This study molecularly elucidates the basis for the dominant negative mechanism of the glucocorticoid receptor (GR) isoform hGR, whose overexpression is associated with human glucocorticoid resistance. Using a series of truncated hGR␣ mutants and sequential mutagenesis to generate a series of hGR␣/ hybrids, we find that the absence of helix 12 is neither necessary nor sufficient for the GR dominant negative phenotype. Moreover, we have localized the dominant negative activity of hGR to two residues and found that nuclear localization, in addition to heterodimerization, is a critical feature of the dominant negative activity. Molecular modeling of wild-type and mutant hGR␣ and hGR provides structural insight and a potential physical explanation for the lack of hormone binding and the dominant negative actions of hGR.Glucocorticoids are among the most widely used classes of drugs in the world. The anti-inflammatory effects of glucocorticoids are routinely exploited in treatment of many pathological conditions ranging from asthma, rheumatoid arthritis, ulcerative colitis, and common eczema. Likewise, the immunosuppressive benefits of glucocorticoids afford them a role in most chemotherapeutic regimes as well as for management of autoimmunity. However, prolonged glucocorticoid treatment, as well as rare genetic dispositions, can result in glucocorticoid resistance (7). An increasing number of studies in the last several years have implicated alternative splicing of the glucocorticoid receptor (GR) gene and subsequent expression of the hGR protein isoform as a contributing factor to glucocorticoid resistance in a variety of pathological conditions (17,21,28,38,39,41). Since hGR does not undergo ligand-induced down regulation and has an increased half-life, the expression of hGR becomes more significant (31). Expression of hGR is also enhanced by proinflammatory cytokines, such as tumor necrosis factor alpha and interleukin 1; however, a precise physiological role for hGR remains elusive (43).The GR, a member of the nuclear hormone receptor superfamily of ligand-activated transcription factors, participates in numerous signaling pathways leading to altered gene expression in target cells and tissues and is essential for life (8). The GR can modulate gene expression either positively or negatively by directly binding as a homodimer to glucocorticoid response elements (GRE) located in the promoter regions of target genes. Alternatively, the ligand-activated GR is known to repress or antagonize other nuclear factors involved in regulating gene expression, such as NF-B and AP-1, through direct protein interactions (29). Both of these functions of GR signaling and transactivation and transrepression, appear to involve distinct and separable regions of the receptor and are major components of the physiological response to both natural and synthetic glucocorticoids.In humans, alternative splicing of the ninth and final GR exon gives rise to hGR␣ and hGR proteins divergent at only the extreme carboxy termini (11,20...