Table 3.

Gucocorticoid resistance

Resistance categories
Generalized steroid resistance
Generalized genetic or familial glucocorticoid resistance.
Partial steroid resistance
Hyperacetylation of heat shock proteins causes poor nuclear translocation of glucocorticoid receptor.
Mutation or polymorphism of genes encoding multidrug resistance.
Low expression or low affinity of glucocorticoid receptors.
Polymorphism of glucocorticoid receptors (isoform β).
False steroid resistance
Insufficient dosage.
Short duration of treatment.
Poor gastrointestinal absorption due to mucosal edema or use of gastric protectors.
Accelerated catabolism caused by drugs that increase the activity of cytochrome P450 (anticonvulsants, rifampin, etc.).