[Studies on the glucocorticoid receptor in human peripheral lymphocytes. III. Correlation between receptor number and...

Although the clinical response to glucocorticoid (GC) therapy varied considerably from patient to patient, it is not known how to predict the responsiveness of each patient. In the present study, it was evaluated whether the responsiveness to GC in an individual patient was predictable by the GC receptor number. GC receptor number in human peripheral lymphocytes was measured by whole cell binding assay using tritiated dexamethasone as a ligand. There was a significant negative correlation between receptor number and dose of GC being given to the patient (down-regulation). The relative receptor number was expressed as a percentage of the receptor number to the mean of the receptor number in the group of patients stratified by every 10mg/day of the dosage of prednisolone. This relative receptor number was constant in an individual subject regardless of GC dosage. In 12 patients with lupus nephritis who had a high receptor number (more than 100%), 9 patients (83%) showed improvement in their urinary findings after GC treatment. On the other hand, only 3 of 11 lupus nephritis patients with a low receptor number (less than 100%) showed improvement after GC therapy. In patients with various collagen diseases treated with 40-60 mg/day of prednisolone, there were significant correlations between receptor number and each of % creatinuria, total cholesterol in serum, and fasting urinary calcium excretion, which were known to be affected by GC administration. Thus, the relative receptor number in lymphocytes was well correlated with both therapeutic and metabolic effects of GC in vivo.(ABSTRACT TRUNCATED AT 250 WORDS)