Glucocorticoid receptors in bronchoalveolar cells from patients with idiopathic pulmonary fibrosis.

In order to clarify the physiologic and clinical significances of glucocorticoid receptors in bronchoalveolar cells, we measured the glucocorticoid receptor content in bronchoalveolar cells obtained from patients with idiopathic pulmonary fibrosis (IPF), normal volunteers, control patients with localized lung cancer, and a group of patients with pulmonary manifestations associated with collagen-vascular diseases, hypersensitivity pneumonitis, pneumoconiosis, and chronic bronchitis. The contents of glucocorticoid receptors in bronchoalveolar cells from patients with IPF (5,561 +/- 3,741 sites per cell) and various pulmonary diseases (4,452 +/- 2,097 sites per cell) were lower than those in bronchoalveolar cells from normal volunteers (9,970 +/- 4,050 sites per cell) and control patients (8,354 +/- 4,367 sites per cell). Patients with IPF, who had a lower glucocorticoid receptor content in bronchoalveolar cells did not respond to glucocorticoids. On the contrary, the patients with IPF who responded well to glucocorticoids had as much glucocorticoid receptor content in bronchoalveolar cells as normal volunteers had. These results suggested that the content of glucocorticoid receptors in bronchoalveolar cells varies during disorders of the lung, and may be a useful parameter for predicting whether glucocorticoid therapy will be effective in IPF.