Blood, 1 August 2006, Vol. 108, No. 3, pp. 1045-1049.
Prepublished online as a Blood First Edition Paper on March 30, 2006; DOI 10.1182/blood-2006-01-0261.
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NEOPLASIA
Glucocorticoid-induced glucocorticoid-receptor expression and promoter usage is not linked to glucocorticoid resistance in childhood ALL
Wim J. E. Tissing,
Jules P. P. Meijerink,
Bas Brinkhof,
Mathilde J. C. Broekhuis,
Renee X. Menezes,
Monique L. den Boer, and
Rob Pieters
From the Department of Pediatric Oncology/Haematology, Erasmus MC-Sophia Children's Hospital, Erasmus University Medical Center Rotterdam, the Netherlands; Department of Pediatric Oncology/Haematology, Beatrix Children's Hospital, University of Groningen and University Medical Center Groningen, the Netherlands; and the Department of Medical Statistics, Leiden University Medical Center, Leiden, the Netherlands.
Glucocorticoid (GC) resistance is an adverse prognostic factor in childhood acute lymphoblastic leukemia (ALL), but little is known about causes of GC resistance. Up-regulation of the glucocorticoid receptor (GR) has been suggested as an essential step to the induction of apoptosis in leukemic cells. In this study we investigated whether baseline mRNA expression levels of the 5 different GR promoter transcripts (1A1, 1A2, 1A3, 1B, and 1C) or differences in the degree of regulation of the GR or GR promoter transcripts upon GC exposure are related to GC resistance. Therefore, mRNA levels of the 5 GR promoter transcripts and of the GR were measured by quantitative real-time reverse transcriptase–polymerase chain reaction (RT-PCR; Taqman) technology in primary ALL cells prior to and after 3, 8, and 24 hours of prednisolone exposure. GR expression is induced upon GC exposure in primary ALL patient samples, which is opposite to what is found in tissues in which GCs do not induce apoptosis. GC resistance in childhood ALL cannot be attributed to an inability of resistant cells to up-regulate the expression of the GR upon GC exposure, nor to differences in GR promoter usage (at baseline and upon GC exposure).
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