The role of progesterone in traumatic brain injury.
The role of progesterone in traumatic brain injury.
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DOI：
10.1097/htr.0b013e31823088fa
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发表时间：
2011-11
期刊：
影响因子：
--
通讯作者：
Wright DW
中科院分区：
文献类型：
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作者：
Espinoza TR;Wright DW
在过去的20年里，大量的文献促进了我们对创伤性脑损伤(TBI)的病理生理机制的理解。最重要的是，我们现在认识到，脑损伤既会引起中枢影响，也会引起全身影响。例如，许多研究表明，孤立性颅脑损伤后，周围组织中促炎症细胞因子的释放增加，氧化应激反应增强。1、2因此，有效的治疗方法是那些在多个部位和程度的损伤中发挥作用的治疗方法，以增强修复和再生机制，同时限制颅脑损伤造成的局部和全身破坏性过程。孕酮是一种类固醇激素，因其在月经周期中的作用而广为人知。它不仅由女性的卵巢和胎盘产生，也由两性的肾上腺和大脑产生。它在大脑中由少突胶质细胞和其他类型的细胞产生，为它在神经动态平衡中的关键作用提供了线索。事实上，一些专家认为，在胎儿生长过程中孕酮增加了10倍，这主要是为了神经元发育。在过去的20年里，临床前研究一再表明黄体酮具有强大的神经保护特性。有证据表明，在生理应激和中枢神经系统以外的损伤后，它在纠正和维持动态平衡方面也发挥着更广泛的作用。4最重要的是，它通过多个蛋白质组发挥作用
WITHIN the last 20 years, a significant body of literature has advanced our understanding of the pathophysiologic mechanisms that result from traumatic brain injury (TBI). Most importantly, we now recognize that brain injuries cause both central and systemic effects. For example, a number of studies have demonstrated increased release of proinflammatory cytokines and augmented oxidative stress reactions in peripheral tissues after isolated head injury. 1, 2 Thus, effective treatment modalities are those that work at multiple sites and levels of injury to enhance repair and regenerative mechanisms while limiting the destructive local and systemic processes that result from TBI. Progesterone is a steroid hormone well known for its role in the menstrual cycle. It is produced not only by the ovaries and placenta in females but also by the adrenal glands and the brain of both sexes. Its production in the brain, by oligodendrocytes and other cell types, provides clues to its critical role in neural homeostasis. 3 Indeed, the 10-fold increase of progesterone during fetal growth is thought by some experts to be primarily for neuronal development. Within the last 20 years, preclinical research has repeatedly shown that progesterone has potent neuroprotective properties. There is evidence that it also plays a much broader role in correcting and maintaining homeostasis after physiologic stress and injury beyond the central nervous system. 4 Most significantly, it exerts its effects through multiple proteomic