Figure 3.

Unified model of glucocorticoid mediation of the immune response. Hypothetical timeline of the immune response to surgery in the presence (red) and absence (blue) of glucocorticoids as proposed by Cain and Cidowoski, based on the biphasic action of glucocorticoids. At low levels, glucocorticoids promote expression of innate immune genes and a rapid initial response to surgical injury. Postoperatively, the stress response and/or corticosteroid supplementation suppresses signalling and inflammation promoting resolution and restoration of homeostasis. When there is an absence or relative lack of glucocorticoid (adrenalectomy or antagonism), the initial response is delayed and the duration of the response is prolonged. Adapted with permission from reference [80].