REGULATION OF GLUCOCORTICOID SENSITIVITY BY ANNEXIN-1

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Steroids like prednisolone or cortisone are very effective at reducing inflammation in diseases like rheumatoid arthritis and are particularly known to decrease substances involved in inflammation. Almost 70% of patients with rheumatoid arthritis are treated more or less continuously with steroids. Steroid resistance (need for higher doses) or changes in steroid-sensitivity has been widely recognized in asthma, inflammatory bowel disease, and rheumatoid arthritis. Many new drug therapies however have the aim of keeping cortisone use to a minimum because of undesirable side effects like osteoporosis. Annexin-1 is an anti-inflammatory substance important in arthritis development which is also known to mediate many of the actions of steroids. However, the possible contribution of annexin-1 to mediate the effect of steroids in the regulation of these substances has not been examined. Moreover, how annexin-1 turns genes on is not known. Our studies will therefore reveal whether the absence of annexin-1 will increase inflammatory substances turn genes, and secondly, by determining the possible substances regulated by annexin-1 if the treatment with steroids are less effective in the absence of annexin-1. If annexin-1 is found either to increase anti-inflammatory substances or to mediate the effect of therapeutic steroids, its capacity to be involved in the beneficial effect of steroids may have an important impact in treatment of arthritis and other inflammatory diseases. If annexin-1 functionally acts as steroids, the reduction or discontinuation of steroid use will be possible.