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10.1001/jamanetworkopen.2024.13172 [DOI] [PMC free article] [PubMed] [Google Scholar] 40

Although cortisol itself has anti-inflammatory effects, prolonged high levels of cortisol may induce glucocorticoid resistance, which in turn downregulates GC receptor-mediated transcriptional activity, diminishing its anti-inflammatory efficacy and exacerbating the inflammatory response (120)