多发性肌炎/皮肌炎患者糖皮质激素治疗前后其受体的改变及意义

The Study of the Change of Glucocorticoid Receptor in Peripheral Leukocytes from Patients with Polymyositis/Dermatomyositis

为了探讨多发性肌炎 /皮肌炎 (PM/DM )患者外周血白细胞糖皮质激素受体 (GCR )的变化与意义及应用糖皮质激素(GC)疗效的关系 ,应用放射配体结合法 ,以3H标记地塞米松 ( 3H Dex)为配体 ,测定 2 4例PM/DM患者应用激素治疗前后白细胞GCR的变化 ,同时采用放射免疫分析法测定血浆皮质醇浓度。结果表明PM/DM患者应用GC治疗前其GCR特异结合量 ( 3 673± 1195位点 /细胞 )低于正常对照组 ( 4 966± 12 10位点 /细胞 ) ,有显著性差异 (P <0 0 1)。应用GC治疗后 ,激素抵抗组其GCR降低幅度 ( 85 9± 10 8位点 /细胞 )高于激素敏感组降低幅度 ( 62 6± 12 7位点 /细胞 ) ,差异有显著性 (P <0 0 0 1)。PM/DM患者应用GC治疗前后其GCR水平与相对应的血浆皮质醇浓度之间 ,无相关性 (P >0 0 5 )。提示PM/DM患者外周血白细胞GCR水平的变化与PM/DM的发病机制、应用GC治疗的疗效判定、预测预后等可能有密切关系 。

To investigate the change of glucocorticoid receptor (GCR) in peripheral leukocytes from patients with polymyositis/dermatomyositis (PM/DM),GCR levels in peripheral leukocytes were measured by the radio ligand binding assay using 3H Dexamethasone as the ligand The concentration of plasma cortisol was determined by the radio immuno assay It was found that the binding capacity of GCR,from patients with PM/DM before receiving GC,was much lower than that in normal subjects ( P <0 01) After treatment with GC,16 patients with steroid sensitive (SS) and 8 with steroid resistant (SR) were found to have decreased GCR level The GCR decreasing range of SR'patients was more than that of SS's ( P <0 001) The concentrations of plasma cortisol in PM/DM patients were within the range There seems to be no relationship between the number of GCR and the concentration of plasma cortisol in PM/DM patients The results showed that the change of GCR levels in leukocytes of PM/DM patients might have close relation to its mechanism and clinic therapy,but the significance of GCR in PM/DM patients complicated with malignancies remains to be studied