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Hydrocortisone is also a potent inhibitor of HA synthesis in fibroblasts. HA synthase 2 is the predominant synthase of dermal fibroblasts, of the three HA synthase genes. Glucocorticoids induces a rapid and near total suppression of HA synthase 2 mRNA levels. The inhibition of HA deposition thus appears to occur at the transcriptional level. Progesterone inhibits HA synthesis in fibroblasts cultured from the human uterine cervix (194). The steroid effect on HA appears to be system-wide.

Edema is one of the four cardinal signs of acute inflammation. The ability of glucocorticoids to suppress inflammation occurs in part by their ability to suppress the deposition of HA, the primary mechanism of edematous swelling of the inflammatory response.

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