Exogenous glucocorticoid dose impacts circulating microRNA expression in patients with adrenal insufficiency due to 21-hydroxylase deficiency
Patients with adrenal insufficiency due to 21-hydroxylase deficiency (21-OHD) are often exposed to supraphysiologic doses of glucocorticoids (GCs), which can augment metabolic dysfunction by altering glucose, lipid and protein metabolism. Exogenous GCs also fail to mimic the natural circadian rhythm of cortisol secretion. MicroRNAs (miRNAs) are important regulators of gene expression involved in various biological and pathological processes. GCs can regulate miRNAs and in turn miRNAs can modulate GC receptor (GR) activity influencing GR-mediated activity. In this pilot study, we examine the effects of exogenous GCs on circulating miRNA levels in patients with adrenal insufficiency due to classic 21-OHD.