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Cortisone

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cortisone (kôr`tĭsōn'), steroid hormone hormone, secretory substance carried from one gland or organ of the body via the bloodstream to more or less specific tissues, where it exerts some influence upon the metabolism of the target tissue.
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 whose main physiological effect is on carbohydrate metabolism. It is synthesized from cholesterol cholesterol , fatty lipid found in the body tissues and blood plasma of vertebrates; it is only sparingly soluble in water, but much more soluble in some organic solvents.
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 in the outer layer, or cortex, of the adrenal gland adrenal gland or suprarenal gland , endocrine gland (see endocrine system) about 2 in. (5.1 cm) long situated atop each kidney. The outer yellowish layer (cortex) of the adrenal gland secretes about 30 steroid hormones, the most important of
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 under the stimulation of adrenocorticotropic hormone adrenocorticotropic hormone , polypeptide hormone secreted by the anterior pituitary gland. Its chief function is to stimulate the cortex of the adrenal gland to secrete adrenocortical steroids, chief among them cortisone.
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 (ACTH). Cortisone is classed as a glucocorticoid with cortisol cortisol or hydrocortisone, steroid hormone that in humans is the major circulating hormone of the cortex, or outer layer, of the adrenal gland.
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 and corticosterone corticosterone , steroid hormone secreted by the outer layer, or cortex, of the adrenal gland. Classed as a glucocorticoid, corticosterone helps regulate the conversion of amino acids into carbohydrates and glycogen by the liver, and helps stimulate glycogen
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; its effects include increased glucose release from the liver, increased liver glycogen synthesis, and decreased utilization of glucose by the tissues. These actions tend to counter the effects of insulin insulin, hormone secreted by the β cells of the islets of Langerhans, specific groups of cells in the pancreas. Insufficiency of insulin in the body results in diabetes. Insulin was one of the first products to be manufactured using genetic engineering.
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 and may aggravate or mimic diabetes in sufficiently high doses. Cortisone also exerts an effect on salt retention in the kidneys similar to that of aldosterone aldosterone , steroid secreted by the cortex of the adrenal gland. It is the most potent hormone regulating the body's electrolyte balance. Aldosterone acts directly on the kidney to decrease the rate of sodium-ion excretion (with accompanying retention of water),
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, although it is not as potent. The hormone causes increased breakdown of proteins and decreased protein synthesis, and large doses given over a long period of time may result in inhibited growth in children or weakening of bones and wasting of muscles in adults. The principal medical use of cortisone comes from its anti-inflammatory and antiallergic effects; it is extremely useful in the treatment of innumerable diseases including asthma and other allergic reactions, arthritis, and various skin diseases. Cortisone is necessary to maintain life and enable the organism to respond to stress; failure of the adrenal glands to synthesize cortisone (Addison's disease) or surgical removal of the adrenals is fatal unless cortisone is given as replacement therapy. Although less cortisone is manufactured in the body than either cortisol or corticosterone and although cortisone is less potent than cortisol, the term cortisone is often used collectively to include the other glucocorticoids, both the naturally occurring and the synthetic compounds such as prednisone. Small quantities of cortisone were first isolated from animal adrenals in 1935–36. A method of manufacture, involving laboratory synthesis from an acid of bile bile, bitter alkaline fluid of a yellow, brown, or green color, secreted, in man, by the liver. Bile, or gall, is composed of water, bile acids and their salts, bile pigments, cholesterol, fatty acids, and inorganic salts.
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, was developed, and in 1949 cortisone was first offered commercially. The specific mechanisms by which cortisone and similar compounds act are still poorly understood.

cortisone

Steroid hormone produced by the adrenal cortex (see adrenal gland). It participates in the regulation of the conversion of proteins to carbohydrates, and to some extent it regulates salt metabolism. Introduced medically in 1948 for its anti-inflammatory effect to treat arthritis, it has been largely replaced by related compounds that do not produce its undesired side effects, which include edema, increased stomach acidity, and imbalances in sodium, potassium, and nitrogen metabolism. See also Cushing syndrome.


cortisone
a glucocorticoid hormone, the synthetic form of which has been used in treating rheumatoid arthritis, allergic and skin diseases, leukaemia, etc.; 17-hydroxy-11-dehydrocorticosterone. Formula: C21H28O5

cortisone [′kȯrd·ə‚sōn]
(biochemistry)
C21H28O5A steroid hormone produced by the adrenal cortex of vertebrates that acts principally in carbohydrate metabolism.

Cortisone 

C21H28O5, one of the active corticosteroids. Colorless crystals; melting point, 215°C; poorly soluble in organic solvents.

Cortisone is isolated from adrenal extracts. Its chemical structure was elucidated by the Swiss chemist T. Reichstein (1936–40) and confirmed by complete synthesis. In animals and man, cortisone is secreted in small quantities into the blood by the adrenals. Once regarded as an adrenocortical hormone, it is now considered a product of the conversion of hydrocortisone.

Cortisone is a glucocorticoid in its biological action: it stimulates the synthesis of carbohydrates from proteins, depresses the lymphoid organs, and has relatively little effect on mineral metabolism. Cortisone acetate is used as a hormonal preparation in substitution therapy for adrenocortical insufficiency and as an anti-inflammatory and antiallergic agent in rheumatic carditis, polyarthritis, and bronchial asthma. Cortisone has been almost completely replaced in modern medical practice by more effective synthetic corticosteroids. It is obtained industrially from steroids of plant and animal origin by complex chemical and microbiological conversions.

REFERENCES

Glynn, J. H. Kortizonoterapiia. Moscow, 1960. (Translated from English.)
Akhrem, A. A., and lu. A. Titov. Polnyi sintez steroidov. Moscow, 1967.

M. A. KREKHOVA



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