Methylprednisolone
Methylprednisolone is a synthetic corticosteroid with inflammatory and
immunomodulating properties which could be beneficial in reducing the
massive inflammatory response that SARS-CoV-2 induces. It binds to and
activates specific nuclear receptors which have α and β isoforms. The
complex formed binds to specific glucocorticoid response elements (GREs)
resulting in altered gene expression and inhibition of pro-inflammatory
and cytokine production. This agent also decreases the number of
circulating lymphocytes, induces cell differentiation and stimulates
apoptosis in sensitive tumour cell populations thereby increasing
survival and accumulation of neutrophils at inflammatory sites as well
as induction of basophil apoptosis (Ferrara et al., 2009; Williams,
2018; Ponticelli & Locatelli, 2018).
The clinical indications include scleroderma, ulcerative colitis,
asthma, vitiligo, autoimmune cytopenia and nephritic syndrome.
The adverse effects are cataract, glaucoma, hypertension, pancreatitis,
myopathy, osteoporosis, psychosis, hyperglycaemia, hypocalcaemia,
metabolic acidosis and secondary adrenal insufficiency (Wang, Y et al.,
2020; Zhou et al., 2020).