Relative Merits of the Adrenocortical Steroids

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Abstract
The importance of the corticosteroids in support of normal body function is well demonstrated. Many attempts to define the chief biochemical effect of these compounds have failed to establish a primary mechanism by which they act. There is also little available information concerning the biochemical role of these hormones in protection against stress or in production of anti-inflammatory effect. Despite these obvious voids in our knowledge concerning these important compounds, a considerable amount of information in regard to their relative merits has been accumulated. Requirements for normal or permissive replacement quantities in the unstressed adrenalectomized individual have been well established, as have been the increased requirements during stressful situations which are of a protective nature. The usefulness of large quantities in the therapy of a number of clinical disorders is also well established but has been limited by the harmful or pernicious effects of the corticosteroids. One of these effects, sodium retention, has been largely eliminated by chemical alterations in the cortisol molecule but attempts to separate other undesirable effects have not been successful. Evidence presently available does not exclude the possibility that permissive, protective, and pernicious effects of the corticosteroids represent quantitative effects on the same basic biochemical reactions.