1
|
Clarisse D, Offner F, De Bosscher K. Latest perspectives on glucocorticoid-induced apoptosis and resistance in lymphoid malignancies. Biochim Biophys Acta Rev Cancer 2020; 1874:188430. [PMID: 32950642 DOI: 10.1016/j.bbcan.2020.188430] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2020] [Revised: 08/13/2020] [Accepted: 09/14/2020] [Indexed: 02/09/2023]
Abstract
Glucocorticoids are essential drugs in the treatment protocols of lymphoid malignancies. These steroidal hormones trigger apoptosis of the malignant cells by binding to the glucocorticoid receptor (GR), which is a member of the nuclear receptor superfamily. Long term glucocorticoid treatment is limited by two major problems: the development of glucocorticoid-related side effects, which hampers patient quality of life, and the emergence of glucocorticoid resistance, which is a gradual process that is inevitable in many patients. This emphasizes the need to reevaluate and optimize the widespread use of glucocorticoids in lymphoid malignancies. To achieve this goal, a deep understanding of the mechanisms governing glucocorticoid responsiveness is required, yet, a recent comprehensive overview is currently lacking. In this review, we examine how glucocorticoids mediate apoptosis by detailing GR's genomic and non-genomic action mechanisms in lymphoid malignancies. We continue with a discussion of the glucocorticoid-related problems and how these are intertwined with one another. We further zoom in on glucocorticoid resistance by critically analyzing the plethora of proposed mechanisms and highlighting therapeutic opportunities that emerge from these studies. In conclusion, early detection of glucocorticoid resistance in patients remains an important challenge as this would result in a timelier treatment reorientation and reduced glucocorticoid-instigated side effects.
Collapse
Affiliation(s)
- Dorien Clarisse
- Translational Nuclear Receptor Research, VIB-UGent Center for Medical Biotechnology, Ghent, Belgium; Department of Biomolecular Medicine, Ghent University, Ghent, Belgium; Cancer Research Institute Ghent (CRIG), Ghent, Belgium.
| | - Fritz Offner
- Cancer Research Institute Ghent (CRIG), Ghent, Belgium; Department of Internal Medicine and Pediatrics, Ghent University Hospital, Ghent, Belgium
| | - Karolien De Bosscher
- Translational Nuclear Receptor Research, VIB-UGent Center for Medical Biotechnology, Ghent, Belgium; Department of Biomolecular Medicine, Ghent University, Ghent, Belgium; Cancer Research Institute Ghent (CRIG), Ghent, Belgium.
| |
Collapse
|
2
|
Sai S, Esteves C, Kelly V, Sakaguchi K, McAndrew R, Chudleigh S, Spence A, Gibson B, Thomas A, Chapman KE. Reciprocal Regulation of HSD11B1 and HSD11B2 Predicts Glucocorticoid Sensitivity in Childhood Acute Lymphoblastic Leukemia. J Pediatr 2020; 220:249-253. [PMID: 31987650 DOI: 10.1016/j.jpeds.2019.12.054] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/21/2019] [Revised: 12/19/2019] [Accepted: 12/20/2019] [Indexed: 12/16/2022]
Abstract
There are few biomarkers to predict efficacy of glucocorticoid treatment in childhood acute lymphoblastic leukemia (ALL) at diagnosis. Here, we demonstrate reciprocal regulation of 11beta-hydroxysteroid dehydrogenase (11β-HSD), may predict the apoptotic response of ALL to glucocorticoid treatment. Our data may be useful to refine glucocorticoid treatment, to retain benefit while minimizing side effects.
Collapse
Affiliation(s)
- Shuji Sai
- Center for Cardiovascular Science, The Queen's Medical Research Institute, The University of Edinburgh, Edinburgh, UK; Department of Pediatrics, Hamamatsu University School of Medicine, Hamamatsu, Japan; Department of Pediatrics, Teine-Keijinkai Hospital, Sapporo, Japan.
