Syndromes of Glucocorticoid Resistance

  title={Syndromes of Glucocorticoid Resistance},
  author={George P. Chrousos and S. D. Detera-Wadleigh and Michael Karl},
  journal={Annals of Internal Medicine},
Dr. George P. Chrousos (Developmental Endocrinology Branch, National Institute of Child Health and Human Development [NICHD], National Institutes of Health [NIH], Bethesda, Maryland): Glucocorticoids have an important role in human physiology, and almost every tissue in the human body is affected by them [1]. Glucocorticoids are crucial for the integrity of central nervous system function and for the maintenance of cardiovascular and metabolic homeostasis [2]. Increased secretion of… 
Syndromes of Glucocorticoid Resistance
It is currently impossible to define a safe glucocorticoid dose for a given patient which provides a maximal beneficial effect with as little side effects as possible, and clinical and laboratory evidence that patients can be divided into steroid sensitive and steroid resistant groups.
Primary Generalized Glucocorticoid Resistance and Hypersensitivity Syndromes: A 2021 Update
The tremendous progress of structural, molecular, and cellular biology, in association with the continued progress of biotechnology, has led to a better and more in-depth understanding of these rare endocrinologic conditions, as well as more effective therapeutic management.
Familial/Sporadic Glucocorticoid Resistance Syndrome and Hypertension
The results suggest that the pathologic mechanisms of glucocorticoid resistance is quite broad, and this is reflected in the wide variability of the clinical picture in patients with the syndrome.
Familial/Sporadic Glucocorticoid Resistance
The study of functional defects of natural hGR mutants enhances the understanding of the molecular mechanisms of hGR action and highlights the importance of integrated cellular and molecular signalling mechanisms for maintaining homeostasis and preserving normal physiology.
Glucocorticosteroid Resistance in Humans. Elucidation of the Molecular Mechanisms and Implications for Pathophysiology
Evidence is found that defects of GR function can appear surreptitiously in a variety of clinical conditions, suggesting that glucocorticoid resistance in humans may be involved in the pathogenesis and/or clinical picture of a plethora of disease states, of which FGR is the archetype.
Primary Generalized Glucocorticoid Resistance and Hypersensitivity: The End-Organ Involvement in the Stress Response
This Presentation summarizes the pathophysiology, clinical manifestations, and molecular mechanisms of the PGGR and PGGH states.
Primary Generalized Glucocorticoid Resistance or Chrousos Syndrome
It is demonstrated that the defective hGRs impair several steps of glucocorticoid signaling cascade depending on the position of the NR3C1 gene defect.
Glucocorticoids and Their Actions: An Introduction
Glucocorticoids regulate a variety of growth, metabolic, developmental, and immune functions and play a pivotal role in preserving basal and stress-related homeostasis and pharmacologic doses used in the treatment of inflammatory, autoimmune, and lymphoproliferative diseases.
Glucocorticoid Resistance and Hypersensitivity
This family of patients, a father and a son, with long-term “hypercortisolism” not associated with clinical manifestations of Cushing’s syndrome were studied extensively as well as several other families with the syndrome of familial glucocorticoid resistance reported since.
Rheumatoid arthritis - a neuroendocrine immune disorder: glucocorticoid resistance, relative glucocorticoid deficiency, low-dose glucocorticoid therapy, and insulin resistance
  • R. Straub
  • Medicine, Biology
    Arthritis Research & Therapy
  • 2014
The outstanding role of low-dose GC was discovered in rheumatoid arthritis (RA) patients using placebo-controlled randomized clinical trials, as summarized in this supplement by Marlies van der Goes and colleagues.


Steroid hormone resistance. Mechanisms and clinical aspects.
This volume represents the first attempt to present in one place the clinical syndromes and the pathophysiologic basis for the "resistance states" to each of the classes of steroid hormones.
Cortisol resistance in acquired immunodeficiency syndrome.
AIDS patients with hypercortisolism and clinical features of peripheral resistance to glucocorticoids are characterized by abnormal glucOCorticoid receptors on lymphocytes, which implies a complex change in immune-endocrine function, which may be important in the course of immunodeficiency syndrome.
Physiological functions of glucocorticoids in stress and their relation to pharmacological actions.
It is proposed that stress-induced increases in glucocorticoid levels protect not against the source of stress itself but rather against the body's normal reactions to stress, preventing those reactions from overshooting and themselves threatening homeostasis.
Glucocorticoid physiology, pharmacology and stress.
It is suggested that stress-induced increases in glucocorticoid levels protect not against the source of stress itself but rather against the body's normal reactions to stress, preventing those reactions from overshooting and themselves threatening homeostasis.
Decreased deoxyribonucleic acid binding of glucocorticoid-receptor complex in cultured skin fibroblasts from a patient with the glucocorticoid resistance syndrome.
Results suggest that the patient's glucocorticoid resistance was due to a decrease in the affinity of the receptor for glucoc Corticoids and a decreases in the binding of the GR complex to DNA.
Cortisol receptor resistance: the variability of its clinical presentation and response to treatment.
Therapy with dexamethasone was successful in female patients with acne and hirsutism, as the secondary increase in the production of adrenal androgens was effectively controlled.
Primary cortisol resistance in man. A glucocorticoid receptor-mediated disease.
Cortisol resistance is a rare familial syndrome owing to an abnormal glucocorticoid receptor with a decreased affinity for cortisol in patients with apparent end-organ resistance to cortisol.
Glucocorticoid hormone action.
  • J. Baxter
  • Biology, Medicine
    Pharmacology & therapeutics. Part B: General & systematic pharmacology
  • 1976
Glucocorticoid receptors in rheumatoid arthritis.
Since glucocorticoids are potent immunosuppressive agents, the decrease in their receptors suggests an impairment of the immune-hypothalamic-pituitary-adrenal axis in patients with RA.
Defective hypothalamic response to immune and inflammatory stimuli in patients with rheumatoid arthritis.
It is suggested that RA patients have an abnormality of the HPA axis response to immune/inflammatory stimuli which may reside in the hypothalamus, and this hypothalamic abnormality may be an additional, and hitherto unrecognized, factor in the pathogenesis of RA.