA

    Amy Y. Sato & Teresita Bellido

  2. Department of Internal Medicine, Division of Endocrinology, Indiana University School of Medicine, Indianapolis, IN, USA

    Munro Peacock & Teresita Bellido

  3. Roudebush Veterans Administration Medical Center, Indianapolis, IN, 46202, USA

    Teresita Bellido

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  1. Amy Y. Sato
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Sato, A.Y., Peacock, M. & Bellido, T. Glucocorticoid Excess in Bone and Muscle. Clinic Rev Bone Miner Metab 16, 33–47 (2018). https://doi.org/10.1007/s12018-018-9242-3

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