1.SUVITH.V.DAS BNYS 3rd sem

2. Contents What are steroids Steroid biosynthesis Cortisol Cortisol/Hydrocortisone functions Hydrocortisone Indications Hydrocortisone Side effects 3. Factors Reducing Cortisol level Factors Increasing Cortisol level Stress and cortisol Role of cortisol in stress induced diseases Yoga, Stress and Cortisol Conclusion 4. What are steroids? Steroids are a class of chemical compounds characterized by four rings of carbon atoms linked in a specific way. All steroid hormones derived from Cholesterol. Formation of four fused rings by 3 Cyclohexane ring & 1 Cyclopentane ring. 5. oDepending upon functional groups attached to the rings, they have wide variety of effects in biological systems. Corticosteroids: Group of steroid hormones produced in Adrenal Cortex oGlucocorticoids e.g., cortisol oMineralocorticoids e.g., Aldosterone oSex hormones e.g., Androgens, or made synthetically e.g., Hydrocortisone 6. Steroids Biosynthesis 7. zona fasciculata; adrenal cortex. It is released in response to stress and a low level of blood glucocorticoids. Its primary functions are to increase blood sugar through gluconeogenesis; suppress the immune system; and aid in fat, protein and carbohydrate metabolism. 8. Synthetic form used to treat variety of diseases. In circulation it is bound to protein, mainly with globulin. High degree of binding to plasma proteins slows the elimination of cortisol from the plasma, therefore cortisol have 60 90 minutes of half life. HPA axis is responsible for regulation of cortisol secretion by Negative feedback mechanism. 9. oControls carbohydrate, fat & protein metabolism and has anti-inflammatory activity. oCortisol inhibits uptake and utilization of glucose and elevates blood glucose level. oIt activates Anti stress & Anti inflammatory pathways. 10. Arousal and Cognition Glucocorticoids act on the hippocampus, amygdala, and frontal lobes. Along with adrenaline, these enhance the formation of flashbulb memories of events associated with strong emotions, both positive and negative. 11. o Metabolic actions: o Carbohydrate metabolism: Gluconeogenesis. o Fat metabolism: mobilization & redistribution o Protein metabolism: decrease the proteins in the cell & increase amino acids in liver. o Electrolytes & water metabolism: accelerates the excretion of water, o Calcium metabolism: excrete calcium through urine. 12. oCardiovascular system oThe presence of glucocorticoids leads to decrease in capillary permeability, adequate vasomotor responses of smaller blood vessels & increased in cardiac output. 13. oImmunity: oCortisol prevents the release of substances in the body that cause inflammation. o Mainly cortisol prevent inflammation by stabilizing the lysosomal membrane. oCortosol decreases the permeability of the capillaries. 14. It decreases the both migration of WBC into the inflamed area and phagocytosis of the damaged cells. oIt cause lymphocyte reproduction to decrease markedly. oLarge doses of cortisol causes significant atrophy of all the lymphoid tissue in the body. 15. Hematology: oCortisol decreases the number of eosinophil's and lymphocytes in the blood. oCortisol increases the production of red blood cells. oEosinopenia & Lymphocytopenia are the markers for the high cortisol level in plasma. 16. oAs an anti-inflammatory medication. Hydrocortisone relieves inflammation in various parts of the body. oTo reduce inflammation in certain kinds of autoimmune diseases, skin conditions, asthma and other lung conditions. oTo manage symptoms of variety of cancers, such as leukemia, lymphoma, and multiple myeloma. 17. oTo treat nausea and vomiting associated with some chemotherapy drugs. oUsed to stimulate appetite in cancer patients with severe appetite problems. oThe lotion (topical) is used in treatment of allergic skin reactions, and relieves symptoms of itching, redness, and swelling. oTo prevent allergic reactions. 