The glucocorticoid receptor (GR) is ubiquitously expressed on nearly all cell types, but tissue-specific deletion of this receptor can produce dramatic whole organism phenotypes. In this study we investigated the role of the endothelial GR in sepsis in vivo and in vitro. Mice with an endothelial-specific GR deletion and controls were treated with 12.5 mg/kg LPS and phenotyped. Mice lacking GR showed significantly increased mortality, more hemodynamic instability, higher nitric oxide levels, and higher levels of the inflammatory cytokines, tumor necrosis factor-alpha (TNF-α) and interleukin-6 (IL-6) compared with controls. There were no differences in rates of apoptosis or macrophage recruitment between the two groups. Both endothelial nitric oxide synthase (eNOS) and inducible nitric oxide synthase (iNOS) expression were increased after LPS challenge in mice with endothelial GR deficiency, and aminoguanidine, a specific iNOS inhibitor in mice was able to rescue hemodynamic collapse in these animals. In vitro, human umbilical vein cells (HUVECs) subjected to GR knockdown by siRNA showed increased expression of eNOS at baseline that persisted after treatment with LPS. Both eNOS and iNOS mRNA was increased by qPCR. In HUVECs lacking GR, NF-κB levels and NF-κB-dependent genes tissue factor and IL-6 were increased compared with controls. Thus, endothelial GR is a critical regulator of NF-κB activation and nitric oxide synthesis in sepsis.T he glucocorticoid receptor (GR) is a nuclear hormone receptor with wide-ranging roles in both health and disease. This receptor is a ligand-bound transcription factor that, in the absence of ligand, resides in the cytoplasm bound to Hsp90 and other stabilizing cofactors. Upon ligand binding the receptor-ligand complex translocates to the nucleus and affects gene transcription as well as a vast complement of downstream signaling pathways (1, 2). GR is the target of a number of synthetic steroids used as therapy for a wide array of autoimmune, inflammatory, and malignant conditions, as well as the receptor for the endogenous, adrenally produced steroid corticosterone.GR is present in nearly every tissue in the body and is widely conserved across species, highlighting its critical role in homeostasis and survival (3). This fact is underscored by the near uniform mortality observed in mice lacking global GR, likely due to severe lung hypoplasia (4). Thus, to address the cell-specific role of GR in mammalian systems, GR has been deleted in a tissuespecific manner. For example, deletion of GR in the central nervous system results in mice with profoundly altered hypothalamic-pituitary-adrenal (HPA) axes and 10-fold elevated circulating corticosterone levels as well as reduced anxietyrelated behavior (5). Tissue-specific excision of GR from hepatoctyes results in a severe growth deficit thought to be due to down-regulation of STAT5-mediated transcription (6, 7). Mice with tissue-specific deletion of GR in lung epithelial cells have been shown to have reduced viability (8). Therefore, the p...