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Glucocorticoid use in sepsis is controversial. In contrast to other extracellular signaling molecules, glucocorticoid receptors (GRs) are intra-cytoplasmic. Several GR isoforms have been identified. A study in Critical Care Forum suggests that sepsis alters the abundance of the dominant negative GRβ. Here we discuss GR isoforms and how they may affect cellular responses to glucocorticoids in sepsis.

Steroid responses in sepsis: some novel thinking that may provide new insight