Ciclesonide

Ciclesonide is an inhaled corticosteroid. After inhalation, ciclesonide is converted within airway epithelial cells by carboxylesterase into the active metabolite des-ciclesonide. This metabolite binds to the intracellular glucocorticoid receptor (GR) and regulates the transcription of multiple genes, promoting the expression of anti-inflammatory genes such as annexin A1, IL-10, and IκB-α, while suppressing the expression of inflammatory genes such as IL-4, IL-5, IL-13, and TNF-α.