18. o Adrenal insufficiency o Anaphylactic reactions o Apthous ulcers o Atopic eczema o Congenital adrenal hyperplasia o Contact allergic dermatitis 19. o Graft rejection o Hypercalcaemia o Infantile eczema o Inflammation o Irritant dermatitis o Itching o Discoid eczema o Flexural psoriasis 20. o Joint inflammation o Perineal trauma o Seborrheic dermatitis o Soft tissue inflammation o Discoid eczema o Flexural psoriasis 21. oIncreased appetite oIrritability oDifficulty sleeping (insomnia) oSwelling in your ankles and feet (fluid retention) oNausea (take with food) 22. o Heartburn o Muscle weakness o Impaired wound healing o Increased blood sugar levels o Osteoporesis o Depression o Insulin resistence o Erectile dysfunction 23. Magnesium supplementation decreases serum cortisol levels after aerobic exercise Music therapy can reduce cortisol levels in certain situations Massage therapy can reduce cortisol. 24. Laughing, and the experience of humour, can lower cortisol levels Regular dance practice decrease the serum cortisol. Black tea may hasten recovery from a high-cortisol 25. Caffeine may increase cortisol levels. Sleep deprivation. Burnout is associated with higher cortisol levels. Severe trauma or stressful events can elevate cortisol levels in the blood for prolonged periods. 26. Subcutaneous adipose tissue regenerates cortisol from cortisone. Anorexia nervosa may be associated with increased cortisol levels. Severe calorie restriction causes elevated baseline levels of cortisol 27. Coping up with demanding situation is called stress. Any type of physical or mental stress can lead to secretion of ACTH and consequently cortisol. Cortisols main function is to restore homeostasis following exposure to stress. 28. Stress Compromises the Blood-Brain Barrier Sustained stress can damage the hippocampus Main function of Cortisol during stress is it redistribute the energy to regions of the body that need it most. 29. In stress, cortisol concentration in blood plasma will be increase. stress response that is supposed to be reserved for life-or-death (fight-or-flight) situations. Injury, hunger, heat, cold, or worry can trigger the stress response. 30. oDiabetes Mellitus : oIncreased insulin resistance. oIn stress, according to the need of energy the blood glucose level will increase. oBut in peoples with diabetics those mechanism to balance glucose level is disturbed, then glucose level will be uncontrolled. 31. oIt causes blindness, kidney problems, & nerve damage leading to foot numbness, it cause serious injuries and hard-to-heal infections. oLowered Immunity: oExcess amount of cortisol inhibit the action of T-lymphocytes. oSuppress phospholipase. oStops the proliferation of macrophages. 32. o Hypertension: o Cortisol-induced hypertension is accompanied by a significant sodium retention and volume expansion. o Preliminary evidence in humans suggests that suppression of the nitric oxide system may play a role in cortisol-induced hypertension. (Whitworth JA, Brown MA, Kelly JJ, Williamson PM.Steroids. 1995 Jan; 60(1):76-80.) 33. oAtherosclerosis oIf the stress continuing. Elevated levels of cortisol increases the heart rate, and increased levels of total and low-density lipoprotein cholesterol and fasting insulin and glucose. 34. In high level of cortisol causes endothelial dysfunction and coronary artery calcification. Endothelial dysfunction is the initial event of Cardio vascular diseases. After this plague is formed in the blood vessel. 35. Vadiraja and colleagues showed that decrease in salivary cortisol at 6 a.m after 6 week yoga intervention in cancer patients. (Vadiraja HS, Effects of yoga program on cortisol rhythm et.al. inter cancer Ther 2009;8:37-46) 36. Decreased serum cortisol concentrations were also found in 8 yoga instructors after 1 hour of yoga practice as compared to before practice. (Kamei T, Toriumi Y, Kimura H, et.al Decrease in serum cortisol during yoga exercise is correlated with alpha wave activation. Percept Mot Skills 2000;90:1027-1032) 37. Decrease in salivary cortisol in undergraduate students after a semester-long Hatha yoga course. (West J, Otte C, Geher K, et.al. Effects of Hatha yoga and salivary cortisol. Ann Behav Med 2004;28:114-118) 38. IF THE STEROIDS USE FOR EMERGENCY CONDITION IT IS HELPFUL, OR IF IT IS MISUSE IT CAUSE DAMAGE TO OUR BODY.