Relationship Between Glucocorticoid Receptor And Chinese Medicine Syndrome In Rheumatoid Arthritis

BackgroundRheumatoid arthritis (RA) is a systemic autoimmune disease. The basic pathological change is the vasculitis and the synovitis, finally may cause the cartilage and the bone tissue destruction. The disease incidence rate of RA in China is 0.26%-0.5%, it may occur in any age, the morbidity peak in 45-50 years old. The cause and the pathogenesis are not yet clear about.Glucocorticoid (GC) is a very important drug to treat RA. Its anti-inflammatory/immunosuppressive actions can relieve clinical symptoms and decrease the rate of erosive progression of the disease. GC's actions is mediated by an intracellular receptor called glucocorticoid receptor (GR). GR has two subtypes, GR a and GRβ. GR a is the classical GR which mediates most GC actions; GRβcan not mediate GC actions and can suppress the action of GR a, so it may related to cortico resistant. But some patients of Chinese Medicine Syndrome does not respond to GC therapy. It indicated that glucocorticoid receptor of different Chinese Medicine Syndrome in RA possibly has the difference.ObjectiveTo detect the expression of GR a and GRβprotein in peripheral blood mononuclear cells(PBMC) in the patients with dampness-heat blockage type and stasis accumulation type of RA,healthy control cases,respectively, to investigate the relationship between the expression of GR a and GRβof RA patients and Chinese Medicine Syndrome, to explore the role of GR in the pathogenesis and progression of RA, to reveal the relationship between the expression of GR a and GRβprotein and the dosage of glucocorticoid.MethodsWe selected 60 patients with rheumatoid arthritis,20 Healthy volunteers from the south hospitol. According to respective inclusive and exclusive standards, RA patients were devided into two groups:30 patients with dampness-heat blockage type of RA,30 patients with stasis accumulation type of RA. The expression of GR a and Grβprotein in PBMC was detected by Western Blotting in RA patients and Healthy volunteers.ResultsThe expression of GR a and GRβprotein in RA were higher than that of control group (P<0.001). Dampness-heat blockage type of RA was higher than that of control group (P<0.001), so as stasis accumulation type (P<0.001). Dampness-heat blockage type of RA was higher than that of stasis accumulation type of RA (P <0.001).The ratio of GRαand GR P of Dampness-heat blockage type of RA was higher than that of stasis accumulation type of RA (P<0.001).ConclusionsGR a and GRβmay be involved in the pathogenesis and development of RA. GR a is related to sensitive of glucocorticoid; GRβmay be associated with cortico resistant. The expression of GR a and GR P protein in the PBMC of RA patients is related to Chinese Medicine Syndrome. The detection of GR a and GRβmay provide a valuable scientific basis for the quantitive treatment with glucocorticoid of Chinese Medicine Syndrome in Rheumatoid Arthritis.