Opinion Review
Copyright ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Jul 26, 2022; 10(21): 7187-7194
Published online Jul 26, 2022. doi: 10.12998/wjcc.v10.i21.7187
Effects of glucocorticoids on leukocytes: Genomic and non-genomic mechanisms
Wan-Yu Jia, Jian-Jiang Zhang
Wan-Yu Jia, Jian-Jiang Zhang, Department of Pediatrics, The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, Henan Province, China
Wan-Yu Jia, Jian-Jiang Zhang, Clinical Center of Pediatric Nephrology of Henan Province, The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, Henan Province, China
Author contributions: Zhang JJ conceived the idea for the manuscript; Jia WY reviewed the literature and drafted the manuscript; all authors have accepted responsibility for the entire content of this manuscript and approved its submission.
Supported by Provinces Co-construction Program of Medical Science and Technique Foundation of Henan Province, No. SB201901042; and Key Scientific Research Project of Colleges and Universities in Henan Province, No. 21A320070.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Jian-Jiang Zhang, Doctor, MD, PhD, Chief Physician, Department of Pediatrics, The First Affiliated Hospital of Zhengzhou University, No. 1 Jianshe East Road, Erqi District, Zhengzhou 450052, Henan Province, China. zhangjianjiang1@hotmail.com
Received: December 24, 2021
Peer-review started: December 24, 2021
First decision: February 14, 2022
Revised: February 21, 2022
Accepted: June 3, 2022
Article in press: June 3, 2022
Published online: July 26, 2022
Processing time: 199 Days and 5.9 Hours
Abstract

Glucocorticoids (GCs) have been widely used as immunosuppressants and anti-inflammatory agents to treat a variety of autoimmune and inflammatory diseases, and they fully exert their anti-inflammatory and immune-regulating effects in the body. The effect of GCs on white blood cells is an important part of their action. GCs can cause changes in peripheral blood white blood cell counts by regulating the proliferation, differentiation, and apoptosis of white blood cells. Although the total number of white blood cells, neutrophil counts, lymphocytes, and eosinophils increases, the counts of basic granulocytes and macrophages decreases. In addition, GCs can regulate the activation and secretion of white blood cells, inhibit the secretion of a variety of pro-inflammatory cytokines, the expression of chemokines, and promote the production of anti-inflammatory cytokines. For patients on GC therapy, the effects of GCs on leukocytes were similar to the changes in peripheral blood caused by bacterial infections. Thus, we suggest that clinicians should be more cautious in assessing the presence of infection in children with long-term use of GCs and avoid overuse of antibiotics in the presence of elevated leukocytes. GCs work through genomic and non-genomic mechanisms in the human body, which are mediated by GC receptors. In recent years, studies have not fully clarified the mechanism of GCs, and further research on these mechanisms will help to develop new therapeutic strategies.

Keywords: Glucocorticoid; Leukocyte; Count; Functions; Glucocorticoid receptor

Core Tip: Glucocorticoids (GCs) increase peripheral blood neutrophil counts through genomic and non-genomic actions and reduce the numbers of lymphocytes, eosinophils, basophils, and monocytes. GCs also regulate cell activity and affect cells. The functions of adhesion, activation, secretion and differentiation inhibit the expression of proinflammatory factors and chemokines. The mechanisms of action of GCs include effects on intracellular transcription and protein expression, effects on mitochondria, physical and chemical interactions with biological membranes, and receptor-mediated interactions with signal proteins.