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在过去的几十年间,人们认为糖皮质激素(glucocorticoid,GC)仅仅是通过改变基因的表达来发挥其生理作用,这个过程需要几个小时来完成。然而,近年来越来越多的证据表明GC对激素分泌、神经元兴奋性、机体行为及细胞形态、糖类代谢等具备快速效应,这些过程往往在数秒钟或者分种内完成,这种作用机制被称为GC的非基因组作用机制。GC的非基因组作用主要可能通过两种不同的机制起作用:(1)通过细胞膜上或者细胞质内结构未知的糖皮质激素受体(glucocorticoid Recptor,GR)来发挥非基因组作用,即为特异性非基因组效应,(2)GC主要通过改变细胞膜理化作用来发挥效应,也称为非特异性非基因组效应(non-spe-cific nongenomic effects,NSNE)。本文通过阐述近年来GC的非基因组的作用的最新研究进展并且讨论了这些非基因组作用临床治疗过程中的联系。对糖皮质激素基因组和非基因组作用机制的深入了解有助于指导我们在临床合理用药并减少其副作用。
Over the past few decades, glucocorticoid (GC) has been suggested to exert its physiological effects simply by altering gene expression, a process that takes several hours to complete. However, there is increasing evidence in recent years that GC has a rapid effect on hormone secretion, neuronal excitability, body behavior and cell morphology, carbohydrate metabolism and the like, and these processes are often completed within a few seconds or minutes The mechanism is called the non-genomic mechanism of GC. The non-genomic effects of GC may play a role mainly through two different mechanisms: (1) Non-genomic effects occur through the structurally unknown glucocorticoid receptor (GR) on the cell membrane or in the cytoplasm, Genome Effects, and (2) GC exerts its effects primarily by altering the physical and chemical effects of cell membranes, also known as non-spe-cific nongenomic effects (NSNEs). This article describes recent advances in the role of non-genomic GCs in recent years and discusses the links between these non-genomic effects in clinical treatment. In-depth understanding of the mechanism of genomic and non-genomic glucocorticoid therapy helps guide our rational clinical use and reduce their side effects.