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Corticosteroid resistance and disease

R DeRijk1, E M Sternberg

  • 1Leiden/Amsterdam Centre for Drug Research, Leiden University, the Netherlands.

Annals of Medicine
|February 1, 1997
PubMed
Summary
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Individual differences in glucocorticoid sensitivity are common and dynamic, impacting treatment efficacy and side effects. This variability in glucocorticoid receptor (GR) function may contribute to diseases like depression and autoimmune disorders.

Area of Science:

  • Endocrinology
  • Molecular Biology
  • Immunology

Background:

  • Glucocorticoid treatment efficacy and side effects vary unpredictably in patients.
  • Individual sensitivity to glucocorticoids is a proposed explanation for this variability.

Purpose of the Study:

  • To review evidence supporting the hypothesis that individual glucocorticoid sensitivity underlies treatment unpredictability.
  • To explore the role of glucocorticoid resistance in disease pathogenesis and genetic variations in the glucocorticoid receptor (GR).

Main Methods:

  • Literature review of existing evidence on glucocorticoid sensitivity and resistance.
  • Analysis of genetic research on mutations in the glucocorticoid receptor (GR) gene and protein.

Main Results:

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  • Glucocorticoid sensitivity is more dynamic and prevalent than previously assumed.
  • Acquired, tissue-specific glucocorticoid resistance may contribute to depression, autoimmune disorders, and AIDS.
  • Mutations in the GR gene and protein are linked to leukemia, hereditary glucocorticoid resistance, and Nelson's syndrome.

Conclusions:

  • Variations in glucocorticoid receptor (GR) function and resistance are central to numerous diseases.
  • Understanding individual glucocorticoid sensitivity is crucial for optimizing clinical treatment and disease management.