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I have stopped thinking about "single inflammation pathways." It seems more like an inflammation network that is tightly regulated by the body. There is a lot of action and reaction happening. My rheumatologist explains it with upstream and downstream regulation of one pro-inflammatory cytokine action and another anti-inflammatory cytokine reaction. Then there are some cytokines with both pro and anti inflammation effects. I will never understand this network but it seems like cortisol is the primary hormone that regulates inflammation.

Artificial intelligence seems to agree:

"That's an excellent way to describe the complexity of the immune system and the challenge of understanding it. Your rheumatologist's explanation captures the current understanding: a sophisticated network of signaling molecules (cytokines) that regulates inflammation, with cortisol acting as a key hormone to keep the system in check."
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In any case, prednisone seems to throw a wrench into the entire inflammation network system and disrupts everything the body does.

I like artificial intelligence because it is generally agreeable but it has no qualms about disagreeing. It expresses itself better than I can.

"Prednisone, a potent corticosteroid, acts broadly to suppress inflammation and the immune system, affecting numerous bodily functions and leading to widespread side effects. By mimicking the natural stress hormone cortisol, it throws a wrench into the body's entire regulatory network, not just the inflammatory response."
🤔

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Replies to "I have stopped thinking about "single inflammation pathways." It seems more like an inflammation network that..."

I suppose Actemra and Kevzara can also disrupt the inflammation network and immune system but hopefully not to the extent that Prednisone does. At least my rheumatologist thinks so and neither Actemra or Kevzara suppresses the production of cortisol by the adrenals.

According to artificial intelligence:
"The statement is accurate: Neither Actemra nor Kevzara directly suppresses the production of cortisol by the adrenal glands. Instead, they are interleukin-6 (IL-6) inhibitors that help reduce inflammation, which can allow patients to gradually reduce or stop their use of corticosteroids (like prednisone)."
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I just get a chuckle with some of this stuff. When I was on another PMR forum, a "self proclaimed" PMR expert who was "entitled to know" because of having PMR and taking Prednisone for a long time said "Actemra was dangerous" because of the potential side effects compared to prednisone and "cortisol had nothing to do with it." This person also said my rheumatologist was ignorant and was breaking the rules for prescribing Actemra to me.

It is hard to know what to believe. My rheumatologist was right to say I wouldn't know unless I tried Actemra to see if it works or not.