Editing Meconium aspiration syndrome (section)

==== Glucocorticoids ====
[[Glucocorticoid]]s have a strong anti-inflammatory activity and works to reduce the migration and activation of [[neutrophil]]s, [[eosinophil]]s, [[Monocyte|mononuclear]] cells, and other cells. They reduce the migration of neutrophils into the lungs ergo, decreasing their adherence to the [[endothelium]]. Thus, there is a reduction in the action of mediators released from these cells and therefore, a reduced inflammatory response.<ref name=":11">{{Cite journal|last1=Mokra|first1=D|last2=Mokry|first2=J|date=2011|title=Glucocorticoids in the Treatment of Neonatal Meconium Aspiration Syndrome|journal=Eur J Pediatr|volume=170|issue=12|pages=1495–1505|doi=10.1007/s00431-011-1453-2|pmc=3221844|pmid=21465122}}</ref><ref name=":7" />

Glucocorticoids also possess a genomic mechanism of action in which, once bound to a [[glucocorticoid receptor]], the activated complex moves into the [[Cell nucleus|nucleus]] and inhibits [[Transcription (biology)|transcription]] of [[Messenger RNA|mRNA]]. Ultimately, effecting whether various proteins get produced or not. Inhibiting the transcription of nuclear factor ([[NF-κB]]) and protein activator ([[AP-1 transcription factor|AP-1]]) attenuates the expression of pro-inflammatory cytokines ([[Interleukin-1 family|IL-1]], [[Interleukin 6|IL-6]], [[Interleukin 8|IL-8]] and [[Tumor necrosis factor superfamily|TNF]] etc.), enzymes ([[Phospholipase A2|PLA<sub>2</sub>]], [[Cyclooxygenase-2|COX-2]], [[Nitric oxide|iNOs]] etc.) and other biologically active substances.<ref name=":12">{{Cite journal|last1=Czock|first1=D|last2=Keller|first2=F|last3=Rasche|first3=FM|last4=Haussler|first4=U|date=2005|title=Pharmacokinetics and Pharmacodynamics of Systemically Administered Glucocorticoids|journal=Clinical Pharmacokinetics|volume=44|issue=1|pages=61–98|doi=10.2165/00003088-200544010-00003|pmid=15634032|s2cid=24458998}}</ref><ref name=":11" /><ref name=":7" /> The anti-inflammatory effect of glucocorticoids is also demonstrated by enhancing the activity of lipocortines which inhibit the activity of PLA<sub>2</sub> and therefore, decrease the production of [[arachidonic acid]] and mediators of [[lipoxygenase]] and [[cyclooxygenase]] pathways.<ref name=":11" />

[[Anti-inflammatory|Anti-inflammatories]] need to be administered as quickly as possible as the effect of these drugs can diminish even just an hour after meconium aspiration. For example, early administration of [[dexamethasone]] significantly enhanced [[gas exchange]], reduced ventilatory pressures, decreased the number of [[neutrophil]]s in the bronchoalveolar area, reduced [[Edema|oedema]] formation and oxidative lung injury.<ref name=":7" /> However, glucocorticoids may increase the risk of infection and this risk increases with the dose and duration of glucocorticoid treatment. Other issues can arise, such as aggravation of [[diabetes mellitus]], [[osteoporosis]], skin [[atrophy]] and [[growth retardation]] in children.<ref name=":12" />