A Method for Screening Patients’ Cells for Response to Steroids Prior to Initiating Steroid Therapy
Steroids are commonly prescribed medications in the US and around the world. Topical steroids are used extensively to treat a wide range of skin disorders such as psoriasis, eczema and dermatitis, while local steroid injections are a mainline therapy for benign fibrotic skin tumors know as keloids. Additionally, oral steroids are to treat systemic autoimmune conditions, while inhaled steroids serve as the mainline therapy for long-term control of asthma and nasal allergies. However, there is a wide variation in the response of patients to steroid therapy. For example, only about 34% of keloid patients benefit from steroid therapy, while 49% do not respond to it and the remaining 17% of patients actually see a worsening of their symptoms upon steroid therapy. This variability in patients' responses to steroids is likely due to individual differences in the patients’ genetic or epigenetic makeup, although the genes or epigenetic pathways involved have not yet been identified. The highly variable patient responses to steroid therapy highlight the dire need for a screening test to determine patients’ response to steroids prior to initiating therapy.
Fortunately, since all of our cells reflect our genetic/epigenetic makeup, they are also potentially capable of accurately reporting our response to steroids. Hence, as long as we can obtain viable cells from patients, we can test them for sensitivity to steroids. We have developed a simple method for screening patient cells obtained from a small biopsy samples and culturing them to determine the effects of steroids using an in vitro cell proliferation assay.