In many chronic inflammatory disorders, glucocorticoid (GC) insensitivity is a challenging clinical problem associated with life-threatening disease progression. The molecular basis of GC insensitivity, however, is unknown. Alternative splicing of the GC receptor (R) pre–messenger RNA generates a second GCR, termed GCR-β, which does not bind GCs but antagonizes the transactivating activity of the classic GCR, termed GCR-α. In the current study, we demonstrate that GC-insensitive asthma is associated with a significantly higher number of GCR-β–immunoreactive cells in peripheral blood than GC-sensitive asthmatics or normal controls. Furthermore, we show that patients with GC-insensitive asthma have cytokine-induced abnormalities in the DNA binding capability of the GCR. These abnormalities can be reproduced by transfection of cell lines with the GCR-β gene resulting in significant reduction of their GCR-α DNA binding capacity. We conclude that increased expression of GCR-β is cytokine inducible and may account for GC insensitivity in this common inflammatory condition.
Association of Glucocorticoid Insensitivity with Increased Expression of Glucocorticoid Receptor β
Address Correspondence to Dr. Donald Y.M. Leung, National Jewish Medical and Research Center, 1400 Jackson St., Denver, CO 80206. Phone: 303-398-1379; FAX: 303-270-2182; E-mail: [email protected]
Abbreviations used in this paper: EMSA, electromobility shift assay; FEV1, forced expiratory volume in one second; GC, glucocorticoid; GRE, glucorticoid response element; mRNA, messenger RNA.
Donald Y.M. Leung, Qutayba Hamid, Alessandra Vottero, Stanley J. Szefler, Wendy Surs, Eleanor Minshall, George P. Chrousos, Dwight J. Klemm; Association of Glucocorticoid Insensitivity with Increased Expression of Glucocorticoid Receptor β . J Exp Med 3 November 1997; 186 (9): 1567–1574. doi: https://doi.org/10.1084/jem.186.9.1567
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