Expression Of Glucocorticoid Receptor Beta (GCR Β) In Asthmatic Patients And Its Correlation With Clinical Severity And Pulmonary Functions

N e w Y o r k S c i e n c e J o u r n a l 2 0 1 0 ; 3 Expression Of Glucocorticoid Receptor Beta (GCR Β) In Asthmatic Patients And Its Correlation With Clinical Severity And Pulmonary Functions Engy Yousry Elsayed , Enas M Foda, khaled AH Mohammed, Hassan Shalaby, Amal Z. Abd El-Halem* and Eman Ramzy** Internal Medicine, Clinical Pathology* and Chest** Departments Faculty Of Medicine, Ain Shams University, cairo, Egypt. [email protected] ABSTRACT Background: Glucocorticoids are the gold standard treatment of bronchial asthma. Although the majority of patients with asthma respond favorably to inhaled and systemic steroid therapy, a subset of asthmatics failed to demonstrate a satisfactory response even to systemic glucocorticoid therapy. GCR β (glucocorticoid receptor beta) is a hormone binding deficit isoform of GCR (glucocorticoid receptor) which has been isolated in humans and when over expressed, it may function as a dominant negative modulator of GCR. Aim of the work: This study was designed to determine the percentage of expression of GCRβ on PBMCs: (peripheral blood mononuclear cells )of asthmatic patients and to correlate it with the clinical severity and pulmonary functions. Subjects and Methods: 60 asthmatic patients (41 males, 19 females) and 20 healthy controls were enrolled in this study. Asthmatics were classified according to GINA guidelines (2002) into mild, moderate and severe asthma. They were subdivided into asthmatic on inhaled corticosteroid (ICS) (n=35) and those not on ICS (n=25). For all studied groups, spirometeric pulmonary functions and immunohisto-chemistry staining of PBMC S were performed to analyze percentage of expression of GCRβ on PBMCs. Results: It showed that the percentage of expression of GCRβ on PBMC S were statistically higher in all asthmatic patient groups compared to control, with higher % of expression in those not on ICS. Also a statistical significant higher % of expression of GCR β in severe asthmatics compared to both mild and moderate groups was detected. In conclusion: This study highlights the importance of glucocorticoid receptor beta isoform in pathogenesis of bronchial asthma and this may be directly linked to asthma severity and can affect the response to medications especially ICS