Glucocorticoids influence a wide array of metabolic, anti-inflammatory, immunosuppressive, and cognitive signaling processes, playing an important role in homeostasis and preservation of normal organ function. Synthesis is regulated by the hypothalamic-pituitary-adrenal (HPA) axis of which cortisol is the primary glucocorticoid in humans. Synthetic glucocorticoids are important pharmacological agents that augment the anti-inflammatory and immunosuppressive properties of endogenous cortisol and are widely used for the treatment of asthma, Crohn's disease, and rheumatoid arthritis, amongst other chronic conditions. The homeostatic activity of cortisol is disrupted by the administration of synthetic glucocorticoids and so there is interest in developing treatment options that minimize HPA axis disturbance while maintaining the pharmacological effects. Studies suggest that optimizing drug administration time can achieve this goal. The present review provides an overview of endogenous glucocorticoid activity and recent advances in treatment options that have further improved patient safety and efficacy with an emphasis on chronopharmacology.

中文翻译：

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糖皮质激素的时间药理学。

糖皮质激素影响广泛的代谢，抗炎，免疫抑制和认知信号传导过程，在体内稳态和维持正常器官功能中起重要作用。合成受下丘脑-垂体-肾上腺（HPA）轴的调节，其中皮质醇是人类主要的糖皮质激素。合成的糖皮质激素是重要的药物，可增强内源性皮质醇的抗炎和免疫抑制特性，广泛用于治疗哮喘，克罗恩病和类风湿性关节炎等慢性病。皮质糖皮质激素的给药破坏了皮质醇的体内平衡活性，因此，人们对开发在保持药理作用的同时将HPA轴干扰减至最小的治疗选择感兴趣。研究表明，优化药物给药时间可以实现这一目标。本综述概述了内源性糖皮质激素的活性和治疗选择的最新进展，这些进展已进一步改善了患者的安全性和疗效，并着重于时变药理学。