| | - Cristina Esteves
- Center for Cardiovascular Science, The Queen's Medical Research Institute, The University of Edinburgh, Edinburgh, UK; Division of Developmental Biology, The Roslin Institute, The University of Edinburgh, Edinburgh, UK
| | - Val Kelly
- Center for Cardiovascular Science, The Queen's Medical Research Institute, The University of Edinburgh, Edinburgh, UK
| | - Kimiyoshi Sakaguchi
- Department of Pediatrics, Hamamatsu University School of Medicine, Hamamatsu, Japan
| | - Rachel McAndrew
- Department of Pediatric Hematology, Royal Hospital for Sick Children, Edinburgh, UK
| | - Sandra Chudleigh
- Department of Pediatric Hematology, Royal Hospital for Sick Children, Yorkhill, Glasgow, UK
| | - Alison Spence
- Department of Pediatric Hematology, Royal Hospital for Sick Children, Yorkhill, Glasgow, UK
| | - Brenda Gibson
- Department of Pediatric Hematology, Royal Hospital for Sick Children, Yorkhill, Glasgow, UK
| | - Angela Thomas
- Department of Pediatric Hematology, Royal Hospital for Sick Children, Edinburgh, UK
| | - Karen E Chapman
- Center for Cardiovascular Science, The Queen's Medical Research Institute, The University of Edinburgh, Edinburgh, UK
| |
Collapse
|
3
|
Sai S, Tamura T, Nagumo K, Chapman KE. Peripheral glucocorticoid signaling in Kawasaki disease. Pediatr Res 2019; 86:550-552. [PMID: 31242500 DOI: 10.1038/s41390-019-0481-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2019] [Revised: 04/30/2019] [Accepted: 06/16/2019] [Indexed: 11/09/2022]
Affiliation(s)
- Shuji Sai
- Department of Pediatrics, Teine-Keijinkai Hospital, Sapporo, Japan. .,Institute for Genetic Medicine, Hokkaido University, Sapporo, Japan.
| | - Takuya Tamura
- Department of Pediatrics, Teine-Keijinkai Hospital, Sapporo, Japan
| | - Kiyoshi Nagumo
- Department of Pediatrics, Teine-Keijinkai Hospital, Sapporo, Japan
| | - Karen E Chapman
- Centre for Cardiovascular Science, The Queen's Medical Research Institute, University of Edinburgh, Edinburgh, UK
| |
Collapse
|
4
|
Verma M, Kipari TMJ, Zhang Z, Man TY, Forster T, Homer NZM, Seckl JR, Holmes MC, Chapman KE. 11β-hydroxysteroid dehydrogenase-1 deficiency alters brain energy metabolism in acute systemic inflammation. Brain Behav Immun 2018; 69:223-234. [PMID: 29162555 PMCID: PMC5871395 DOI: 10.1016/j.bbi.2017.11.015] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2017] [Revised: 10/16/2017] [Accepted: 11/17/2017] [Indexed: 12/19/2022] Open
Abstract
Chronically elevated glucocorticoid levels impair cognition and are pro-inflammatory in the brain. Deficiency or inhibition of 11β-hydroxysteroid dehydrogenase type-1 (11β-HSD1), which converts inactive into active glucocorticoids, protects against glucocorticoid-associated chronic stress- or age-related cognitive impairment. Here, we hypothesised that 11β-HSD1 deficiency attenuates the brain cytokine response to inflammation. Because inflammation is associated with altered energy metabolism, we also examined the effects of 11β-HSD1 deficiency upon hippocampal energy metabolism. Inflammation was induced in 11β-HSD1 deficient (Hsd11b1Del/Del) and C57BL/6 control mice by intraperitoneal injection of lipopolysaccharide (LPS). LPS reduced circulating neutrophil and monocyte numbers and increased plasma corticosterone levels equally in C57BL/6 and Hsd11b1Del/Del mice, suggesting a similar peripheral inflammatory response. However, the induction of pro-inflammatory cytokine mRNAs in the hippocampus was attenuated in Hsd11b1Del/Del mice. Principal component analysis of mRNA expression revealed a distinct metabolic response to LPS in hippocampus of Hsd11b1Del/Del mice. Expression of Pfkfb3 and Ldha, key contributors to the Warburg effect, showed greater induction in Hsd11b1Del/Del mice. Consistent with increased glycolytic flux, levels of 3-phosphoglyceraldehyde and dihydroxyacetone phosphate were reduced in hippocampus of LPS injected Hsd11b1Del/Del mice. Expression of Sdha and Sdhb, encoding subunits of succinate dehydrogenase/complex II that determines mitochondrial reserve respiratory capacity, was induced specifically in hippocampus of LPS injected Hsd11b1Del/Del mice, together with increased levels of its product, fumarate. These data suggest 11β-HSD1 deficiency attenuates the hippocampal pro-inflammatory response to LPS, associated with increased capacity for aerobic glycolysis and mitochondrial ATP generation. This may provide better metabolic support and be neuroprotective during systemic inflammation or aging.
