Potential age-dependent effects of estrogen on neural injury.

Potential age-dependent effects of estrogen on neural injury.
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雌激素对神经损伤的潜在年龄依赖性影响。

DOI:
10.1016/j.ajpath.2011.01.057
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发表时间:
2011
期刊:
The American journal of pathology
影响因子:
--
通讯作者:
Rosen,CharlesL
Rosen,CharlesL
中科院分区:
--
文献类型:
--
作者:
Leon,RachelL;Huber,JasonD;Rosen,CharlesL

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2000年,大约有1000万妇女正在接受激素替代疗法(HRT)以缓解更年期症状。先前的一些动物研究表明,HRT可能具有神经保护和心脏保护作用。然后,在2003年,妇女健康倡议(WHI)的报告表明,长期补充雌激素/孕激素导致中风发生率增加。在有子宫切除史的妇女中,WHI的第二个分支发现,单独补充雌激素与中风发生率之间的相关性更强。对这些数据的后续分析,以及来自其他较小临床试验的数据,也表明单独接受HRT或雌激素治疗的女性中风严重程度增加。这篇综述对表明雌激素在动物模型中是神经保护剂的研究进行了审查,并探索了为什么在绝经后女性中可能不是这样的潜在原因。具体地说,讨论了与年龄相关的雌激素受体和大脑中雌激素行为的差异,得出的结论是,疾病的动物模型必须密切模仿人类疾病,才能产生临床相关的结果。
In 2000, approximately 10 million women were receiving hormone replacement therapy (HRT) for alleviation of menopausal symptoms. A number of prior animal studies suggested that HRT may be neuroprotective and cardioprotective. Then, in 2003, reports from the Women's Health Initiative (WHI) indicated that long-term estrogen/progestin supplementation led to increased incidence of stroke. A second branch of the WHI in women with prior hysterectomy found an even stronger correlation between estrogen supplementation alone and stroke incidence. Follow-up analyses of the data, as well as data from other smaller clinical trials, have also demonstrated increased stroke severity in women receiving HRT or estrogen alone. This review examines the studies indicating that estrogen is neuroprotectant in animal models and explores potential reasons why this may not be true in postmenopausal women. Specifically, age-related differences in estrogen receptors and estrogenic actions in the brain are discussed, with the conclusion that animal models of disease must closely mimic human disease to produce clinically relevant results.
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