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Published ahead of print on December 30, 2005, doi:10.1164/rccm.200507-1046OC

Am. J. Respir. Crit. Care Med., Volume 173, Number 6, March 2006, 607-616

A more recent version of this article appeared on March 15, 2006
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Submitted on July 6, 2005
Accepted on December 22, 2005

Increased Glucocorticoid Receptor Beta Alters Steroid Response in Glucocorticoid Insensitive Asthma

Elena Goleva1, Ling-bo Li1, P. Taylor Eves2, Matthew J Strand3, Richard J Martin2, and Donald YM Leung4*

1 Department of Pediatrics, National Jewish Medical and Research Center, Denver, CO, USA, 2 Department of Medicine, National Jewish Medical and Research Center, Denver, CO, USA, 3 Division of Biostatistics, National Jewish Medical and Research Center, Denver, CO, USA, 4 Department of Pediatrics, National Jewish Medical and Research Center, Denver, CO, USA; Department of Pediatrics, University of Colorado Health Sciences Center, Denver, CO, USA

* To whom correspondence should be addressed. E-mail: leungd{at}njc.org.

Rationale: Glucocorticoids (GC) are highly effective in the treatment of asthma. However, a subset of astmatics are GC insensitive. Objectives: To evaluate functional response of bronchoalveolar lavage (BAL) cells from sites of airway inflammation from GC insensitive vs GC sensitive asthmatics to steroids. As well, attempt to define the functional role of glucocorticoid receptor (GCR){beta} (a splicing variant of the classic GCR{alpha} which functions as a dominant negative inhibitor of GCR{alpha}) in controlling GCR{alpha} nuclear translocation and transactivation at a molecular level. Methods and Measurements: Fiberoptic bronchoscopy with collection of BAL was performed on a group of 7 GC sensitive and 8 GC insensitive asthmatics. GCR{alpha} cellular shuttling in response to 10-6 M dexamethasone treatment and GCR{beta} expression was analyzed in BAL cells by immunofluorescent staining. The effects of overexpression and silencing of GCR{beta} mRNA on GCR{alpha} function was assessed. Main Results: Significantly reduced nuclear translocation of GCR{alpha} in response to steroids was found in BAL cells from GC insensitive asthmatics. BAL macrophages from GC insensitive asthmatics had significantly increased levels of cytoplasmic and nuclear GCR{beta}. It was demonstrated that GCR{alpha} nuclear translocation and its transactivation properties were proportionately reduced by level of viral transduction of the GCR{beta} gene into the D0-11.10 cell line. RNA silencing of GCR{beta} mRNA in human BAL macrophages from GC insensitive asthmatics resulted in enhanced dexamethasone-induced GCR{alpha} transactivation. Conclusions: GC insensitivity is associated with loss of GCR{alpha} nuclear translocation in BAL cells and elevated GCR{beta}, which may inhibit GCR{alpha} transactivation in response to steroids.


Key words: glucocorticoid receptor, glucocorticoid insensitivity, asthma, BAL cells




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