Glucocorticoid receptor function in health and disease

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Abstract
The action of corticosteroid hormones is determined by the concentration of bioavailable hormone and the responsiveness of the target to the steroid. This responsiveness depends on the expression and properties of the corticosteroid receptors and the interaction with affiliated nuclear factors such as activation protein-1 and nuclear factor kB. It appears that the nature as well as extent of this cross-talk is implicated in differential tissue sensitivity to corticosteroids. This review discusses recent evidence on factors modulating corticosteroid receptor function in the immune system and the brain. Cytokines, as released during immune system activation, have the ability to locally impair or enhance corticosteroid receptor function with consequences for vulnerability to inflammatory and immune disorders. In the brain, factors involved in receptor regulation are being recognized. Because in the brain these receptor changes occur in the same centers that regulate steroid secretion, the whole body may suffer from over- or underexposure to corticosteroids.

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