Liew Su-Yi, Akker Scott A, Guasti Leonardo, Pittaway James F H
Centre for Endocrinology, William Harvey Research Institute, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, Charterhouse Square, London, EC1M 6BQ, UK.
Curr Opin Endocr Metab Res. 2019 Oct;8:152-159. doi: 10.1016/j.coemr.2019.08.011. Epub 2019 Sep 4.
Since the original description of adrenal insufficiency by Thomas Addison in 1855, there has been an exponential growth in the understanding of adrenal gland biology and its role in the hypothalamic-pituitary-adrenal axis. Despite this, the mainstay of therapeutic glucocorticoid replacement for most clinicians has remained unchanged for nearly 50 years. More recently, there has been better recognition of the morbidity and mortality associated with current approaches and the challenges to tackle in reducing this and improving clinical outcomes. In this review, we have summarised the history of glucocorticoid replacement therapy from its nascence in the 1930s, through common practice and culminating in more recent glucocorticoid replacement strategies plus the potential of stem cell therapy in the future.
自1855年托马斯·艾迪生首次描述肾上腺功能不全以来，人们对肾上腺生物学及其在下丘脑-垂体-肾上腺轴中的作用的理解呈指数级增长。尽管如此，近50年来，大多数临床医生进行治疗性糖皮质激素替代的主要方法一直没有改变。最近，人们越来越认识到当前方法所带来的发病率和死亡率，以及在降低这些风险和改善临床结果方面所面临的挑战。在这篇综述中，我们总结了糖皮质激素替代疗法的历史，从20世纪30年代的诞生，到常见的治疗方法，再到最近的糖皮质激素替代策略，以及未来干细胞疗法的潜力。
