The role of tissue specific metabolism of endogenous glucocorticoids (GCs) in the pathogenesis of human disease has been a field of intense interest over the last 20 years, fuelling clinical trials of metabolism inhibitors in the treatment of an array of metabolic diseases. Localised pre-receptor metabolism of endogenous and therapeutic GCs by the 11β-hydroxysteroid dehydrogenase (11β-HSD) enzymes (which interconvert endogenous GCs between their inactive and active forms) are increasingly recognised as being critical in mediating both their positive and negative actions on bone homeostasis. In this review we explore the roles of endogenous and therapeutic GC metabolism by the 11β-HSD enzymes in the context of bone metabolism and bone cell function, and consider future strategies aimed at modulating this system in order to manage and treat various bone diseases.

中文翻译：

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骨骼中的内源性糖皮质激素代谢：朋友还是敌人。

过去 20 年来，内源性糖皮质激素 (GCs) 的组织特异性代谢在人类疾病发病机制中的作用一直是一个备受关注的领域，推动了代谢抑制剂在一系列代谢疾病治疗中的临床试验。11β-羟基类固醇脱氢酶 (11β-HSD) 对内源性和治疗性 GC 的局部前受体代谢（内源性 GC 在其非活性和活性形式之间相互转化）越来越被认为是介导它们对骨骼的积极和消极作用的关键稳态。在这篇综述中，我们探讨了 11β-HSD 酶在骨代谢和骨细胞功能方面的内源性和治疗性 GC 代谢的作用，