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Document downloaded from http://www.elsevier.es, day 24/04/2017. This copy is for personal use. Any transmission of this document by any media or format is strictly prohibited. REVIEW ARTICLES Molecular Mechanisms of Glucocorticoids B.G. Cosío,a A. Torrego,b and I.M. Adcockb aServicio de Neumología, Hospital Universitario Son Dureta, Palma de Mallorca, Baleares, Spain. bDepartment of Thoracic Medicine, National Heart and Lung Institute, Imperial College, London, United Kingdom. Introduction Glucocorticoids: Structure and Function Inflammatory processes are central to many Most of the glucocorticoid activity is associated with respiratory diseases such as asthma, chronic obstructive cortisol (or hydrocortisone). The use of cortisone in the pulmonary disease (COPD), cystic fibrosis, and many treatment of rheumatoid arthritis earned Hensch the Nobel types of diffuse interstitial lung disease. The specific Prize for Medicine in 1950. This same year, cortisone characteristics of the inflammatory response and started to be used in the treatment of asthma. At present, inflammation site vary according to the disease, but clinicians have at their disposal many types of recruitment and activation of different inflammatory glucocorticoid molecule, most of which are synthetic. The cells and changes in structural cells of the lung are chemical structures of these molecules are based on implicated in all of them. Glucocorticoids are currently natural corticosteroids, but with changes to optimize local the most potent antiinflammatory drugs available. In antiinflammatory potency. For example, the molecule fact, glucocorticoids, whether administered systemically may be tailored to increase liposolubility to favor uptake or by inhalation, are the first-line drugs in the treatment by tissues t