We compared the expression of prostaglandin H synthase-2 (PGHS-2, cyclooxygenase) message and protein in alveolar macrophages (AM) and blood monocytes (BM) from 20 atopic subjects (AS) and nine control subjects (CS) at baseline and after 1 to 14 d of oral administration of therapeutic doses of prednisone. At baseline, the amounts of PGHS-2 mRNA in AM and BM varied within a similar range among subjects from each group. PGHS-2 protein was present in AM and BM from most AS, but it was also present in CS. In AS, PGHS-2 mRNA and protein significantly increased after prednisone administration, whereas in CS PGHS-2 message and protein remained undetectable or, if present at baseline, was decreased after prednisone. Ex vivo both atopic and normal monocytes and macrophages exhibited the expected decrease in stimulated PGHS-2 mRNA with glucocorticoids. PGHS-1 expression was not altered by prednisone in either group. The differential regulation of the inducible PGHS isoform by prednisone may be mediated by effects on cytokine production in AS.