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Glucocorticoid and mineralocorticoid receptor expression in critical illness:A narrative review

World Journal of Critical Care Medicine 2021年第4期10卷 102-111页

作者： Alice G Vassiliou Nikolaos Athanasiou Dimitra A Vassiliadi edison jahaj Chrysi Keskinidou Anastasia Kotanidou Ioanna Dimopoulou 1^(st)Department of Critical Care Medicine&Pulmonary Services School of MedicineNational&Kapodistrian University of Athens“Evangelismos”HospitalAthens 10676Greece Department of Endocrinology Diabetes and Metabolism“Evangelismos”HospitalAthens 10676Greece

The glucocorticoid receptor(GCR)and the mineralocorticoid receptor(MR)are members of the steroid receptor superfamily of hormone-dependent transcription *** receptors are structurally and functionally *** are localized in the cytosol and translocate into the nucleus after ligand *** and MRs can be co-expressed within the same cell,and it is believed that the balance in GCR and MR expression is crucial for homeostasis and plays a key role in normal *** critical illness,the hypothalamic-pituitary-adrenal axis is activated,and as a consequence,serum cortisol concentrations are ***,a number of patients exhibit relatively low cortisol levels for the degree of illness ***(GC)actions are facilitated by GCR,whose dysfunction leads to GC tissue *** MR is unique in this family in that it binds to both aldosterone and *** GCs play a critical role in controlling inflammatory responses in critical *** GC concentrations can differ greatly from blood levels due to the action of the two 11β-hydroxysteroid dehydrogenase isozymes,type 1 and type 2.11β-hydroxysteroid dehydrogenases interconvert endogenous active cortisol and intrinsically inert *** degree of expression of the two isozymes has the potential to dramatically influence local GC availability within cells and *** this review,we will explore the clinical studies that aimed to elucidate the role of MR and GCR expression in the inflammatory response seen in critical illness.

关键词： Mineralocorticoid receptor Glucocorticoid receptor,Critical illness 11betahydroxysteroid dehydrogenase Aldosterone Cortisol

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