Anti-inflammatory  drugs  such  as dexamethasone can have harmful side effects on the skin, 

bones and metabolism. Structural biology research from Emory University School of Medicine 

has implications for the long-standing quest to separate these drugs' benefits from their side 

effects.

The findings were recently published in Nature Communications.

Dexamethasone is a synthetic glucocorticoid hormone, used to treat conditions such as allergi

es,  asthma,  autoimmune  diseases  and  cancer.  It  mimics the action of the natural hormone 

cortisol. Both cortisol and synthetic hormones act by binding the glucocorticoid receptor (GR) 

protein.

GR can bind DNA in two modes. At some sites, it pairs up or "dimerizes" – turning genes on. A

t others, it binds one at a time, turning genes off. For GR-targeting drugs, the side effects are 

thought to come from turning on genes involved in  processes such as metabolism and bone 

growth, while  the  desired  anti-inflammatory  effects  result mainly from turning inflammatory 

and immune system genes off.