Glucocorticoid receptors: The key of the response to steroid therapy in autoimmune hepatitis

Mohamed A. S. El-Guindi; Haidy M. Zakaria; Doha M. Taie; Mohammed A. Khedr; Nermin M. Adawy; Basma M. Abd-Elaati

doi:10.5114/ceh.2024.140322

eISSN: 2449-8238
ISSN: 2392-1099

Clinical and Experimental Hepatology

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abstract:

Original paper

Glucocorticoid receptors: The key of the response to steroid therapy in autoimmune hepatitis

Mohamed A. S. El-Guindi

¹

,

Haidy M. Zakaria

²

,

Doha M. Taie

³

,

Mohammed A. Khedr

¹

,

Nermin M. Adawy

¹

,

Basma M. Abd-Elaati

¹

Department of Pediatric Hepatology, Gastroenterology and Nutrition, National Liver Institute, Menoufia University, Shebin El-Kom, Menoufia, Egypt
Department of Clinical Research and Health Development, Menoufia Directorate of Health Affairs, Ministry of Health and Population, Shebin El-Kom, Menoufia, Egypt
Department of Histopathology, National Liver Institute, Menoufia University, Shebin El-Kom, Menoufia, Egypt

Clin Exp HEPATOL 2024; 10, 2: 111-119

DOI: https://doi.org/10.5114/ceh.2024.140322

Online publish date: 2024/06/18

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Aim of the study:
This study was performed to investigate the hepatic expression of glucocorticoid receptors (GR) and 11b-hydroxysteroid dehydrogenase type 1 (11b-HSD1) in pediatric autoimmune hepatitis (AIH) patients and its relation to the steroid response.

Material and methods:
This study included 100 patients diagnosed with AIH on immunosuppressive therapy with different responses to treatment. The patients were subjected to full history taking and thorough clinical examination, laboratory investigations, abdominal ultrasound and liver biopsy for histopathological evaluation and assessment of the hepatic expression of GR and 11b-HSD1.

Results:
Out of the 100 cases, 82 cases showed a complete response, 11 a partial response and 7 cases were non-responders. The sex, age distribution and clinical presentation of the disease were comparable among the different response groups. Glucocorticoid receptors reactivity was significantly more intense in patients with a complete response than both patients with a partial response and non-responders. 11b-HSD intensity was higher in complete and partial responders in comparison with non-responders but without significance. The percentage of patients with a GR intensity score ≥ 200 was significantly higher in patients with a complete response than patients with a partial response and non-responders (p < 0.05). The GR intensity score had a significant positive correlation with intensity of 11b-HSD (r = 0.369, p < 0.0001).

Conclusions:
Glucocorticoid receptors expression was significantly variable in children with AIH and closely related to the response to therapy. However, the 11b-HSD expression was comparable between different response groups.

keywords:

Glucocorticoid receptors: The key of the response to steroid therapy in autoimmune hepatitis

Mohamed A. S. El-Guindi 1 , Haidy M. Zakaria 2 , Doha M. Taie 3 , Mohammed A. Khedr 1 , Nermin M. Adawy 1 , Basma M. Abd-Elaati 1

immunosuppressive therapy, autoimmune hepatitis, glucocorticoids

Mohamed A. S. El-Guindi

¹

,

Haidy M. Zakaria

²

,

Doha M. Taie

³

,

Mohammed A. Khedr

¹

,

Nermin M. Adawy

¹

,

Basma M. Abd-Elaati

¹