Ⅰ型AIH患者GRα、β mRNA的表达与糖皮质激素疗效的相关性

Relationship between the expression of glucocorticoid receptor α and β mRNA in patients with typeⅠautoimmune hepatitis and the glucocorticoid therapeutic efficacy

目的探讨Ⅰ型自身免疫性肝炎(AIH)患者外周血单个核细胞(PBMC)内糖皮质激素受体(GR)两种亚型GRα、GRβmRNA的表达与糖皮质激素(GC)治疗效应之间的关系。方法应用逆转录—聚合酶链反应法检测不同激素效应(激素敏感、激素亚敏感、激素抵抗)的Ⅰ型AIH患者及正常对照者的GRα、GRβmRNA的表达水平。结果Ⅰ型AIH患者及正常对照者均可检测到GRαmRNA,与正常对照相比,激素敏感、激素亚敏感、激素抵抗者的GRαmRNA的表达无统计学差异(P>0.05);GRβmRNA在激素抵抗组中高于其他各组(P<0.01)。结论Ⅰ型AIH患者GRβmRNA的表达增多可能与GC治疗抵抗有关。

Objective To study the relationship between glucocorticoid receptors（GR） and response to glucocortieoid in peripheral blood mononuclear cells （PBMCs） of patients with type Ⅰ autoimmune hepatitis. Methods The expression of glucocorticoid recptor-alpha and beta （GRcxand GRβ）mRNA from different hormone-responsive patients with type Ⅰ autoimmune hepatitis （ hormone-sensitive, hormone-subsensitive and hormone-resistant） and normal controls, were detected by reverse transcription polymerase chain reaction （RT-PCR）. Results GRαmRNA was detected in all patients with type Ⅰ autoimmune hepatitis and all normal controls, no significant differences of the expression of GRα mRNA in peripheral blood mononuclear cells（PBMCs） were observed among hormone-sensitive patients, hormone-subsensitive patients, hormone-resistant patients and normol controls（P 〉 0.05）. In contrast , in hormone-resistant patients, the expression of GRβ mRNA in peripheral blood mononuclear cells was significaintly higher than that of the others（P 〈 0.01 ）. Conclusions The phenomenon of hormone-resistant in some patients with type Ⅰ autoimmune hepatitis might be related to the increased expression of GRβ mRNA in PBMCs.