Major Treatment Options for Inflammation

Major Treatment Options for Inflammation
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  • 0:07 Ways to Combat Inflammation
  • 0:49 Review of Inflammation
  • 2:13 How Steroids Stop Inflammation
  • 4:07 What Are NSAIDs?
  • 5:57 Other Inhibitors of…
  • 7:20 Lesson Summary
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Lesson Transcript
Instructor: Artem Cheprasov
This lesson will discuss two major classes of drugs involved in suppressing the immune system: steroids and NSAIDs. We will discuss what they do, how they stop inflammation, and what side effects they may have.

Different Ways to Combat Inflammation

In other lessons, you've learned that inflammation is like a fire within your body. While designed to help you, the inflammatory process is also involved in causing you pain, a fever, and destruction of your body's tissues and organs if it overreacts or lasts for too long. That's why putting out a fire, be it in the woods or within your body, is very important.

Depending on the cause of the fire and where it is occurring, you can use everything from special foam, to a fire extinguisher, to water to put it out. Various ways of putting out the fire within you, inflammation, exist as well. And that is what this lesson will be about.

A Brief Review of Inflammation

Another lesson went into more detail about how inflammation may be initiated in the body. As a brief review, we discussed how a fatty acid, called arachidonic acid, is a precursor for the formation of eicosanoids, called prostaglandins and leukotrienes, by the cyclooxygenase and lipoxygenase enzymes.

This fatty acid, AA for short, is released by an important enzyme called 'phospholipase A2.' This release is what allows the COX (cyclooxygenase) and LOX (lipoxygenase) enzymes to form prostaglandins and leukotrienes from arachidonic acid so that they can play their important roles in initiating and promoting inflammation. While eicosanoids are important mediators of inflammation that may hurt us in some cases, they also play critical roles in keeping our body functioning properly.

Therefore, keep in mind as we go along in this lesson that stopping their function can have serious consequences when you're trying to stop inflammation. It's a delicate act of trying to stop one thing without stopping too much of the other.

How Steroids Stop Inflammation

There's a class of drugs collectively called glucocorticoids, a corticosteroid subclass that is used to suppress inflammation and other aspects of the immune system.

You've probably heard of quite a few of them:

  • Dexamethasone
  • Prednisone or Prednisolone
  • Hydrocortisone

And beyond. Some of them are more powerful than others, some last longer than others, and giving higher amounts of them will affect the body a bit differently than giving smaller amounts. I don't want to bog you down with those details. Save some space in your brain for medical school where you'll learn about how exactly to give what kind of steroid, when, how much, and for how long.

What you need to know now for this lesson is that glucocorticoids modulate the process of inflammation partially by, in the end, shutting down the activity of phospholipase A2. If phospholipase A2 cannot perform its role in the inflammatory cascade, then arachidonic acid cannot be released and the inflammatory mediators cannot be formed.

In essence, corticosteroids act as a wrench jamming a gear in a production factory. By shutting down the activity of important components of a machine that builds inflammatory molecules, the machine shuts down and is unable to produce any inflammatory mediators, or at least not as many as before.

While glucocorticoids can be very effective in stopping the inflammatory process, they can have terrible side effects, including:

  • Gastric ulceration
  • Thinning of the skin
  • Loss of muscle mass
  • Development of secondary diseases such as diabetes mellitus

And, believe me, many other problems no less severe than what I already mentioned.

What are NSAIDs?

One other class of drugs commonly used to fight off some of the inflammatory system's components are known as NSAIDs, or nonsteroidal anti-inflammatory drugs.

Examples of these abound, and you see TV commercials for them all of the time. Two notable ones are:

  • Aspirin
  • Ibuprofen

What you need to know is that NSAIDs don't exert as powerful an effect on the suppression of the inflammatory system as steroids because they only target a select portion of the inflammatory cascade; namely, they stop the COX enzymes from functioning and producing a portion of the inflammatory mediators.

However, because NSAIDs can be used to selectively target specific portions of the inflammatory cascade, they usually don't have nearly as many side effects as the more powerful glucocorticoid class of drugs.

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