Glucocorticoids (GCs) are stress hormones that regulate developmental and physiological processes and are among the most potent anti-inflammatory drugs to suppress chronic and acute inflammation. GCs act through the glucocorticoid receptor (GR), a ubiquitously expressed ligand-activated transcription factor, which translocates into the nucleus and can act via two different modes, as a GR monomer or as a GR dimer. These two modes of action are not clearly differentiated in practice and may lead to completely different therapeutic outcomes. Detailed aspects of GR mechanisms are often not taken into account when GCs are used in different clinical scenarios. Patients, with critical illness-related corticosteroid insufficiency, treated with natural or synthetic GCs are still missing a clearly defined therapeutic strategy. This review discusses the different modes of GR function and its importance on organ function in vivo.

中文翻译：

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糖皮质激素受体功能障碍下游效应对危重病相关全身炎症器官功能的影响

糖皮质激素 (GC) 是调节发育和生理过程的应激激素，是抑制慢性和急性炎症的最有效的抗炎药物之一。GC 通过糖皮质激素受体 (GR) 发挥作用，这是一种普遍表达的配体激活转录因子，它易位到细胞核中，可以通过两种不同的模式发挥作用，作为 GR 单体或作为 GR 二聚体。这两种作用方式在实践中没有明确区分，可能导致完全不同的治疗结果。当 GC 用于不同的临床场景时，通常不会考虑 GR 机制的详细方面。使用天然或合成 GC 治疗的与危重疾病相关的皮质类固醇不足的患者仍然缺少明确定义的治疗策略。