ステロイドの使い方

Corticosteroid Therapy in Patients with Autoimmune Diseases of the Central Nervous System

ステロイド治療は免疫疾患をはじめとする炎症性疾患の治療において中心的役割を果たしている。糖質コルチコステロイドは遺伝子発現調整や膜蛋白への作用により抗炎症作用をもたらすが，その作用は免疫細胞によって異なる。自己免疫性疾患におけるステロイド用量は疾患の病態によるが，原則的にプレドニゾロン換算で7.5mg/日以下の維持量での疾患コントロールを目標として，困難な場合はその他の免疫抑制薬の併用を検討する。

Abstract

Corticosteroids play an important role in the treatment of inflammatory disorders including neuroinflammatory diseases. Corticosteroids with glucocorticoid receptors directly regulate transcription of many genes associated with inflammation and interfere with pro-inflammatory transcription factors. Glucocorticoids produce non-genomic effects by intercalation into the plasma membrane. These effects differ depending on the immunophenotype of immune cells. The corticosteroid dosage that is effective against inflammatory disorders depends on the pathological background of autoimmune diseases; however, owing to limited clinical evidence, the dosage has been empirically determined in routine medical practice. The corticosteroid dosage should be ＜7.5mg prednisolone equivalent/day to reduce the risk of adverse effects associated with these drugs.