Is Progesterone a Candidate Neuroprotective Factor for Treatment following Ischemic Stroke?
Is Progesterone a Candidate Neuroprotective Factor for Treatment following Ischemic Stroke?
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DOI：
10.1177/1073858409333069
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发表时间：
2009-08-01
期刊：
影响因子：
5.6
通讯作者：
Rathbone, James
中科院分区：
文献类型：
--
作者：
Gibson, Claire L.;Coomber, Ben;Rathbone, James
中风结果的性别差异暗示类固醇激素是潜在的神经保护候选者。然而，没有临床试验检查激素替代治疗对缺血性卒中后的结局，研究了单用炔雌醇治疗的效果。在这篇综述中，作者研究了孕酮的神经保护潜力的实验证据，并深入了解缺血性卒中后的潜在作用机制。迄今为止，17项实验研究已经调查了孕酮在减少细胞丢失和增加功能结局方面对缺血性卒中的神经保护潜力。在这17项已发表的研究中，大多数报告了有益效果，3项研究报告了零影响，只有1项研究报告了负面影响。然而，有一些重要的问题，作者在本次审查中解决的方法学质量的研究有关的STAIR的建议。根据所提出的孕酮神经保护机制，我们表明孕酮是多功能的，作用于多个靶点，以促进神经元存活并最大限度地减少细胞损伤和损失。大量的实验证据表明，孕酮是缺血性卒中的神经保护候选者：然而，要进展到临床试验，一些关键的实验研究仍然悬而未决。
Gender differences in stroke outcome have implicated steroid hormones as potential neuroprotective candidates. However, no clinical trials examining hormone replacement therapy on outcome following ischemic stroke have investigated the effect of progesterone-only treatment. In this review the authors examine the experimental evidence for the neuroprotective potential of progesterone and give an insight into potential mechanisms of action following ischemic stroke. To date, 17 experimental studies have investigated the neuroprotective potential of progesterone for ischemic stroke in terms of ability to both reduce cell loss and increase functional Outcome. Of these 17 published studies the majority reported a beneficial effect with three studies reporting a nil effect and only one study reporting a negative effect. However, there are important issues that the authors address in this review in terms of the methodological quality of studies in relation to the STAIR recommendations. In terms of the proposed mechanisms of progesterone neuroprotection we show that progesterone is versatile and acts at Multiple targets to facilitate neuronal survival and minimize cell damage and loss. A large amount of experimental evidence indicates that progesterone is a neuroprotective candidate for ischemic stroke: however, to progress to clinical trial a number of key experimental studies remain outstanding.