GRα, the classic glucocorticoid receptor is ubiquitously expressed and mediates most of the known actions of glucocorticoids [
3,
5]. The human GRα consists of 777 amino acids and has 3 major distinct functional domains, the N-terminal or immunogenic domain (NTD), the DNA-binding domain (DBD) and the ligand-binding domain (LBD) [
6] (). The LBD of GRα consists of 12 α-helices and 4 β-sheets, among which helices 3, 4, 11 and 12 form the ligand-binding pocket for binding to glucocorticoids [
16–
18] (). GRα is located primarily in the cytoplasm in the absence of glucocorticoid ligand, as part of hetero-oligomeric complexes containing heat shock proteins (HSPs) 90, 70, 50, 20 and, possibly, other proteins as well [
5,
6] (). After binding to its agonist ligand, GRα undergoes conformational changes, dissociates from the heat shock proteins, homo-dimerizes, and translocates as a monomer or dimer into the nucleus through the nuclear pore, via an active ATP-dependent process mediated by its nuclear localization signals (NL)-1 and -2 [
12,
19]. NL-1 is located in the junction of DBD and the hinge region, while NL-2 spans the entire LBD [
19] ().
Inside the nucleus, the ligand-activated GRα directly interacts as a dimer with specific DNA sequences, the glucocorticoid response elements (GREs), in the promoter regions of target genes, or as a monomer or dimer with other transcription factors via protein-protein interactions, indirectly influencing the activity of the latter on their own target genes [
5,
12] (). GR contains two transactivation domains, activation function (AF)-1 and -2, located at its NTD and LBD, respectively, through which the GR interacts with many proteins and protein complexes, such as the nuclear receptor coactivator [p160, p300/CREB-binding protein (CBP) and p300/CBP-associated factor (p/CAF)] complexes and the SWI/SNF and vitamin D receptor-interacting protein/thyroid hormone receptor-associated protein (DRIP/TRAP) chromatin-remodeling complexes, eventually influencing the activity of RNA polymerase II and its ancillary factors, altering the transcription rates of glucocorticoid-responsive genes [
5,
6,
20] ().
GR also interacts with the nuclear receptor corepressor (NCoR) and its homolog silencing mediator of retinoic acid and thyroid hormone receptor (SMRT), which are macromolecular docking platforms for nuclear receptors and many transcription factors, repressing the transcriptional activity of the GR by attracting histone deacetylase/Sin3 complexes [
20]. The p160 type coactivators and the NCoR/SMRT type corepressors establish equilibrium in their interaction with the GR to respectively facilitate or block its transcriptional activity [
21]. Accumulation of coactivators and corepressors on the promoter-bound GR is dependent on the kind of ligands bound to the GR: agonist glucocorticoids attract the coactivator complexes to the promoter-bound GR, while antagonists, like RU 486, accumulate the corepressor complexes [
22] ().
In addition to transactivation of the glucocorticoid-responsive genes explained above, GRα modulates other signal transduction cascades through mutual protein-protein interactions with specific transcription factors, by influencing their ability to stimulate or inhibit the transcription rates of their respective target genes (). This activity may be more important than the GRE-mediated one, granted that mice harboring a mutant GRα, which is active in terms of protein-protein interactions but inactive in terms of transactivation via DNA GREs, survive and procreate, in contrast to mice with a deletion of the entire GR gene that die immediately after birth from severe respiratory distress syndrome [
23,
24]. The former mouse model and additional
in vitroresults indicate that GR interacts with and influences other transcription factors primarily as a monomer [
23,
25].
The protein-protein interactions of GRα with other transcription factors may take place on promoters that do not contain GREs (tethering mechanism), as well as on promoters that have both GRE(s) and responsive element(s) of transcription factors that interact with GRα (“composite promoters”) [
26]. Suppression of transactivation of other transcription factors through protein-protein interactions may be particularly important in the suppression of immune function and inflammation by glucocorticoids [
23,
25]. A substantial part of the effects of glucocorticoids on the immune system may be explained by the interaction between GRα with nuclear factor-κB (NF-κB), activator protein-1 (AP-1) and probably the signal transducers and activators of transcription (STATs) [
27–
30].
In addition to co-regulators and other transcription factors that modulate GR-induced transcriptional activity, several distinct signaling pathways regulate the transcriptional activity of the GR via post-translational modifications of the receptor protein [
5]. These include methylation, acetylation, nitrosylation, sumoylation and ubiquitination, as well as phosphorylation, which has been studied best. Indeed, several kinases, such as the cell-cycle-related kinases, mitogen-activated kinases and the glycogen synthase kinases, phosphorylate specific serine or threonine residues of the GR. Interestingly, the majority of these residues are located in the AF-1 domain of the human GR NTD, thus phosphorylation of some or all of them modulates GR-induced transcriptional activity through alteration of co-regulator attraction to the promoter region of glucocorticoid-responsive genes, possibly by changing their affinity to the AF-1 domain of GR [
31].