Messenger RNA Expression Of Glucocorticoid Receptors And Cytokine Receptors From Peripheral Blood Mononuclear Cells In Patients With Pemphigus Vulgaris

Pemphigus is an autoimmune bullous disease associated with high morbidity as well as a significant mortality rate. Systemic glucocorticoid(GC), with or without the addition of immunosuppressive agents, constitute the mainstay of therapy. However, the adverse effects associated with prolonged administration of the high doses of GC that are often needed to control the disease are severe, even potentially fatal. Most deaths are now related to GC adverse effects. The response to GC is different among pemphigus patients, a subset of them are GC resistant. It is important to recognize these patients early because failure to GC therapy often leads to long course of very high doses of GC therapy and consequent adverse effects.It has been clearly demonstrated that autoantibodies play a key role in the pathogenesis of pemphigus. Deposition of intercellular IgG antibodies, howerer, is not limited to diseased skin. Hence, mechanisms other than antibody deposition appear to be also important in blister formation in pemphigus. Cytokines have not been extensively studied in pemphigus, howerer, evidence for a role of cytokines in the pathogenesis of pemphigus has been shown by several authors. Till now, there have no reports about the expression of cytokine receptors in pemphigus patients except soluble IL-2 receptor (IL-2R) .This study was divided into two parts.Part I: Expression of glucocorticoid receptors mRNA in peripheral blood mononuclear cells from patients with pemphigus vulgaris.Objectives To clarify whether reverse-transcription polymerase chain reaction (RT-PCR) analysis of glucocorticoid receptors (GR) mRNA can predict the response to GC in patients with pemphigus vulgaris.Methods RT-PCR method was applied to determine the expression of GRa mRNA and GRβ mRNA in PBMCs from 37 patients with pemphigus vulgaris (PV) and 30 healthy volunteers.Results GRa mRNA was detected in all patients and all healthy controls, and the level of GRa mRNA in patients was significantly lower than that in healthy controls...