Collapse
Affiliation(s)
- Manu Verma
- University/BHF Centre for Cardiovascular Science, The Queen's Medical Research Institute, 47 Little France Crescent, Edinburgh EH16 4TJ, UK
| | - Tiina M J Kipari
- MRC Centre for Inflammation Research, The Queen's Medical Research Institute, 47 Little France Crescent, Edinburgh EH16 4TJ, UK
| | - Zhenguang Zhang
- University/BHF Centre for Cardiovascular Science, The Queen's Medical Research Institute, 47 Little France Crescent, Edinburgh EH16 4TJ, UK
| | - Tak Yung Man
- University/BHF Centre for Cardiovascular Science, The Queen's Medical Research Institute, 47 Little France Crescent, Edinburgh EH16 4TJ, UK
| | - Thorsten Forster
- Division of Infection and Pathway Medicine, University of Edinburgh, The Chancellor's Building, 49 Little France Crescent, Edinburgh EH16 4SB, UK
| | - Natalie Z M Homer
- University/BHF Centre for Cardiovascular Science, The Queen's Medical Research Institute, 47 Little France Crescent, Edinburgh EH16 4TJ, UK; Mass Spectrometry Core, Edinburgh Clinical Research Facility, University of Edinburgh, The Queen's Medical Research Institute, 47 Little France Crescent, Edinburgh EH16 4TJ, UK
| | - Jonathan R Seckl
- University/BHF Centre for Cardiovascular Science, The Queen's Medical Research Institute, 47 Little France Crescent, Edinburgh EH16 4TJ, UK
| | - Megan C Holmes
- University/BHF Centre for Cardiovascular Science, The Queen's Medical Research Institute, 47 Little France Crescent, Edinburgh EH16 4TJ, UK
| | - Karen E Chapman
- University/BHF Centre for Cardiovascular Science, The Queen's Medical Research Institute, 47 Little France Crescent, Edinburgh EH16 4TJ, UK.
| |
Collapse
|
5
|
Song QQ, Xie WY, Tang YJ, Zhang J, Liu J. Genetic variation in the glucocorticoid pathway involved in interindividual differences in the glucocorticoid treatment. Pharmacogenomics 2017; 18:293-316. [PMID: 28112586 DOI: 10.2217/pgs-2016-0151] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Glucocorticoids (GCs) are widely used for treating asthma, rheumatoid arthritis, nephrotic syndrome, acute lymphoblastic leukemia and other autoimmune diseases. However, in a subgroup of patients, failure to respond to GCs is known as GC resistance or GC insensitivity. This represents an important barrier to effective treatment and a clinical problem requiring an urgent solution. Genetic variation in the GC pathway is a significant factor in interindividual differences in GC treatment. This article reviews the pharmacogenetics of GCs in diverse diseases based on the GC pathway.
