Impaired Glucocorticoid Receptor Signaling Aggravates Lung Injury after Hemorrhagic Shock

We previously showed that attenuated lung injury after hemorrhagic shock (HS) coincided with enhanced levels of the glucocorticoid (GC) receptor (GR) in lung tissue of swine. Here, we investigated the effects of impaired GR signaling on the lung during resuscitated HS using a dysfunctional GR mouse model (GR(dim/dim)). In a mouse intensive care unit, HS led to impaired lung mechanics and aggravated lung inflammation in GR(dim/dim) mice compared to wildtype mice (GR(+/+)). After HS, high levels of the pro-inflammatory and pro-apoptotic transcription factor STAT1/pSTAT1 were found in lung samples from GR(dim/dim) mice. Lungs of GR(dim/dim) mice revealed apoptosis, most likely as consequence of reduced expression of the lung-protective Angpt1 compared to GR(+/+) after HS. RNA-sequencing revealed increased expression of pro-apoptotic and cytokine-signaling associated genes in lung tissue of GR(dim/dim) mice. Furthermore, high levels of pro-inflammatory cytokines and iNOS were found in lungs of GR(dim/dim) mice. Our results indicate impaired repression of STAT1/pSTAT1 due to dysfunctional GR signaling in GR(dim/dim) mice, which leads to increased inflammation and apoptosis in the lungs. These data highlight the crucial role of functional GR signaling to attenuate HS-induced lung damage.