Regulation of the glucocorticoid receptor by glucocorticoids in human mononuclear leukocytes.

We analyzed glucocorticoid receptor binding in peripheral blood mononuclear leukocytes from normal adult males and from females at the follicular and luteal phases. Healthy controls were analyzed before and after 17 days of treatment with two synthetic glucocorticoids: prednisone and an oxazoline derivative of prednisolone (deflazacort). We also studied for comparison 4 patients with adrenocortical insufficiency, two of them on long-term corticoid replacement, and 7 patients with Cushing's syndrome. Using a whole-cell competitive binding assay and 3H-dexamethasone as tracer, normal human mononuclear leukocytes (19 males, 6 females) were found to have 4,529 +/- 1,532 (mean +/- SD) binding sites per cell and a dissociation constant (Kd) of 9.5 +/- 2.3 nM. In Cushing's syndrome the receptor parameters were within the normal range. Cells from patients with untreated Addison's disease had low levels of sites per cell. The number of binding sites increased to normal after long-term glucocorticoid replacement. All the adrenal insufficiency cases had a normal Kd. Finally, following treatment with the synthetic glucocorticoid, deflazacort, the sites per cell were reduced but the Kd remained unchanged. Prednisone had no effects.