Collapse
Affiliation(s)
- Qian-Qian Song
- Department of Clinical Pharmacology, Xiangya Hospital, Central South University, Changsha 410008, Hunan, P.R. China.,Institute of Clinical Pharmacology, Central South University; Hunan Key Laboratory of Pharmacogenetics, Changsha 410078, Hunan, P.R. China
| | - Wan-Ying Xie
- Department of Clinical Pharmacology, Xiangya Hospital, Central South University, Changsha 410008, Hunan, P.R. China.,Institute of Clinical Pharmacology, Central South University; Hunan Key Laboratory of Pharmacogenetics, Changsha 410078, Hunan, P.R. China
| | - Yong-Jun Tang
- Department of Clinical Pharmacology, Xiangya Hospital, Central South University, Changsha 410008, Hunan, P.R. China.,Institute of Clinical Pharmacology, Central South University; Hunan Key Laboratory of Pharmacogenetics, Changsha 410078, Hunan, P.R. China
| | - Jun Zhang
- Department of Nephrology, Xiangya Hospital, Central South University, Changsha 410008, Hunan, P.R. China
| | - Jie Liu
- Department of Clinical Pharmacology, Xiangya Hospital, Central South University, Changsha 410008, Hunan, P.R. China.,Institute of Clinical Pharmacology, Central South University; Hunan Key Laboratory of Pharmacogenetics, Changsha 410078, Hunan, P.R. China
| |
Collapse
|
6
|
Taves MD, Plumb AW, Korol AM, Van Der Gugten JG, Holmes DT, Abraham N, Soma KK. Lymphoid organs of neonatal and adult mice preferentially produce active glucocorticoids from metabolites, not precursors. Brain Behav Immun 2016; 57:271-281. [PMID: 27165988 DOI: 10.1016/j.bbi.2016.05.003] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2016] [Revised: 04/22/2016] [Accepted: 05/07/2016] [Indexed: 11/16/2022] Open
Abstract
Glucocorticoids (GCs) are circulating adrenal steroid hormones that coordinate physiology, especially the counter-regulatory response to stressors. While systemic GCs are often considered immunosuppressive, GCs in the thymus play a critical role in antigen-specific immunity by ensuring the selection of competent T cells. Elevated thymus-specific GC levels are thought to occur by local synthesis, but the mechanism of such tissue-specific GC production remains unknown. Here, we found metyrapone-blockable GC production in neonatal and adult bone marrow, spleen, and thymus of C57BL/6 mice. This production was primarily via regeneration of adrenal metabolites, rather than de novo synthesis from cholesterol, as we found high levels of gene expression and activity of the GC-regenerating enzyme 11β-hydroxysteroid dehydrogenase type 1 (11β-HSD1), but not the GC-synthetic enzyme CYP11B1. Furthermore, incubation with physiological concentrations of GC metabolites (11-dehydrocorticosterone, prednisone) induced 11β-HSD1- and GC receptor-dependent apoptosis (caspase activation) in both T and B cells, showing the functional relevance of local GC regeneration in lymphocyte GC signaling. Local GC production in bone marrow and spleen raises the possibility that GCs play a key role in B cell selection similar to their role in T cell selection. Our results also indicate that local GC production may amplify changes in adrenal GC signaling, rather than buffering against such changes, in the immune system.
Collapse
Affiliation(s)
- Matthew D Taves
- Department of Psychology, University of British Columbia, 2136 West Mall, Vancouver V6T 1Z4, Canada; Department of Zoology, University of British Columbia, 4200-6270 University Blvd, Vancouver V6T 1Z4, Canada.
| | - Adam W Plumb
- Department of Microbiology and Immunology, University of British Columbia, 1365-2350 Health Sciences Mall, Vancouver V6T 1Z3, Canada.
| | - Anastasia M Korol
- Department of Psychology, University of British Columbia, 2136 West Mall, Vancouver V6T 1Z4, Canada.
| | | | - Daniel T Holmes
- Department of Laboratory Medicine, St Paul's Hospital, 1081 Burrard St, Vancouver, BC V6Z 1Y6, Canada.
| | - Ninan Abraham
- Department of Zoology, University of British Columbia, 4200-6270 University Blvd, Vancouver V6T 1Z4, Canada; Department of Microbiology and Immunology, University of British Columbia, 1365-2350 Health Sciences Mall, Vancouver V6T 1Z3, Canada.
| | - Kiran K Soma
- Department of Psychology, University of British Columbia, 2136 West Mall, Vancouver V6T 1Z4, Canada; Department of Zoology, University of British Columbia, 4200-6270 University Blvd, Vancouver V6T 1Z4, Canada; Djavad Mowafaghian Centre for Brain Health, University of British Columbia, 2215 Wesbrook Mall, Vancouver, BC V6T 1Z3, Canada.
| |
Collapse
|
7
|
Sai S, Yamamoto M, Yamaguchi R, Chapman KE, Hongo T. Reciprocal Regulation of 11β-HSDs May Predict Steroid Sensitivity in Childhood Nephrotic Syndrome. Pediatrics 2016; 138:peds.2015-4011. [PMID: 27507896 DOI: 10.1542/peds.2015-4011] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/24/2016] [Indexed: 11/24/2022] Open
Abstract
Childhood nephrotic syndrome, in which steroid-dependence occurs concurrently with steroid-resistance, requires aggressive therapy to prevent relapse. Predictive biomarkers that can be used to stratify treatment are urgently needed. Here we report that reciprocal regulation of the glucocorticoid metabolizing enzymes, 11β-hydroxysteroid dehydrogenase types 1 and 2, is associated with steroid-responsiveness and disease remission in childhood nephrotic syndrome, potentially providing a marker to identify patients in which aggressive therapy is required.
