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NFKB1 Glucocorticoid receptor Transcription factor AP-1 Glucocorticoid receptor Prostaglandin G/H synthase 2 Annexin A1 Cytosolic phospholipase A2 Annexin A1 ATP-binding cassette sub-family A member 1 Prostaglandin G/H synthase 1 Prostaglandin G/H synthase 2 Prostaglandin G/H synthase 1 Prostaglandin G/H synthase 2 Prostacyclin synthase Prostaglandin E synthase Prostaglandin- H2 D-isomerase Aldo-keto reductase family 1 member C3 Aldo-keto reductase family 1 member C3 Carbonyl reductase [NADPH] 1 Alkaline phosphatase, tissue- nonspecific isozyme Glucocorticoid receptor Glucocorticoid receptor Glucocorticoid receptor Heat shock protein HSP 90-alpha Heat shock 70 kDa protein 1A/1B Peptidyl-prolyl cis-trans isomerase FKBP4 Peptidyl-prolyl cis-trans isomerase FKBP4 Heat shock protein HSP 90-alpha Heat shock 70 kDa protein 1A/1B Thromboxane-A synthase Arachidonic acid Betamethasone Betamethasone Betamethasone Betamethasone phosphate Betamethasone phosphate Betamethasone phosphate O2 Prostaglandin G2 Prostaglandin H2 H2O Thromboxane A2 Prostaglandin I2 Prostaglandin E2 Prostaglandin D2 NADPH 11-Epi-PGF2a NADP Prostaglandin F2a NADPH NADP PC(18:0/20:4(5Z,8Z,11Z,14Z)) H2O LysoPC(18:0/0:0) Betamethasone Betamethasone Heme Heme Glutathione Betamethasone Betamethasone Acceptor Reduced acceptor Activator Protein 1 NF-kB C/EBP Prostaglandin Synthase G/H 2 Promoter Annexin-1 Linoleic Acid Metabolism Eicosanoids Calcium Heme Heme Heme Heme Glucocorticoid receptor-betamethasone complex binds to the promoter for Annexin-1 (A1) and upregulates the transcription of it. Glucocorticoid receptor-betamethasone complex inhibits transcription factors NF-kB and Activator Protein 1 (AP-1) from synthesizing prostaglandin G/H synthase 2 (COX-2). Lower concentrations of prostaglanding I2 reduces vasodilation so the swelling of inflammation decreases. Prostaglandin I2 is apart of the hyperalgesia response so it's decrease results in a reduced pain sensitivity. Lower concentrations of prostaglandin D2 decreases the activity of platelet aggregation as well as reducing vasodilation. Nucleus Lower concentrations of prostaglandin E2 have similar effects fo PGI2 as it's reduction decreases vasodilation and pain sensitivity. Lower concentrations of prostagladin F2a decreases the amount of bronchoconstriction allowing air to flow more easily. Betamethasone readily crosses the cell membrane since they are highly lipophillic. Cytosol Phospholipase A2 is inhibited by Annexin-1 as it binds to the Ca2+ which is needed by phospholipase A2 to function. This inhibition reduces the amount of arachidonic acid that is cleaved from phospholipids. Lower concentrations of prostaglandin G/H synthase 2 result in the synthesis of prostaglandin G2 and H2 to be reduced. The reduction lowers the amount of prostanoids being produced which have varying effects on decreasing inflammation and immune response. As betamethasone binds to the glucocorticoid receptor, the chaperone proteins fall off. Glucocorticoid receptor-betamethasone complex translocate into the nucleus. Thromboxane A2 is responsible for activation of new platelets as well as platelet aggravation. Decreased levels of thromboxane A2 will decrease levels of platelet activity. Endoplasmic Reticulum Prostaglandin G/H Synthase 2 exits the nucleus through nuclear pores into the cell cytosol. Human Cell Blood Vessel Liver Betamethasone phosphate is rapidly de-esterified in the liver to produce betamethasone (the active metabolite). Hepatocyte Muscle Blood Vessel