Budesonide
Budesonide is a synthetic glucocorticoid with anti-inflammatory and immunomodulating properties. Upon administration, budesonide binds to intracellular glucocorticoid receptors (GRs) and induces the expression of glucocorticoid-responsive genes that encode for anti-inflammatory mediators, such as certain anti-inflammatory cytokines, including interleukin 10 (IL-10), and lipocortins. Lipocortins inhibit phospholipase A2, thereby blocking the release of arachidonic acid from membrane phospholipids and preventing the synthesis of prostaglandins and leukotrienes, both mediators of inflammation. In addition, budesonide prevents the release of pro-inflammatory cytokines from epithelial cells and macrophages, including interleukin 6 (IL-6), IL-8, interferon-beta (IFNb), and inhibits nuclear factor kappa-B (NF-kB) activation thereby decreasing NF-kB-mediated inflammation.