Collapse
Affiliation(s)
- Shuji Sai
- Department of Pediatrics, Hamamatsu University School of Medicine, Hamamatsu, Japan; Centre for Cardiovascular Science, The Queen's Medical Research Institute, University of Edinburgh, Edinburgh, Scotland;
| | - Masaki Yamamoto
- Department of Pediatrics, Hamamatsu University School of Medicine, Hamamatsu, Japan; Department of Pediatrics, Seirei Hamamatsu General Hospital, Hamamatsu, Japan; and
| | - Rie Yamaguchi
- Department of Pediatrics, Hamamatsu University School of Medicine, Hamamatsu, Japan
| | - Karen E Chapman
- Centre for Cardiovascular Science, The Queen's Medical Research Institute, University of Edinburgh, Edinburgh, Scotland
| | - Teruaki Hongo
- Department of Pediatrics, Iwata City Hospital; Iwata, Japan
| |
Collapse
|
8
|
Karachunsky AI, Rumyantseva YV, Lagoiko SN, Bührer C, Tallen G, Aleinikova OV, Bydanov OI, Korepanova NV, Baidun LV, Nasedkina TV, Stackelberg AV, Novichkova GA, Maschan AA, Litvinov DV, Ponomareva NI, Kondratchik KL, Mansurova EG, Fechina LG, Streneva OV, Yudina NB, Sharapova GR, Shamardina AV, Gerbek IE, Shapochnik AP, Rumyantsev AG, Henze G. [Age-related characteristics of the efficacy of different glucocorticosteroids in the therapy of acute lymphoblastic leukemia]. TERAPEVT ARKH 2015; 87:41-50. [PMID: 26390724 DOI: 10.17116/terarkh201587741-50] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
AIM To determine predictors for decision-making on a differential approach to choosing glucocorticosteroids (GCS) for children and adolescents with acute lymphoblastic leukemia (ALL). SUBJECTS AND METHODS The analysis covered 1064 primary patients aged to 1 to 18 years with ALL who had been registered at the clinics of Russia and Belorussia in April 2002 to November 2006. Before induction therapy, the patients were randomized into a dexamethasone (DEXA) 6 mg/m2 group (n=539) and a methylprednisolone (MePRED) 60 mg/m2 one (n=525). RESULTS The entire group showed no statistically significant differences in survival rates between the patients receiving DEXA or MePRED. However, an analysis of age groups revealed the benefits of DEXA in children younger than 14 years (the event-free survival (EFS) was 76±2 and 71±2%, respectively (p=0.048); the overall survival (OS) was 81±2 and 77±2%, respectively (p=0.046); therapy-induced mortality was 6.4% (DEXA) andl 1.1% (MePRED) (p=0.01 4); the rate of isolated extramedullary relapses was 1.5% (DEXA) and 4.4% (MePRED) (p=0.009). At the same time, EFS and OS in 14-to-18-year-old adolescents were statistically significantly higher than in those who used MePRED (EFS, 65±6 and 52±6%, respectively (p=0.087); OS, 72±6 and 61±6%, respectively; (p=0.l 7). CONCLUSION The findings suggest that it is possible that the choice of a GCS for ALL therapy must be also based on a patient's age. There is a need for further studies of this matter in prospective randomized multicenter trials in children and adolescents.
