Increased Glucocorticoid Receptor Alpha Expression and Signaling in Critically Ill Coronavirus Disease 2019 Patients.
| Title: | Increased Glucocorticoid Receptor Alpha Expression and Signaling in Critically Ill Coronavirus Disease 2019 Patients. |
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| Authors: | Vassiliou AG; 1st Department of Critical Care Medicine & Pulmonary Services, Evangelismos Hospital, Athens Medical School, National and Kapodistrian University of Athens, Athens, Greece.; Athanasiou N; 1st Department of Critical Care Medicine & Pulmonary Services, Evangelismos Hospital, Athens Medical School, National and Kapodistrian University of Athens, Athens, Greece.; Keskinidou C; 1st Department of Critical Care Medicine & Pulmonary Services, Evangelismos Hospital, Athens Medical School, National and Kapodistrian University of Athens, Athens, Greece.; Jahaj E; 1st Department of Critical Care Medicine & Pulmonary Services, Evangelismos Hospital, Athens Medical School, National and Kapodistrian University of Athens, Athens, Greece.; Tsipilis S; 1st Department of Critical Care Medicine & Pulmonary Services, Evangelismos Hospital, Athens Medical School, National and Kapodistrian University of Athens, Athens, Greece.; Zacharis A; 1st Department of Critical Care Medicine & Pulmonary Services, Evangelismos Hospital, Athens Medical School, National and Kapodistrian University of Athens, Athens, Greece.; Botoula E; Department of Endocrinology, Diabetes and Metabolism, Evangelismos Hospital, Athens, Greece.; Diamantopoulos A; Department of Endocrinology, Diabetes and Metabolism, Evangelismos Hospital, Athens, Greece.; Ilias I; Department of Endocrinology, Helena Venizelos Hospital, Athens, Greece.; Vassiliadi DA; Department of Endocrinology, Diabetes and Metabolism, Evangelismos Hospital, Athens, Greece.; Tsagarakis S; Department of Endocrinology, Diabetes and Metabolism, Evangelismos Hospital, Athens, Greece.; Kotanidou A; 1st Department of Critical Care Medicine & Pulmonary Services, Evangelismos Hospital, Athens Medical School, National and Kapodistrian University of Athens, Athens, Greece.; Dimopoulou I; 1st Department of Critical Care Medicine & Pulmonary Services, Evangelismos Hospital, Athens Medical School, National and Kapodistrian University of Athens, Athens, Greece. |
| Source: | Critical care medicine [Crit Care Med] 2021 Dec 01; Vol. 49 (12), pp. 2131-2136. |
| Publication Type: | Journal Article; Observational Study; Research Support, Non-U.S. Gov't |
| Language: | English |
| Journal Info: | Publisher: Lippincott Williams & Wilkins Country of Publication: United States NLM ID: 0355501 Publication Model: Print Cited Medium: Internet ISSN: 1530-0293 (Electronic) Linking ISSN: 00903493 NLM ISO Abbreviation: Crit Care Med Subsets: MEDLINE |
| Imprint Name(s): | Publication: Philadelphia, PA : Lippincott Williams & Wilkins; Original Publication: New York, Kolen. |
| MeSH Terms: | COVID-19/*physiopathology ; Hydrocortisone/*blood ; Leucine Zippers/*physiology ; Receptors, Glucocorticoid/*biosynthesis; Academic Medical Centers ; Adult ; Aged ; Comorbidity ; Critical Illness ; Female ; Greece ; Humans ; Intensive Care Units ; Male ; Middle Aged ; Prospective Studies ; SARS-CoV-2 ; Severity of Illness Index |
| Abstract: | Objectives: Critical illness is characterized by increased serum cortisol concentrations and bioavailability resulting from the activation of the hypothalamic-pituitary-adrenal axis, which constitutes an essential part of the stress response. The actions of glucocorticoids are mediated by a ubiquitous intracellular receptor protein, the glucocorticoid receptor. So far, data on coronavirus disease 2019 and glucocorticoid receptor alpha expression are lacking.; Design: Prospective observational study.; Setting: One academic multidisciplinary ICU.; Subjects: Twenty-six adult coronavirus disease 2019 patients; 33 adult noncoronavirus disease 2019 patients, matched for age, sex, and disease severity, constituted the control group. All patients were steroid-free.; Interventions: None.; Measurements and Main Results: Glucocorticoid receptor alpha, glucocorticoid-inducible leucine zipper expression, and serum cortisol were measured on ICU admission. In coronavirus disease 2019 patients, glucocorticoid receptor alpha and glucocorticoid-inducible leucine zipper messenger RNA expression were upregulated (4.7-fold, p < 0.01 and 14-fold, p < 0.0001, respectively), and cortisol was higher (20.3 vs 14.3 μg/dL, p < 0.01) compared with the control group.; Conclusions: ICU coronavirus disease 2019 patients showed upregulated glucocorticoid receptor alpha and glucocorticoid-inducible leucine zipper expression, along with cortisol levels, compared with ICU noncoronavirus disease 2019 patients. Thus, on ICU admission, critical coronavirus disease 2019 appears to be associated with hypercortisolemia, and increased synthesis of glucocorticoid receptor alpha and induced proteins.; (Copyright © 2021 by the Society of Critical Care Medicine and Wolters Kluwer Health, Inc. All Rights Reserved.) |
| Competing Interests: | The authors have disclosed that they do not have any potential conflicts of interest. |
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| Substance Nomenclature: | 0 (Receptors, Glucocorticoid); 0 (glucocorticoid receptor alpha); WI4X0X7BPJ (Hydrocortisone) |
| Entry Date(s): | Date Created: 20210525 Date Completed: 20211123 Latest Revision: 20230728 |
| Update Code: | 20260130 |
| PubMed Central ID: | PMC8594506 |
| DOI: | 10.1097/CCM.0000000000005097 |
| PMID: | 34034298 |
| Database: | MEDLINE |
Journal Article; Observational Study; Research Support, Non-U.S. Gov't