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目的探讨糖皮质激素受体(GR)亚型GRα、GRβ在皮肌炎/多肌炎(DM/PM)患者发病及对糖皮质激素治疗反应不同的分子机制。方法采用反转录聚合酶链反应(RT-PCR)方法检测36例DM/PM患者(其中激素敏感组24例、激素抵抗组12例)外周血单个核细胞(PBMCs)内GRα与GRβmRNA表达水平的变化。结果与正常对照组相比,DM/PM患者GRαmRNA的表达水平均降低,差异有统计学意义(P<0.05);GRβmRNA在激素抵抗组中表达明显增高,差异有统计学意义(P<0.01);而在激素敏感组中表达无统计学意义(P>0.05)。结论DM/PM患者GRα、GRβmRNA表达水平的变化,导致GRα与GRβ比例失调,使组织细胞对激素的敏感性降低。因此,导致DM/PM患者对糖皮质激素治疗反应不同,DM/PM患者出现激素抵抗可能与GRβmRNA表达水平增高有关。
Objective To explore the molecular mechanism of the different incidence of glucocorticoid receptor (GR) subtypes GRα and GRβ in patients with dermatomyositis / polymyositis (DM / PM) and their response to glucocorticoid therapy. Methods The expression of GRα and GRβ mRNA in peripheral blood mononuclear cells (PBMCs) from 36 patients with DM / PM (24 in hormone sensitive group and 12 in hormone resistant group) were detected by reverse transcriptase polymerase chain reaction (RT-PCR) The change. Results The expression of GRα mRNA in DM / PM patients was significantly lower than that in normal controls (P <0.05). The expression of GRβ mRNA in Hormone resistance group was significantly higher than that in normal controls (P <0.01) ; While in hormone-sensitive group, there was no statistical significance (P> 0.05). Conclusion The changes of GRα and GRβmRNA expression in DM / PM patients lead to the imbalance of GRα and GRβ, which leads to the decrease of hormone sensitivity to cells. Therefore, DM / PM patients respond differently to glucocorticoid therapy, and hormone resistance in DM / PM patients may be related to the increased expression of GRβmRNA.