Collapse
Affiliation(s)
- A I Karachunsky
- D. Rogachev Federal Research Clinical Center of Pediatric Hematology, Oncology, and Immunology, Moscow, Russia; N.I. Pirogov Russian National Research Medical University, Ministry of Health of Russia, Moscow, Russia
| | - Yu V Rumyantseva
- D. Rogachev Federal Research Clinical Center of Pediatric Hematology, Oncology, and Immunology, Moscow, Russia; N.I. Pirogov Russian National Research Medical University, Ministry of Health of Russia, Moscow, Russia
| | - S N Lagoiko
- D. Rogachev Federal Research Clinical Center of Pediatric Hematology, Oncology, and Immunology, Moscow, Russia
| | - C Bührer
- Department of Pediatric Oncology/Hematology, Charité-Universitätsmedizin Berlin, Germany
| | - G Tallen
- Department of Pediatric Oncology/Hematology, Charité-Universitätsmedizin Berlin, Germany
| | - O V Aleinikova
- Republican Research and Practical Center for Pediatric Oncology and Hematology, Minsk, Belarus
| | - O I Bydanov
- D. Rogachev Federal Research Clinical Center of Pediatric Hematology, Oncology, and Immunology, Moscow, Russia; Republican Research and Practical Center for Pediatric Oncology and Hematology, Minsk, Belarus
| | - N V Korepanova
- D. Rogachev Federal Research Clinical Center of Pediatric Hematology, Oncology, and Immunology, Moscow, Russia
| | - L V Baidun
- Russian Children's Clinical Hospital, Ministry of Health of Russia, Moscow, Russia
| | - T V Nasedkina
- D. Rogachev Federal Research Clinical Center of Pediatric Hematology, Oncology, and Immunology, Moscow, Russia
| | - A Von Stackelberg
- Department of Pediatric Oncology/Hematology, Charité-Universitätsmedizin Berlin, Germany
| | - G A Novichkova
- D. Rogachev Federal Research Clinical Center of Pediatric Hematology, Oncology, and Immunology, Moscow, Russia; N.I. Pirogov Russian National Research Medical University, Ministry of Health of Russia, Moscow, Russia
| | - A A Maschan
- D. Rogachev Federal Research Clinical Center of Pediatric Hematology, Oncology, and Immunology, Moscow, Russia; N.I. Pirogov Russian National Research Medical University, Ministry of Health of Russia, Moscow, Russia
| | - D V Litvinov
- D. Rogachev Federal Research Clinical Center of Pediatric Hematology, Oncology, and Immunology, Moscow, Russia; N.I. Pirogov Russian National Research Medical University, Ministry of Health of Russia, Moscow, Russia
| | - N I Ponomareva
- Russian Children's Clinical Hospital, Ministry of Health of Russia, Moscow, Russia
| | - K L Kondratchik
- N.I. Pirogov Russian National Research Medical University, Ministry of Health of Russia, Moscow, Russia; Morozov City Children's Clinical Hospital, Moscow Healthcare Department, Moscow, Russia
| | - E G Mansurova
- N.I. Pirogov Russian National Research Medical University, Ministry of Health of Russia, Moscow, Russia
| | - L G Fechina
- Regional Children's Clinical Hospital One, Yekaterinburg, Russia
| | - O V Streneva
- Regional Children's Clinical Hospital One, Yekaterinburg, Russia
| | - N B Yudina
- Voronezh Regional Children's Clinical Hospital One, Voronezh, Russia
| | - G R Sharapova
- Nizhnevartovsk District Children's Clinical Hospital, Nizhnevartovsk, Khanty-Mansi Autonomic District-Yugra, Russia
| | - A V Shamardina
- Nizhny Novgorod Regional Children's Clinical Hospital, Nizhny Novgorod, Russia
| | - I E Gerbek
- Tomsk Regional Clinical Hospital, Tomsk, Russia
| | - A P Shapochnik
- Orenburg Regional Clinical Oncology Dispensary, Orenburg, Russia
| | - A G Rumyantsev
- D. Rogachev Federal Research Clinical Center of Pediatric Hematology, Oncology, and Immunology, Moscow, Russia
| | - G Henze
- Department of Pediatric Oncology/Hematology, Charité-Universitätsmedizin Berlin, Germany
| |
Collapse
|
9
|
Efficacy and toxicity of dexamethasone vs methylprednisolone-long-term results in more than 1000 patients from the Russian randomized multicentric trial ALL-MB 2002. Leukemia 2015; 29:1955-8. [PMID: 25748686 DOI: 10.1038/leu.2015.63] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
|
10
|
