Pharmacodynamic model for joint exogenous and endogenous corticosteroid suppression of lymphocyte trafficking

J Pharmacokinet Biopharm. 1994 Dec;22(6):469-80. doi: 10.1007/BF02353790.

Abstract

The circadian pattern of the immune system correlates with that of circulating T-helper cells and inversely with cortisol concentrations. Corticosteroids, both endogenous and exogenous, cause lymphocyte dimunition in blood by retention of cells in the lymphatic circulation. A physiologic pharmacodynamic model was developed to describe changes in circulating lymphocytes as a function of both endogenous cortisol and methylprednisolone concentrations. The model was applied to T-helper and T-suppressor cell data collected from six asthmatic men during baseline, after single-dose, and after 6 days of 20 mg daily methylprednisolone. The model described all phases of the study well. Baseline circadian rhythm of lymphocytes was related to cortisol concentrations. Multiple-dosing of methylprednisolone caused apparent tolerance and decreased the sensitivity of lymphocytes to corticosteroids by 116% and markedly reduced endogenous cortisol concentrations. A 60% increase in circulating T-helper cells was observed which could be accounted for by dual changes in receptor sensitivity and endogenous cortisol.

Publication types

  • Clinical Trial
  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adrenal Cortex Hormones / pharmacology*
  • Adrenal Cortex Hormones / physiology*
  • Adult
  • Asthma / blood
  • CD4-CD8 Ratio
  • Circadian Rhythm / physiology
  • Glucocorticoids / pharmacology
  • Humans
  • Hydrocortisone / pharmacology
  • Lymphocyte Count / drug effects
  • Lymphocytes / drug effects*
  • Lymphocytes / physiology*
  • Male
  • Methylprednisolone / pharmacology
  • Models, Biological
  • T-Lymphocytes, Helper-Inducer / drug effects
  • T-Lymphocytes, Helper-Inducer / physiology

Substances

  • Adrenal Cortex Hormones
  • Glucocorticoids
  • Hydrocortisone
  • Methylprednisolone