The ability of natural and synthetic glucocorticoids to elicit numerous and diverse physiological responses is remarkable. How the product of a single gene can participate in such a myriad of cell- and tissue-specific pathways has remained largely unknown. The last several years have seen increased description of glucocorticoid receptor (GR) protein isoforms. Here we review the current state of knowledge regarding naturally occurring GR isoforms and discuss how this array of receptor species generates the diversity associated with the glucocorticoid response. We propose that the multiplicity of receptor forms have unique tissue- specific actions on the downstream biology providing a mechanism to create GR signaling networks.
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