Quax RA, Manenschijn L, Koper JW, Hazes JM, Lamberts SWJ, van Rossum EFC, Feelders RA. Glucocorticoid sensitivity in health and disease. Nat Rev Endocrinol 2013; 9:670-86. [PMID: 24080732 DOI: 10.1038/nrendo.2013.183] [Citation(s) in RCA: 198] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Glucocorticoids regulate many physiological processes and have an essential role in the systemic response to stress. For example, gene transcription is modulated by the glucocorticoid-glucocorticoid receptor complex via several mechanisms. The ultimate biologic responses to glucocorticoids are determined by not only the concentration of glucocorticoids but also the differences between individuals in glucocorticoid sensitivity, which is influenced by multiple factors. Differences in sensitivity to glucocorticoids in healthy individuals are partly genetically determined by functional polymorphisms of the gene that encodes the glucocorticoid receptor. Hereditary syndromes have also been identified that are associated with increased and decreased sensitivity to glucocorticoids. As a result of their anti-inflammatory properties, glucocorticoids are widely used in the treatment of allergic, inflammatory and haematological disorders. The variety in clinical responses to treatment with glucocorticoids reflects the considerable variation in glucocorticoid sensitivity between individuals. In immune-mediated disorders, proinflammatory cytokines can induce localized resistance to glucocorticoids via several mechanisms. Individual differences in how tissues respond to glucocorticoids might also be involved in the predisposition for and pathogenesis of the metabolic syndrome and mood disorders. In this Review, we summarize the mechanisms that influence glucocorticoid sensitivity in health and disease and discuss possible strategies to modulate glucocorticoid responsiveness.
Collapse
Affiliation(s)
- Rogier A Quax
- Department of Internal Medicine, Division of Endocrinology, Erasmus Medical Center, 's-Gravendijkwal 230, 3015 CE Rotterdam, Netherlands
| | | | | | | | | | | | | |
Collapse
|
11
|
Chapman K, Holmes M, Seckl J. 11β-hydroxysteroid dehydrogenases: intracellular gate-keepers of tissue glucocorticoid action. Physiol Rev 2013; 93:1139-206. [PMID: 23899562 DOI: 10.1152/physrev.00020.2012] [Citation(s) in RCA: 535] [Impact Index Per Article: 48.6] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Glucocorticoid action on target tissues is determined by the density of "nuclear" receptors and intracellular metabolism by the two isozymes of 11β-hydroxysteroid dehydrogenase (11β-HSD) which catalyze interconversion of active cortisol and corticosterone with inert cortisone and 11-dehydrocorticosterone. 11β-HSD type 1, a predominant reductase in most intact cells, catalyzes the regeneration of active glucocorticoids, thus amplifying cellular action. 11β-HSD1 is widely expressed in liver, adipose tissue, muscle, pancreatic islets, adult brain, inflammatory cells, and gonads. 11β-HSD1 is selectively elevated in adipose tissue in obesity where it contributes to metabolic complications. Similarly, 11β-HSD1 is elevated in the ageing brain where it exacerbates glucocorticoid-associated cognitive decline. Deficiency or selective inhibition of 11β-HSD1 improves multiple metabolic syndrome parameters in rodent models and human clinical trials and similarly improves cognitive function with ageing. The efficacy of inhibitors in human therapy remains unclear. 11β-HSD2 is a high-affinity dehydrogenase that inactivates glucocorticoids. In the distal nephron, 11β-HSD2 ensures that only aldosterone is an agonist at mineralocorticoid receptors (MR). 11β-HSD2 inhibition or genetic deficiency causes apparent mineralocorticoid excess and hypertension due to inappropriate glucocorticoid activation of renal MR. The placenta and fetus also highly express 11β-HSD2 which, by inactivating glucocorticoids, prevents premature maturation of fetal tissues and consequent developmental "programming." The role of 11β-HSD2 as a marker of programming is being explored. The 11β-HSDs thus illuminate the emerging biology of intracrine control, afford important insights into human pathogenesis, and offer new tissue-restricted therapeutic avenues.
