Pharmacokinetic/Pharmacodynamic Factors and Steroid Sensitivity

BACKGROUNDUp to 29% of patients with severe ulcerative colitis (UC) fail to respond to steroid treatment and require surgery. Previous studies have failed to show a clear correlation between failure of steroid treatment in severe UC and measures of disease severity. The reasons for treatment failure therefore remain unknown.AIMTo investigate the hypothesis that patients with severe UC who fail to respond to steroid treatment have steroid resistant T lymphocytes.METHODSEighteen patients with severe UC were studied. After seven days’ treatment with high dose intravenous steroids they were classified as complete responders (CR), incomplete responders (IR), or treatment failures (TF). Within 48 hours of admission blood was taken and the antiproliferative effect of dexamethasone on phytohaemagglutinin stimulated peripheral blood T lymphocytes was measured. Maximum dexamethasone induced inhibition of proliferation (Imax) was measured.RESULTSIn vitro T lymphocyte steroid sensitivity of TF and IR patients was significantly less than that of CR patients. Both TF and 3/5 IR patients had an Imax of less than 60%; all CR patients had an Imax of greater than 60%. No significant correlation was seen between response to treatment and disease severity on admission. When in vitro T lymphocyte steroid sensitivity was remeasured three months later, there was no difference between the groups.CONCLUSIONSResults suggest that T lymphocyte steroid resistance is an important factor in determining response to steroid treatment in patients with severe UC and may be more predictive of outcome than disease severity.

Download Full-text

Steroid Sensitivity of the Nervous System

Hormones and Brain Function ◽

10.1007/978-1-4684-2007-4_38 ◽

1973 ◽

pp. 375-378 ◽

Cited By ~ 1

Author(s):

J. P. Schadé ◽

H. van Wilgenburg

Keyword(s):

Nervous System ◽

Steroid Sensitivity

Download Full-text

Neural steroid sensitivity and aggression: comparing individuals of two songbird subspecies

Journal of Evolutionary Biology ◽

10.1111/jeb.12094 ◽

2013 ◽

Vol 26 (4) ◽

pp. 820-831 ◽

Cited By ~ 29

Author(s):

C. M. Bergeon Burns ◽

K. A. Rosvall ◽

E. D. Ketterson

Keyword(s):

Steroid Sensitivity

Download Full-text

OC-004 In Vitro Steroid Sensitivity Accurately Predicts 6 Month Mortality in Patients with Severe Alcoholic Hepatitis

Gut ◽

10.1136/gutjnl-2013-304907.004 ◽

2013 ◽

Vol 62 (Suppl 1) ◽

pp. A2.1-A2

Author(s):

A Dhanda ◽

A Di Mambro ◽

A McCune ◽

F Gordon ◽

J Portal ◽

...

Keyword(s):

Alcoholic Hepatitis ◽

Severe Alcoholic Hepatitis ◽

Steroid Sensitivity

Download Full-text

ASSOTIATIONS OF PECULIARITIES OF HLA-PHENOTYPE AND THE SENSIBILITY TO THE CORTICOSTEROID TREATMENT IN PATIENTS WITH CHRONIC GLOMERULONEPHRITIS WITH NEPHROTIC SYNDROME

Ukrainian Journal of Nephrology and Dialysis ◽

10.31450/ukrjnd.1(37).2013.07 ◽

2017 ◽

pp. 37-44

Author(s):

M. Kolesnyk ◽

G. Drannik ◽

V. Driyanska ◽

O. Petrina ◽

M. Velychko

Keyword(s):

Nephrotic Syndrome ◽

Hla Antigens ◽

Corticosteroid Treatment ◽

Steroid Resistance ◽

Control Group ◽

Chronic Glomerulonephritis ◽

Healthy Donors ◽

Steroid Sensitive ◽

Steroid Sensitivity ◽

Hla Phenotype

The purpose of study was determination of HLA -antigens I and II classes as predictors of ineffectiveness of initial steroid therapy, and according prognozonegative markers of chronic glomerulonephritis with nephrotic syndrome. Methods. In 59 chronic glomerulonephritis with nephrotic syndrome patients (steroid sensitive n=33 (1 gr.) and steroid resistant’s n= 26 (2 gr.)) and 350 healthy donors( control group) studied HLA antigens I and II classes of the special anti- HLA-antigens panel (20 antigens of locus A, 31 – of locus B and 9- of locus DR). Result. In patients with chronic glomerulonephritis, nephrotic syndrome with hormone sensitivity relative risk is high at the presents of A28 (RR=8,5, r р <0,001), it made attributive risk (=0,37). In comparison with a control group, RR>2 for antigens A11 (RR=2,23), A23 (RR=4,28), A24 (RR=3,3), A29 (RR=10,78) that A30 (RR=11,23); attributive risk more than 0,1 for the antigen A11 (=0,16) ; A24 (=0,13), other did not differ from control. Subzero connection is exposed for the antigens of A2 (р<0,001), А9 (р=0,007). In locus antigen B14 (RR=5,65, р =0,001) are exposed, B44 (RR=48,25, р =0,004), B51(RR=12,32, р =0,006) and attributive risk of development of disease (according =0,24, 0,12 ; 0,14); and antigens B38 and B41 (RR=11,57, р=0,05). The steroid sensitivity was associated with the antigens B5 (p=0,033), B12 (p=0,005) and B35 (p=0,021). In locus DR made etiologic faction antigens DR4 (RR=7,0 and =0,24) DRw52 (RR=7,0 and =0,25). Conclusions. For patients with chronic glomerulonephritis with a nephrotic syndrome antigens of HLA-B14,B38, B51, DRw52 are associated with steroid sensitivity. The attributive risk of steroid resistance is high for split A19+31+32, antigens B8, B55.

Download Full-text