From:  Glucocorticoid receptor alpha as a core survival receptor: mechanisms, and implications for health and critical illness

 Systemic functions of glucocorticoid receptor alpha (GRα) across major organ systems.

Organ/SystemGRα function summary
Immune systemCoordinates resolution of inflammation by suppressing NF-κB/AP-1 cytokines, upregulating GILZ/MKP-1/Annexin A1, limiting neutrophil/macrophage survival, and supporting Treg-mediated tolerance [2022].
Central nervous systemModulates synaptic plasticity, hippocampal neurogenesis, and stress adaptation; provides negative feedback on the HPA axis to control glucocorticoid levels; influences emotional regulation via MR/serotonin signaling [28].
Peripheral nervous systemInfluences autonomic outflow and neuroimmune crosstalk; regulates inflammatory tone and contributes to sensory and metabolic homeostasis under stress [23, 24].
Endocrine systemControls HPA axis reactivity and feedback; modulates thyroid, gonadal, and growth hormone axes; coordinates stress hormonal signaling across endocrine networks [6, 25].
Cardiovascular and endotheliumUpregulates adrenergic receptors, enhances catecholamine sensitivity and NO production via eNOS; maintains vascular tone, limits inflammation and permeability; regulates sodium-fluid balance [19, 2632].
LungsSuppresses airway inflammation, enhances β2-adrenergic bronchodilation, promotes alveolar repair and surfactant production, reduces vascular leakage in ARDS [33].
KidneysPromotes AQP2/ENaC expression to retain sodium/water; limits oxidative stress and inflammation; supports podocyte and epithelial structure under systemic stress [3436].
LiverRegulates gluconeogenesis, lipid metabolism, acute-phase proteins; modulates inflammation and circadian-metabolic adaptation; ensures substrate mobilization [6, 37].
Gastrointestinal tractEnhances barrier integrity via tight junction regulation; modulates gut microbiota composition; and reduces oxidative stress and systemic inflammation via gut immune signaling [6, 3840].
PancreasRegulates insulin/glucagon secretion, controls 11β-HSD1 expression in islets; maintains glucose homeostasis; modulates circadian gene expression in β-cells [4143].
Adipose tissuePromotes lipolysis, modulates insulin sensitivity, limits inflammation; preserves mitochondrial function, and regulates adipokines under metabolic stress [4446].
MuscleFacilitates protein catabolism during stress adaptation, preserves mitochondrial integrity and glucose metabolism, and regulates oxidative stress and energy utilization [4749].

This table summarizes the systemic functions of GRα across major organ systems, highlighting its integrative role in coordinating physiological stress responses. For a comprehensive recent review, which includes GRα regulation of circulating cells, see [6]. NF-κB: nuclear factor kappa B; AP-1: activator protein-1; GILZ: glucocorticoid-induced leucine zipper; HPA: hypothalamic-pituitary-adrenal; MR: mineralocorticoid receptor; NO: nitric oxide; eNOS: endothelial nitric oxide synthase; ARDS: acute respiratory distress syndrome; AQP: aquaporin; ENaC: epithelial sodium channel.