title: Molecular basis of mechanisms of steroid resistance in children with nephrotic syndrome.
abstract: Steroid therapy, due to a wide range of anti-inflammatory properties of steroids, is a basic field of treatment in many human diseases including the nephrotic syndrome in children. However, not all patients respond positively to therapy which divides them into steroid sensitive (SS) and steroid resistance (SR) individuals. Many potential factors associated with steroid resistance have been identified so far. It seems that genetic factors associated with glucocorticoid receptor α (GRα), the structure of heterocomplex of GR as well as glycoprotein P or cytochrome P450 may play a role in the induction of glucocorticoid resistance. Here we described several of the molecular mechanisms, which can regulate glucocorticoid sensitivity and resistance. Moreover, we presented genetic defects, which can lead to various effects of treatment and, in a longer perspective, enable clinicians to individualize therapies.
authors.affiliation: Department of Histology and Embryology, Poznań University of Medical Sciences, Poznań, Poland.
authors.forename: Monika
authors.initials: M
authors.lastname: Swierczewska
authors.forename: Danuta
authors.initials: D
authors.lastname: Ostalska-Nowicka
authors.forename: Bartosz
authors.initials: B
authors.lastname: Kempisty
authors.forename: Michał
authors.initials: M
authors.lastname: Nowicki
authors.forename: Maciej
authors.initials: M
authors.lastname: Zabel
mesh_terms: D020168:ATP Binding Cassette Transporter, Subfamily B, Member 1 / Q000235:genetics / Q000378:metabolism; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use*; D002648:Child; D003577:Cytochrome P-450 Enzyme System / Q000235:genetics / Q000378:metabolism; D004361:Drug Tolerance / Q000235:genetics*; D020022:Genetic Predisposition to Disease; D005938:Glucocorticoids / Q000627:therapeutic use*; D006801:Humans; D007668:Kidney / Q000378:metabolism / Q000473:pathology; D008661:Metabolism, Inborn Errors / Q000235:genetics* / Q000378:metabolism / Q000473:pathology; D009154:Mutation; D009404:Nephrotic Syndrome / Q000188:drug therapy* / Q000235:genetics / Q000378:metabolism / Q000473:pathology; D011110:Polymorphism, Genetic; D020033:Protein Isoforms / Q000235:genetics / Q000378:metabolism; D011965:Receptors, Glucocorticoid / Q000172:deficiency* / Q000235:genetics / Q000378:metabolism
chemical_list: D020168:ATP Binding Cassette Transporter, Subfamily B, Member 1; D000893:Anti-Inflammatory Agents; D005938:Glucocorticoids; D020033:Protein Isoforms; D011965:Receptors, Glucocorticoid; C411470:glucocorticoid receptor alpha; D003577:Cytochrome P-450 Enzyme System