Kennedy Institute of Rheumatology, Imperial College London
Doi
Abstract
Glucocorticoids (GCs) have been used for decades in the treatment of chronic inflammatory
and autoimmune diseases, thanks to their powerful anti‐inflammatory properties. However,
long term treatment can lead to deleterious side effects, and some patients also experience
resistance to their therapeutic effects.
GCs act through the glucocorticoid receptor (GR) to regulate transcription both positively
and negatively. Negative regulation of transcription involves a process known as
transrepression, in which ligand‐activated GR impairs transcriptional activation by nuclear
factor κB (NF‐κB) and other transcription factors. It is widely believed that transrepression
accounts for most of the anti‐inflammatory effects of GCs, whereas the activation of
transcription (transactivation) is responsible for most side effects of GCs. Based on this
principle, several pharmaceutical companies are trying to identify selective GR modulators
(SGRMs) that preferentially induce transrepression rather than transactivation. Such
compounds are predicted to retain the anti‐inflammatory properties of classical GCs but
cause fewer side effects.
There are several problems with a dogma that equates anti‐inflammatory effects of GR with
transcriptional repression. One is that GCs have long been known to destabilise many pro-inflammatory
mRNAs, and this property is not explained by the transrepression model.
Another issue is that GCs induce the expression of many factors with powerful anti-inflammatory
effects. One of these is dual specificity phosphatase 1 (DUSP1), an enzyme
that dephosphorylates and inactivates mitogen‐activated protein kinases. Studies of the
Dusp1‐/‐ mouse have underlined the importance of the phosphatase in the antiinflammatory
response to GCs.
In this work, I investigated the role of DUSP1 in (1) the post‐transcriptional regulation of
pro‐inflammatory mRNA stability by GCs and (2) the anti‐inflammatory actions of SGRMs.
1‐ The classical dexamethasone (dex) was shown to upregulate DUSP1 in mouse
macrophages, and to inhibit the expression of cyclooxygenase 2 (COX‐2) in a manner
that was partially dependent on DUSP1. Dex destabilised COX‐2 and interleukin 1α
mRNAs, and this post‐transcriptional effect appeared to require DUSP1.
2‐ Two SGRMs were characterised and shown to preferentially mediate transrepression
rather than transactivation. However, they were capable of inducing the expression
of DUSP1 in several different cellular systems, and their capacity to inhibit the
expression of COX‐2 was correlated with DUSP1 induction. Finally, several of the
anti‐inflammatory effects of the SGRMs were found significantly impaired in mouse
macrophages lacking DUSP1