Molecular mechanisms underlying corticosteroid unresponsiveness in the treatment of systemic lupus erythematosus

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Author:
JIANG Shan(Department of Dermatology,Renmin Hospital of Wuhan University,Wuhan 430060,China)
LEI Tie-chi(Department of Dermatology,Renmin Hospital of Wuhan University,Wuhan 430060,China)
Journal Title:
INTERNATIONAL JOURNAL OF DERMATOLOGY AND VENEREOLOGY
Issue:
Volume 35, Issue 03, 2009
DOI:
10.3760/cma.j.issn.1673-4173.2009.03.008
Key Word:
Lupus erythematosus,systemic;Glucocorticoid;Glycoproteins;Treatment failure

Abstract: It is an awkward issue to treat systemic lupus erythematosus(SLE)in patients with corticosteroid unresponsiveness.Recently,P-glycoprotein(P-gP)and macrophage migration inhibition factor (MIF)have been clearly linked to the modulation of corticosteroid sensitivity.The following two mechanisms seem to be involved in corticosteroid unresponsiveness.First,over-expression of P-gp on activated peripheral lymphocytes can cause the exclusion of intercellular corticosteroid from lymphocytes.Second,the expression Of MIF.which exerts a potent antagonistic effect on corticosteroid suppression of immune-mediated inflammation.is increased in patients with SLE.It may restore the sensitivity to corticosteroid to down-regulate or suppress the expression of P-gp and MIF in patients with SLE.

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