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KMID : 0614620050450020103
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Korean Journal of Gastroenterology
2005 Volume.45 No. 2 p.103 ~ p.110
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Clinical Usefulness of Glucocorticoid Receptor β Expression and NF-kB Activity in Patients with Ulcerative Colitis
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김규종/Kim KJ
명승재/홍성수/이윤정/이선미/변정식/양석균/홍원선/김진호/민영일/Myung SJ/Hong SS/Lee YJ/Lee SM/Byeon JS/Yang SK/Hong WS/Kim JH/Min JI
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Abstract
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Background/Aims: Glucocorticoid resistance poses a challenging clinical problem in inflammatory bowel disease because more than one fourth of patients with severe ulcerative colitis do not respond to anti-inflammatory steroids. Recently, it has been reported that glucocorticoid response is related to the expression of human glucocorticoid receptor β (hGRβ) and nuclear factor-kappa B (NF-κB) activity. The aims of this study were to clarify whether these factors may predict the responsiveness before treatment.
Methods: Total RNA was extracted from peripheral blood mononuclear cell (PBMC) and colonic mucosa in 17 patients of ulcerative colitis before steroid ministration. RNA was reverse transcribed and the resulting complementary DNA was amplified using
specific primers for hGR α and β. Concomitantly, NF-κB activity in colonic mucosa was assessed by immunohistochemical stain.
Results: The expression of hGR β mRNA was detected in 10 patients (58.8%) in PBMC and 8 patients (47.1%) in colon, respectively. Operations were performed in 5 patients due to steroid unresponsiveness. Only 5 of 17 patients (29.4%) were consistent in the expression of hGR β between PBMC and colon. Seven of 15 patients (46.7%) showed an alteration in the expression of hGR β in PBMC after glucocorticoid treatment. NF-κB activity was found in both epithelial cell and lamina propria in 12, epithelial cell alone in 1, lamina propria alone in 1 and all negative in 3 patients, respectively.
Conclusions: The expression of hGR β was discordant between PBMC and colon in the same patient and showed a change in the expession after the glucocorticoid treatment in nearly half. The expression of hGR β and colonic NF-κB activity patterns do not provide useful information about glucocorticoid response in patients with ulcerative colitis
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