Budesonide is a glucocorticoid with potent local anti-inflammatory effects. Budesonide enhances the stability of endothelial cells, smooth muscle cells, and lysosomal membranes, inhibits immune responses, and reduces antibody synthesis, thereby decreasing the release and activity of allergic mediators such as histamine. Budesonide is used in the treatment of bronchial asthma, asthmatic chronic bronchitis, allergic rhinitis, nasal polyps, Crohn's disease, and ulcerative colitis[1-4].
In vitro, Budesonide (1μM–25μM) was used to treat LS180 and Caco-2 intestinal cell lines for 48h–72h. Budesonide induced the expression of MDR1/P-gp in LS180 cells and down-regulated the expression of MDR1/P-gp in Caco-2 cells[5]. Budesonide (0.1–25μM) was co-treated with SARS-CoV-2 (MOI=0.1) in Vero E6 cells for 24 hours. Budesonide significantly reduced the viral titer in Vero E6 cells without affecting cell viability[6].
In vivo, Budesonide (10mg/kg/day) was administered daily via oral gavage to female C57BL/6 mice for 5 days. Budesonide significantly increased the mortality rate in Clostridium difficile-infected mice[7]. Budesonide (1mg) combined with Calcitriol (100ng) was administered daily via nebulized inhalation and intraperitoneal injection to asthmatic model BALB/c mice for 8 weeks. Budesonide and Calcitriol synergistically inhibited airway remodeling in asthmatic mice[8].
References:
[1] Olivas I, Cobreros M, Londoño MC, et al. Budesonide in the first line treatment of patients with autoimmune hepatitis. Gastroenterol Hepatol. 2022 Aug-Sep;45(7):561-570.
[2] Grossmann C, Scholz T, Rochel M, et al. Transactivation via the human glucocorticoid and mineralocorticoid receptor by therapeutically used steroids in CV-1 cells: a comparison of their glucocorticoid and mineralocorticoid properties. Eur J Endocrinol. 2004 Sep;151(3):397-406.
[3] Dong L, Zhu YH, Liu DX, et al. Intranasal Application of Budesonide Attenuates Lipopolysaccharide-Induced Acute Lung Injury by Suppressing Nucleotide-Binding Oligomerization Domain-Like Receptor Family, Pyrin Domain-Containing 3 Inflammasome Activation in Mice. J Immunol Res. 2019 Feb 27;2019:7264383.
[4] Pereira MA, Tao L, Liu Y, et al. Modulation by budesonide of DNA methylation and mRNA expression in mouse lung tumors. Int J Cancer. 2007 Mar 1;120(5):1150-3.
[5] Maier A, Zimmermann C, Beglinger C, et al. Effects of budesonide on P-glycoprotein expression in intestinal cell lines. Br J Pharmacol. 2007 Feb;150(3):361-8.
[6] Heinen N, Meister TL, Klöhn M, et al. Antiviral Effect of Budesonide against SARS-CoV-2. Viruses. 2021 Jul 20;13(7):1411.
[7] Lin Q, Li Z, Lu L, et al. Budesonide, an anti-inflammatory drug, exacerbate clostridioides difficile colitis in mice. Biomed Pharmacother. 2023 Nov;167:115489.
[8] Qian J, Xu Y, Yu Z. Budesonide and Calcitriol Synergistically Inhibit Airway Remodeling in Asthmatic Mice. Can Respir J. 2018 May 2;2018:5259240.
















