cortisone

Cortisone is a naturally occurring glucocorticoid hormone produced by the adrenal cortex. In medical use, the term most often refers to cortisone acetate, a synthetic prodrug that is rapidly converted in the body to hydrocortisone (cortisol), the active glucocorticoid.

As an anti-inflammatory and immunosuppressant, cortisone compounds are used to treat a range of inflammatory and autoimmune conditions, including rheumatoid arthritis, dermatitis, asthma, allergic reactions, and certain ocular diseases. They can be administered orally, by injection, topically, or intravenously, depending on the condition and desired depth of effect. Cortisone therapies may be used for short courses to manage acute flares or, with caution, for longer-term management under medical supervision.

Pharmacologically, the beneficial effects arise from glucocorticoid receptor–mediated changes that reduce inflammatory mediators, suppress leukocyte migration, and inhibit phospholipase A2, thereby dampening the immune response. As a prodrug, cortisone is converted to cortisol in the liver and other tissues, where it exerts its active hormonal effects.

Common adverse effects accompany long-term systemic use and can include weight gain, osteoporosis, hyperglycemia, hypertension, increased susceptibility to infections, thinning of the skin, mood changes, and suppression of the hypothalamic-pituitary-adrenal axis. These risks necessitate careful dosing, monitoring, and avoidance of unnecessary prolonged use, especially in patients with diabetes, peptic ulcer disease, or cardiovascular risk factors.

Historically, cortisone was among the first glucocorticoids used therapeutically after its discovery in the mid-20th century, contributing to Nobel Prize–winning work by Hench, Kendall, and Reichstein.