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目的探讨皮肌炎/多发性肌炎患者外周血单个核细胞糖皮质激素受体(GR)的变化意义及其机制。方法采用放射配基结合位点分析法与反转录聚合酶链反应(RT-PCR)方法检测36例皮肌炎/多发性肌炎治疗前后及30名正常对照组外周血单个核细胞糖皮质激素受体位点数及GR mRNA表达水平,同时采用放射免疫分析法检测患者血中糖皮质激素水平。结果皮肌炎/多发性肌炎患者血中糖皮质激素水平与正常对照组相比,差异无统计学意义(P>0.05);而糖皮质激素受体位点数[位点/细胞]及GR mRNA表达水平,较正常对照组降低,差异有统计学意义(P<0.01);治疗前糖皮质激素受体位点数[位点/细胞]及GR mRNA表达水平高者,治疗效果好,而治疗前糖皮质激素受体位点数[位点/细胞]及GR mRNA表达水平低者治疗效果差。结论皮肌炎/多发性肌炎患者糖皮质激素受体位点数及GR mRNA表达水平降低,糖皮质激素受体的变化不仅与皮肌炎/多发性肌炎的发病有关,还与治疗反应有关。皮肌炎/多发性肌炎患者糖皮质激素受体位点目的减少可能与GR mRNA表达水平降低有关。
Objective To investigate the significance of the changes of glucocorticoid receptor (GR) in peripheral blood mononuclear cells in patients with dermatomyositis / polymyositis and its mechanism. Methods Radio-ligand binding site analysis and reverse transcription-polymerase chain reaction (RT-PCR) were used to detect the levels of peripheral blood mononuclear cells in 36 cases of dermatomyositis / polymyositis and 30 normal controls Hormone receptor sites and GR mRNA expression levels, while using radioimmunoassay in patients with blood glucocorticoid levels. Results The levels of glucocorticoid in patients with dermatomyositis / polymyositis were not significantly different from those in controls (P> 0.05). However, the number of glucocorticoid receptor sites [sites / cells] and GR (P <0.01). Before treatment, the sites of glucocorticoid receptor [sites / cells] and GR mRNA expression were higher, and the treatment effect was better. However, the therapeutic effect was better than that of the normal control group Pre-glucocorticoid receptor loci [loci / cells] and GR mRNA expression is low, the treatment effect is poor. Conclusions Patients with dermatomyositis / polymyositis have lower glucocorticoid receptor loci and GR mRNA expression. The changes of glucocorticoid receptor are not only associated with the onset of dermatomyositis / polymyositis, but also with the response to treatment . A decrease in the purpose of glucocorticoid receptor sites in patients with dermatomyositis / polymyositis may be related to a decrease in GR mRNA expression.