Prednisone is a corticosteroid used to treat inflammation or immune-mediated reactions and to treat endocrine or neoplastic diseases. It is indicated as an anti-inflammatory or immunosuppressive drug for allergic, dermatologic, gastrointestinal, hematologic, ophthalmologic, nervous system, renal, respiratory, rheumatologic, infectious, endocrine, or neoplastic conditions as well as in organ transplant. It is derived from cortisone.1 It is biologically inert and converted to prednisolone in the liver by the enzyme Corticosteroid 11-beta-dehydrogenase isozyme 1. As prednisolone is a glucocorticoid, it's mechanism of actions is that of the glucocorticoid response element of influencing COX-2/prostaglandin G/H synthase 2 suppression and lipocortin/annexin induction. By binding to the glucocorticoid receptor, it influences transcription factors AP-1 and NF-kB to block the transcription of COX-2/prostaglandin G/H synthase 2 which reduces the amount of prostanoids being produced from arachidonic acid. Prostanoids such as PGI2 and thromboxane A2 influence effects of inflammation through vasoconstriction/dilation, pain sensitivity and platelet aggregation. Prednisolone also affects the promoter of annexin-1, an important inflammatory protein as it affects leukocytes and blocks phospholipase A2 which reduces the amount of arachidonic acid being cleaved from the phospholipid bilayer. Reducing the amount of arachidonic acid formed further decreases concentrations of prostanoids mentioned calming inflammation.

Prednisone Anti-inflammatory Pathway References