Sex, Sex Steroids, and Brain Injury

被引:118
作者
Herson, Paco S. [1 ,2 ]
Koerner, Ines P. [1 ,2 ]
Hurn, Patricia D. [1 ,2 ,3 ,4 ]
机构
[1] Oregon Hlth & Sci Univ, Dept Anesthesiol, Portland, OR 97201 USA
[2] Oregon Hlth & Sci Univ, Dept Perioperat Med, Portland, OR 97201 USA
[3] Oregon Hlth & Sci Univ, Dept Physiol & Pharmacol, Portland, OR 97201 USA
[4] Oregon Hlth & Sci Univ, Dept Neurol, Portland, OR 97201 USA
关键词
Stroke; brain ischemia; estradiol; neurosteroids; progesterone; allopregnanolone; androgens; ESTROGEN-RECEPTOR-ALPHA; CEREBRAL-ARTERY OCCLUSION; SPONTANEOUSLY HYPERTENSIVE-RATS; ISCHEMIA-REPERFUSION INJURY; MYELIN BASIC-PROTEIN; DEHYDROEPIANDROSTERONE-SULFATE; STROKE-PRONE; CELL-DEATH; MEDROXYPROGESTERONE ACETATE; PROGESTERONE INCREASES;
D O I
10.1055/s-0029-1216276
中图分类号
R71 [妇产科学];
学科分类号
100211 ;
摘要
Biologic sex and sex steroids are important factors in clinical and experimental stroke and traumatic brain injury (TBI). Laboratory data strongly, show that progesterone treatment after TBI reduces edema, improves outcomes, and restores blood-brain barrier function. Clinical studies to date agree with these data, and there are ongoing human trials for progesterone treatment after TBI. Estrogen has accumulated an impressive reputation as a neuroprotectant when evaluated at physiologically, relevant doses in laboratory studies of stroke, but translation to patients remains to be shown. The role of androgens in male stroke or TBI is understudied and important to pursue given the epidemiology of stroke and trauma in men. To date, male sex steroids remain largely evaluated at the bench rather than the bedside. This review evaluates key evidence and highlights the importance of the platform on which brain Injury occurs (i.e., genetic sex and hormonal modulators).
引用
收藏
页码:229 / 239
页数:11
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