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The objective of this article is to make a brief compilation of the physiology of the hypothalamic-pituitary-adrenal axis in order to understandthe role of the exogenous corticoids as therapeutic tools in innumerable pathologies, but when used inappropriately, it can produce important deleterious effects. The history of the corticoids began 164 years ago in 1843 when Thomas Addison described the symptoms of the adrenal gland insufficiency. On September 21st 1948, almost one hundred years after, Dr. Hench injected cortisone for the first time in a patient with arthritis. In 1950 Hench, Kendall and Reichsteinreceived the Nobel Prize in Medicine and Physiology. In the cortex of the adrenal glands, three different hormones are synthesized from cholesterol, and these hormones produce diverseeffects on the homeostasis of the body. The synthetic glucocorticoids are classified by their anti-inflammatory power, half life, and mineralocorticoideffect; they operate in almost every cell through genomic and non genomic mechanismsof action producing different responses. This is the reason of their wide therapeutic effect in respiratory diseases like asthma and COPD,multiple sclerosis, rejection of transplants, among others. |
