The importance of glucocorticoid receptors in systemic lupus erythaematosus. A systematic review

The therapeutic management of systemic lupus erythaematosus (SLE) is still a great debate. Despite the latest innovation agents or developing trials, there is not an integrated and common approach for treating SLE. For decades, natural and synthetic glucocorticoids (GCs) have been the first and most frequently used immune suppressive agents in SLE. Therefore, GCs are the most important therapy in SLE in daily routine, however the response to GCs differs widely and long-term therapy is associated with side-effects. Still now, clinicians and physicians are unable to predict the exact and ideal dose and term of therapy for patients suffering from various symptoms and degree of disease activity of SLE. The biological mechanism of GCs is regulated through activation of glucocorticoid receptors (GRs). There are two major isoforms of GRs: GR alpha and GR beta; however, the GR alpha is the predominant one which binds steroids and activates target genes. In the present review, we summarise the anti-inflammatory and immune suppressive effects of GCs via GRs to regulate the target genes. (C) 2015 Elsevier B.V. All rights reserved.