Abstract:Glucocorticoids are essential for life and play critical roles in many diverse physiological processes including metabolism, development, growth, inflammation, and apoptosis. Drugs that mimic the actions of glucocorticoids are widely used to treat diseases such as cancer, inflammation, and autoimmune disorders. The effects of glucocorticoids and their synthetic derivatives are mediated by the glucocorticoid receptor (GR, NR3C1), a member of the nuclear receptor superfamily of ligand-dependent transcription factors. Upon binding hormone, the GR translocates into the nucleus where it regulates gene expression by direct binding to DNA and/or through interactions with other transcription factors. The GR is derived from a single gene, yet recent work has demonstrated that alternative processing of this gene generates an astonishing array of GR isoforms with unique expression, functional, and gene regulatory profiles. Here, we discuss the molecular and cellular mechanisms of GR signaling, and the potential role for GR isoforms in regulating the specificity and sensitivity of glucocorticoid responsiveness in healthy and diseased tissues.
INTRODUCTIONGlucocorticoids are endogenous hormones essential for life that are released by the adrenal cortex in a circadian manner and in response to stress. The secretion of these hormones is under control of the hypothalamic-pituitary-adrenal (HPA) axis. In response to physical or emotional stress, the hypothalamus releases corticotrophin releasing hormone (CRH) which acts on the anterior pituitary to stimulate the synthesis and secretion of adrenocorticotropin hormone (ACTH). ACTH then acts on the adrenal cortex to stimulate the production and secretion of glucocorticoids. Only about 10% of circulating glucocorticoid is free, as the majority of the hormone is transported in the blood bound to corticosteroid binding globulin. Glucocorticoids act on nearly all tissues and cells to regulate many diverse physiological processes that function to maintain homeostasis in the face of stressful perturbations. Named for their metabolic effects converting proteins and lipids into glucose during times of low blood sugar, glucocorticoids also play critical roles in immune 63