Chronic inflammatory diseases often have residual CD8 ؉ T-cell infiltration despite treatment with systemic corticosteroids, which suggests divergent steroid responses between CD4 ؉ and CD8 ؉ cells. To examine steroid sensitivity, dexamethasone (DEX)-induced histone H4 lysine 5 (K5) acetylation and glucocorticoid receptor ␣ (GCR␣) translocation were evaluated. DEX treatment for 6 hours significantly induced histone H4 K5 acetylation in normal CD4 ؉ cells (P ؍ .001) but not in CD8 ؉ cells. DEX responses were functionally impaired in CD8 ؉ compared with CD4 ؉ cells when using mitogen-activated protein kinase phosphatase (1 hour; P ؍ .02) and interleukin 10 mRNA (24 hours; P ؍ .004) induction as a readout of steroid-induced transactivation. Normal DEX-induced GCR␣ nuclear translocation and no significant difference in GCR␣ and GCR mRNA expression were observed in both T-cell types. In addition, no significant difference in SRC-1, p300, or TIP60 expression was found. However, activating transcription factor-2 (ATF2) expression was significantly lower in CD8 ؉ compared with CD4 ؉ cells (P ؍ .009).
Importantly
IntroductionCurrently, glucocorticoids (GC)s are the most effective antiinflammatory therapy used for treatment of chronic inflammatory and immune diseases. 1,2 However, sensitivity to GCs varies considerably among immune cells. 1,3,4 For instance, clinical data demonstrate residual CD8 ϩ T-cell infiltration despite treatment with systemic GCs with more-severe disease outcomes. These cells, therefore, could be one of the key mediators for resistance to steroid therapy. It was found that in patients with multiple myeloma, a decrease in the CD4 ϩ /CD8 ϩ ratio that results from an increased number of HLA-DR-expressing 5 and cancer germline-specific CD8 ϩ cells 6 is usually a good indicator of poor steroid response. In GC-resistant cases of systemic lupus erythematosus, CD8 ϩ T cells have been shown to be refractory to steroid-mediated apoptosis, 7 and this is monitored as an indicator for the therapeutic efficacy of steroids. Relapses of multiple sclerosis are treated commonly with high-dose intravenous methylprednisolone. 8 Several independent studies have reported that steroid treatment can significantly decrease the numbers of CD4 ϩ T cells in these patients 8 ; however, the same studies observed no change or even an increase in the number of CD8 ϩ T cells after treatment in patients with poorly controlled disease. 9 In patients with asthma, a decline in lung function as an asthma outcome has been shown to correlate with the number of lung-infiltrating CD8 ϩ cells. 10 In patients with chronic obstructive pulmonary disease, it has been shown that CD8 ϩ and CD68 ϩ cells and neutrophils are refractory to treatment with inhaled steroids, which highlights a need for understanding differential cell response to GCs. 11,12 GCs exert their biologic effect through a specific receptor, GC receptor ␣ (GCR␣), which is expressed in virtually all cells. GCR␣ is a DNA-binding protein located in the cell cytoplasm. ...