Corticosteroids are widely used in medicine for the treatment of various diseases. Cortisone & hydrocortisone have acquired great importance for the treatment of severe rheumatic diseases, inflammatory processes, bronchial asthma and a number of other diseases. They have a strong anti-inflammatory and anti-allergic effect, work as an anti-shock, and exhibit an immunosuppressive effect (you can learn more about corticosteroids in the article on corticosteroid definition). You may ask a question: What is the key difference between them? First, let’s figure out what exactly each of them is.
Cortisone – definition and features
Cortisone is a hormone belonging to the class of steroids, along with estrogens and anabolics. Chemically it is a corticosteroid which is very similar to corticosterone. More precisely, it belongs to glucocorticosteroid group. Its artificial form is used to treat a wide variety of illnesses and can be taken intravenously, orally, and in the joints. The substance suppresses immunity (it is an immunosuppressant), thus reducing the inflammatory response, neutralizing painful sensations and swelling at the damaged site. However, its influences on the immune system can lead to several side effects, particularly when cortisone is used over a long period of time. The body produces corticosteroids, including cortisone, naturally in the cortex of the adrenal glands. The hormone affects the work of many systems of the body (cardiac, immune, muscle, bone as well as the endocrine and nervous systems). Cortisone, like hydrocortisone, has a large number of effects including influencing metabolism of carbs, proteins and fats. The substance helps maintain the balance of fluids and electrolytes.
What is hydrocortisone (cortisol)?
Cortisol (hydrocortisone) is a hormone of steroid nature secreted by the cells of the cortex, that is, the outer layer of the adrenal glands under the effect of adrenocorticotropic hormone synthesized by the pituitary gland. Its main functions are to increase the level of blood glucose through gluconeogenesis, suppress the immunity and help the metabolism of fatty acids, protein, and carbs. It takes an active part in the regulation of many biological processes taking place in the body:
- regulation of different types of metabolism (fat, protein, etc.);
- contraction of muscle fibers;
- decrease in the activity of inflammatory processes;
- inhibition of histamine activity and, due to this, a decrease in the severity of allergic reactions;
- formation of stress reactions.
Synthesis of cortisol implies a long chain of biochemical reactions. First, pregnenolone is formed from the fat-like cholesterol compound, which then turns into progesterone (both the former and the latter are sex hormones). On the basis of progesterone, corticosterone is formed, a low-activity glucocorticoid, which later develops into a more powerful and active form, cortisol.
Cortisol received the nickname “stress hormone” due to the formation of defensive responses to external threats and stressful situations. It increases heart rate, and raises arterial pressure. At the same time, cortisol keeps the vascular tone under control, preventing a critical change in blood pressure.
Cortisol has a very useful function: it serves as an internal “alarm” and helps people wake up in the morning. This hormone acts as a kind of signaling, which leads the body to alertness at risk and encourages a vigorous awakening every morning.
Common features and difference between cortisone and hydrocortisone
Cortisone and cortisol are not the same. Cortisol is the most abundant glucocorticoid in humans, while cortisone is less abundant, but is dominant in rodents. Both of them occur in the fascicular zone of the adrenal glands, but cortisone is produced, in addition in zona glomerulosa. The difference also lies in the fact that cortisone is the precursor molecule of aldosterone, a mineralocorticoid crucial for homeostatic modulators of sodium and potassium levels. Here is a list of common and distinctive features of cortisone and hydrocortisone.
- Both cortisone and hydrocortisone are corticosteroids and steroids.
- Cortisone and hydrocortisone are released in similar forms (steroid pills, steroid injections, and others). But cortisone is not active topically. People sometimes call hydrocortisone cream cortisone.
- In general, these hormones have similar functions in the body. They affect metabolism, regulate the level of stress, etc. Some people call both cortisol and cortisone the “stress hormone”.
- Hormones were discovered almost at the same time. Cortisol and cortisone were among the compounds discovered in the 1930’s by E. Kendall, T. Reichstein and P. Hench, who received the Nobel prize for their contribution to science in 1950.
- The main difference between cortisone and hydrocortisone lies in their chemical structure. In chemical structure, hydrocortisone differs from cortisone by the presence of hydroxyl and a hydrogen atom instead of oxygen at the carbon atom in position C (11).
- These hormones have different chemical names. In chemistry, cortisone is known as 17α,21-dihydroxypregn-4-ene-3,11,20-trione. Cortisol name is 11β, 17α, 21-Trihydroxypregn-4-ene-3,20-dione.
- These hormones have different chemical formulas. The chemical formula of hydrocortisone (cortisol) is C21H30O5. The chemical formula of cortisone is C21H28O5.
- These hormones have a different molar mass. The molar mass of hydrocortisone (cortisol) is 362.460 g / mol. The molar mass of cortisone is 360.45 g · mol-1.
- Hydrocortisone (cortisol) is an active substance in the aspect of glucocorticoid activity. Cortisone is a kind of precursor that can be converted into cortisol.
- Cortisol (hydrocortisone) has a shorter half-life than its “brother”. Cortisol’s half-life is around 100 min, while cortisone’s is several hours.
In general, the hormones (that is, their synthetic forms) have the similar side effects of steroids. These effects include Cushing’s syndrome, sodium and water retention in the body with development of edema, elevated blood sugar, aggravation of stomach ulcers (especially in case of combined use of corticosteroids and non-steroidal anti-inflammatory drugs) and much more. In patients, intraocular pressure may increase and, as a consequence, optic nerve disorders may occur. Trophic transformation of the cornea, exophthalmos, and cataract can also occur. In addition, there may be such possible side effects as an increased risk of developing eye viral, bacterial, or fungal infections (secondary). However, hydrocortisone is believed to be safer than cortisone.
Hydrocortisone vs cortisone – what is better?
Currently, in the pharmaceutical market, cortisone is gradually replaced by hydrocortisone, which has similar side effects. However, hydrocortisone is believed to be more effective in suppressing the inflammatory response. So, more than likely, in the hydrocortisone vs. cortisone battle, hydrocortisone (cortisol) will be the winner.