Various efforts have been made to better understand the interplay of glucocorticoid receptor (GCR) expression and critical illness, but many unknowns remain. Shibata et al hypothesized that a subset of critically ill children with cardiovascular (CV) collapse would demonstrate decreased expression of GCR and would have more severe illness (based on Pediatric Risk of Mortality [PRISM] III measurements) and more organ failure than critically ill children with no CV collapse.
In a comparison of these two groups, the investigators discovered a statistically significant decrease in GCR expression in CD4+ and CD8+ cells in critically ill children with CV failure. They also discovered that this diminished expression could be found in patients with higher PRISM III scores and those with greater organ failure burden. Ultimately, this study’s findings suggest that the lack of GCR expression in critically ill patients could serve as a risk factor for worsening severity of illness and CV failure.
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