| Objective:To explore the relationship between glucocorticoid efficacy and expression of glucocorticoid receptor(GR) aandβmRNA in peripheral blood white cell of patients with general and ocular myasthenia gravis(MG). Methods:First part: Real-time quantitative reverse transcription-polymerase chain reaction(real-time quantitative RT-PCR) was used to quantite the expression of GRaandβmRNA in peripheral blood white cells of 43 MG patients, all of which had been given GC treatment (target dosasge less than 1mg/kg.d).18 cases of general MG patients were sensitive to GC, and 10 cases of general MG patients were resistant to GC.10 cases of ocular MG patients were sensitive to GC and 5 cases of ocular MG patients were resistant to GC. Second part:We also used real-time quantitative RT-PCR to quantite the expression of GRαandβmRNA in peripheral blood white cells of 5 cases with ocular MG patients resistant to GC before and after accepting large dosage infusion of GC. Result:The expression of GRαmRNA in general and ocular MG patients sensitive to GC were higher than those in normal controls, also significantly higher than those in MG patients resistant to GC. There was no significant difference in the expression of GRβmRNA among general and ocular MG patients and the normal control. However, a significant higher expression of GRαand a lower expression of GRPmRNA was noticed in ocular MG patients after large dosage of GC treatment. Conclusion:The higher expression of GRαmRNA in general and ocular MG patients may be related to thier sensitivity to GC therapy. However, the relation between GRβmRNA expression and GC resistency is not clarified in our MG patients. In addition, high dosage of GC infusion can improve the syptoms and signs of GCresistant ocular MG patients. The possible mechanism is due to increasing sensitivity to GC induced by up-regulated GRαmRNA expression and down-regulated GRβmRNA expression.
|
PDF Full Text Request