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The glucocorticoid insensitivity syndrome

S W Lamberts1

  • 1Department of Medicine, Erasmus University, Rotterdam, The Netherlands.

Hormone Research
|January 1, 1996
PubMed

Insights

Genetic variations in glucocorticoid receptor genes cause hypersensitivity or resistance in some individuals. This explains varied responses to glucocorticosteroid therapy and guides personalized dosing for patients.

Area of Science:

  • Pharmacogenomics
  • Endocrinology
  • Immunology

Background:

  • Glucocorticosteroids are widely used but exhibit variable patient responses.
  • Individual sensitivity to glucocorticoids differs due to genetic factors.
  • Adverse effects and therapeutic resistance are common clinical challenges.

Purpose of the Study:

  • To investigate the prevalence of hereditary glucocorticoid receptor gene abnormalities.
  • To explain the heterogeneity in patient response to glucocorticosteroid therapy.
  • To differentiate between hereditary and acquired glucocorticoid resistance.

Main Methods:

  • Analysis of genetic variations in the glucocorticoid receptor gene.
  • Review of clinical data on patient responses to glucocorticosteroid treatment.
  • Examination of cytokine profiles at inflammation sites.

Main Results:

  • Hereditary gene abnormalities affect 6.6% (hypersensitive) and 2.3% (resistant) of the population.
  • Genetic variations explain differing side effect profiles and therapeutic efficacy.
  • Acquired resistance at inflammation sites, driven by cytokines, is common in rheumatoid arthritis and asthma.

Conclusions:

  • Genetic screening may predict safe glucocorticosteroid doses.
  • Acquired, localized resistance necessitates alternative immunosuppressive therapies.
  • Understanding glucocorticoid sensitivity is crucial for effective treatment strategies.

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