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Mechanism of action of corticosteroids in oral lichen Planus

Mechanism of action of corticosteroids in oral lichen planus Corticosteroids block many abnormally activated inflammatory pathways and they have a very wide spectrum of anti inflammatory actions 24 They bind to glucocorticoid receptor GR which is localized to the cytoplasm of target cells The effect is produced on responsive cells by activating GR to regulate the transcription of certain target genes directly or indirectly 25 26 Activated GRs bind directly to several other activated transcription factors such as protein protein interaction This is the key mechanism by which corticosteroids switch off inflammatory genes 24 They also recruit histone deacetylase activity HDACs to the transcription sites causing decrease in inflammatory gene transcription 27 This also determines corticosteroid responsiveness Corticosteroids inhibit inflammation by inhibiting the synthesis of inflammatory proteins They increase the synthesis of anti inflammatory proteins like lipocortin 1 and 37 kDa They inhibit transcription and synthesis of many cytokines and chemokines such as 1L 1 beta and TNF alpha which also causes reduction in adhesion molecules too Steroids reduce the survival of certain inflammatory cells kike eosinophils and have direct inhibitory actions on several inflammatory cells like macrophages eosinophils T cells Mast cells and epithelial cells 24

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