GR-alpha and GR-beta mRNA levels in peripheral blood mononuclear cells of acute myelitis patients can assist in the identification of glucocorticoid sensitivity and are correlated with glucocorticoid therapeutic effect

Acute myelitis (AM) is a rare neuro-immune spinal cord disease. This study sought to explore the transcription level of glucocorticoid (GC) receptors alpha and beta (GR-alpha/GR-beta) in peripheral blood mononuclear cells (PBMCs) and their correlation with GC efficacy and sensitivity in AM patients. AM patients were grouped into the GC-sensitive group (N = 80) and GC-refractory group (N = 67). The GR-alpha and GR-beta mRNA levels in PBMCs were detected. The differentiating value of GR-alpha, GR-beta, and GR-alpha + GR-beta on GC sensitivity and resistance in AM patients was assessed. The independent correlation between GR-alpha and GR-beta mRNA levels and GC sensitivity in AM patients,t and the correlation between GR-alpha and GR-beta mRNA levels and spinal function after GC treatment were analyzed. GR-alpha mRNA level in PBMCs of GC-refractory patients was lower than that of GC-sensitive patients, while GR-beta mRNA level was higher than that of GC-sensitive patients. GR-alpha + GR-beta mRNA had a high diagnostic value for GC sensitivity and resistance in AM patients (area under the ROC curve = 0.881, sensitivity = 79.1%, specificity = 85.0%). GR-alpha and GR-beta mRNA levels were independently correlated with GC sensitivity. GR-alpha and GR-beta mRNA levels were correlated with the spinal function of AM patients after GC treatment. Overall, GR-alpha and GR-beta mRNA levels in PBMCs of AM patients can assist in the identification of GC sensitivity and are correlated with GC efficacy.