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The mechanism by which corticosteroids might induce GI bleeding or perforation has not been fully established, but corticosteroids may impair tissue repair, thus leading to delayed wound healing, decreased proliferation (if the tissue is already damaged), and increased tissue remodeling (if the tissue is not damaged). Corticosteroids may also contribute to the risk of peritoneal ulcers by increasing intraperitoneal hemorrhage , and may increase the incidence of gastric and bile duct and pancreatic adenomas . One mechanism by which corticosteroids may induce acute GI bleeding is via stimulation of platelet aggregation, which may increase pro-inflammatory cytokines such as interleukin-1α, interleukin-8, transforming growth factor-β1, pro-inflammatory cytokines (cytokine), and tumor necrosis factor-α [32–34]. However, the exact mechanisms of these associations are yet to be established, 2022 Mr. Olympia. Corticosteroids have long been implicated, alongwith several other classes (e.g. antiangiogenic compounds), in the development of asthma. Antihistamines act on epidermal growth factor receptors to inhibit the proliferation of astrocytes, thereby suppressing asthma exacerbations , and anti-thyroid hormone is a potent inhibitor of platelet aggregation, inhibiting the number to which platelets can aggregate. Therefore, anti-thyroid hormone may contribute to the development of asthma exacerbations by increasing the incidence of platelet aggregation , 2022 Mr. Olympia. Corticosteroid receptor agonists are widely used in childhood asthma therapy to prevent asthma exacerbations, anabolic-androgenic steroids and depression. The use of anti-thyroid hormone was initially observed to be associated with asthma exacerbations and subsequent treatment was discontinued because of increased incidence of asthma exacerbations . Corticosteroids decrease intestinal absorption of calcium, which is necessary during growth and early development of the intestine . These same mechanisms may decrease intestinal calcium absorption by promoting the calcification of intestinal tissue. The intestinal tissue calcification is the most frequent cause of calcium-deficiency anaemia and is caused by factors such as hyperparathyroidism as reflected by the occurrence in many of the pediatric patients with asthma (which also occurs by the genetic and environmental risk factors) , chronic inflammatory bowel disease (CIBD) , systemic sclerosis (SIDS) , and obesity , topical corticosteroids mechanism of action. Corticosteroids may also increase the level of a calcium-absorbing intestinal bacterium called Escherichia coli (E. coli) found in the small intestine, leading to the development of a number of infections.
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