CORRELATION BETWEEN SYNOVIAL CELL GLUCOCO RTICOID RECEPTOR DENSITY AND CLINICAL-RESPONSE TO STEROIDAL TREATMENT IN PATIENTS WITH RHEUMATOID-ARTHRITIS

Background: The target cellular response to glucocorticoids is proport ional to the concentrations or affinity of specific receptors to these substances. Aim: To look for a correlation between glucocorticoid rec eptor concentrations in synovial wall cells and the clinical response to steroidal treatment in patients with rheumatoid arthritis. Patients and methods: Twenty eight patients with rheumatoid arthritis were stu died. Each subject was subjected to a synovial biopsy, in which a dry radioautographic technique for diffusible compounds was used. Patients were treated afterwards with three 500 mg intravenous pulses of methi lprednisolone. Results: A mean of 44.8% of synovial cells (range 30.1- 62.8%) had binding sites for H-3 dexamethasone. All patients had a sig nificant clinical improvement after methylprednisolone. Multiple regre ssion analysis did not show a correlation between clinical response an d glucocorticoid receptor concentrations and clinical response could b e due to the large steroid dose used, that saturated all available rec eptors.