Glucocorticoid (GC) insensitivity is a major clinical challenge in the treatment of many inflammatory diseases. It has been shown previously that GC insensitivity, in several inflammatory cell types, is due to an overabundance of the  isoform of the glucocorticoid receptor (GCR) relative to the ligand binding isoform, GCR␣. GCR functions as a dominant inhibitor of GCR␣ action. A number of GCR isoforms are created from the same pre-mRNA transcript via alternative splicing, and the factor or factors that control alternative splicing of GCR pre-mRNA are of great importance. In the current study, we have identified the predominant alternative splicing factor present in human neutrophils, which is known to be exceptionally GC-insensitive. The predominant alternative splicing factor in neutrophils is SRp30c, which is one of several highly conserved serinearginine-rich (SR) proteins that are involved in both constitutive and alternative splicing in eukaryotic cells. Inhibition of SRp30c expression with antisense oligonucleotide strongly inhibited expression of GCR and stimulated expression of GCR␣. Antisense molecules targeted to other SR proteins had no effect. Our data indicate that SRp30c is necessary for alternative splicing of the GCR pre-mRNA to create mRNA encoding GCR.Glucocorticoid (GC) 1 insensitivity is a major clinical challenge in the treatment of chronic inflammatory diseases. The pharmacologic actions of GCs are mediated through intracellular receptors, the glucocorticoid receptors (GCR). There are two isoforms of GCR in human cells, GCR␣ and GCR, which are generated from a single gene via alternative splicing of the primary RNA transcript. Several studies indicate that GC insensitivity has been associated with increased expression of GCR (1-7). GCR is truncated at the C terminus, which corresponds to the ligand binding domain. Thus, GCR cannot bind GC. In addition, GCR does not transactivate GC-sensitive genes and functions as a dominant inhibitor of GCR␣ (8). Previous studies suggest that GCR␣:GCR heterodimer formation may account for the reduced effectiveness of GC action in cells overexpressing GCR (8). Recent experiments in our lab demonstrated that overexpression of human GCR by mouse hybridoma cells results in the development of GC insensitivity by these cells (9).Regulation of GCR expression is not well understood. Different cell types from the same individual can have very different ratios of GCR␣ to GCR. For example, freshly isolated peripheral blood neutrophils are GC-insensitive. Both the absolute level of GCR and the ratio of GCR to GCR␣ protein are much higher in neutrophils than in peripheral blood mononuclear cells (PBMC) from the same individuals (10). The ratio of GCR to GCR␣ can be altered by cytokine stimulation. After stimulation of neutrophils with IL-8, GCR mRNA levels increased remarkably, and GCR␣ mRNA decreased to undetectable levels. Similarly, exposure of PBMC to IL-2 and IL-4 resulted in increased GCR expression and development of steroid insensitivity (1,...