Collapse
Affiliation(s)
- Karen Chapman
- Endocrinology Unit, Centre for Cardiovascular Science, The Queen’s Medical Research Institute, University of Edinburgh, Edinburgh, United Kingdom
| | | | | |
Collapse
|
12
|
Shah DS, Kumar R. Steroid resistance in leukemia. World J Exp Med 2013; 3:21-25. [PMID: 24520542 PMCID: PMC3905587 DOI: 10.5493/wjem.v3.i2.21] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/10/2013] [Revised: 06/02/2013] [Accepted: 06/20/2013] [Indexed: 02/06/2023] Open
Abstract
There are several types of leukemia which are characterized by the abnormal growth of cells from the myeloid or lymphoid lineage. Because of their lympholytic actions, glucocorticoids (GCs) are included in many therapeutic regimens for the treatment of various forms of leukemia. Although a significant number of acute lymphoblastic leukemia patients respond well to GC treatment during initial phases; prolonged treatments sometimes results in steroid-resistance. The exact mechanism of this resistance has yet not been completely elucidated, but a correlation between functional GC receptor expression levels and steroid-resistance in patients has been found. In recent years, several other mechanisms of action have been reported that could play an important role in the development of such drug resistances in leukemia. Therefore, a better understanding of how leukemic patients develop drug resistance should result in drugs designed appropriately to treat these patients.
Collapse
|
13
|
Sai S, Nakagawa Y, Yamaguchi R, Suzuki M, Sakaguchi K, Okada S, Seckl JR, Ohzeki T, Chapman KE. Expression of 11beta-hydroxysteroid dehydrogenase 2 contributes to glucocorticoid resistance in lymphoblastic leukemia cells. Leuk Res 2011; 35:1644-8. [PMID: 21794917 DOI: 10.1016/j.leukres.2011.07.002] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2011] [Revised: 06/23/2011] [Accepted: 07/01/2011] [Indexed: 01/02/2023]
Abstract
Synthetic glucocorticoids (GCs) form a crucial first-line treatment for childhood acute lymphoblastic leukemia (ALL). However prolonged GC therapy frequently leads to GC-resistance with an unclear molecular mechanism. 11β-hydroxysteroid dehydrogenase (11β-HSD) 2 inactivates GCs within cells. Here, we show the association between GC sensitivity and 11β-HSD2 expression in human T-cell leukemic cell lines. 11β-HSD2 mRNA and protein levels were considerably higher in GC-resistant MOLT4F cells than in GC-sensitive CCRF-CEM cells. The 11β-HSD inhibitor, carbenoxolone pre-treatment resulted in greater cell death with prednisolone assessed by methyl-thiazol-tetrazolium assay and caspase-3/7 assay, suggesting that 11β-HSD2 is a cause of GC-resistance in ALL.
Collapse
Affiliation(s)
- Shuji Sai
- Department of Pediatrics, Hamamatsu University School of Medicine, Hamamatsu, Japan.
| | | | | | | | | | | | | | | | | |
Collapse
|
14
|
Coutinho AE, Chapman KE. The anti-inflammatory and immunosuppressive effects of glucocorticoids, recent developments and mechanistic insights. Mol Cell Endocrinol 2011; 335:2-13. [PMID: 20398732 PMCID: PMC3047790 DOI: 10.1016/j.mce.2010.04.005] [Citation(s) in RCA: 1058] [Impact Index Per Article: 81.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2009] [Revised: 04/02/2010] [Accepted: 04/06/2010] [Indexed: 02/08/2023]
Abstract
Since the discovery of glucocorticoids in the 1940s and the recognition of their anti-inflammatory effects, they have been amongst the most widely used and effective treatments to control inflammatory and autoimmune diseases. However, their clinical efficacy is compromised by the metabolic effects of long-term treatment, which include osteoporosis, hypertension, dyslipidaemia and insulin resistance/type 2 diabetes mellitus. In recent years, a great deal of effort has been invested in identifying compounds that separate the beneficial anti-inflammatory effects from the adverse metabolic effects of glucocorticoids, with limited effect. It is clear that for these efforts to be effective, a greater understanding is required of the mechanisms by which glucocorticoids exert their anti-inflammatory and immunosuppressive actions. Recent research is shedding new light on some of these mechanisms and has produced some surprising new findings. Some of these recent developments are reviewed here.
Collapse
Affiliation(s)
| | - Karen E. Chapman
- Corresponding author. Tel.: +44 131 242 6736; fax: +44 131 242 6779.
| |
Collapse
|