The Role of 17β-Estradiol in Delirium

17β-雌二醇在谵妄中的作用

• 批准号: 10667233
• 负责人: Shouri Lahiri
• 金额: $ 20.88万
• 依托单位: CEDARS-SINAI MEDICAL CENTER
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-04-01 至 2025-03-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10667233
• 关键词: Acceleration; Acute; Affect; Age; Anatomy; Animals; Anti-Inflammatory Agents; Apoptotic; Attention; Behavior; Blood; Brain; Brain Injuries; CASP3 gene; Cell membrane; Clinical; Clinical Trials; Data; Delirium; ESR1 gene; Elderly; Estradiol; Estrogens; Female; GPER gene; Hippocampus; Hormones; Hospitalization; Human; Immune; Immunohistochemistry; Impaired cognition; Impairment; Infection Control; Length of Stay; Mediating; Mediator; Modeling; Modification; Mus; Nerve Degeneration; Neuronal Dysfunction; Pathogenesis; Pharmaceutical Preparations; Pharmacological Treatment; Phenotype; Postmenopause; Predisposition; Proteomics; Quality of life; Research; Risk; Risk Factors; Role; Short-Term Memory; Signal Transduction; Specimen; Testing; Urinary Tract Finding; Urinary tract infection; Western Blotting; antagonist; aptamer; behavior test; behavioral impairment; evidence base; executive function; frontal lobe; human old age (65+); improved; insight; men; mortality; mouse model; neuroprotection; non-genomic; novel; older women; pharmacologic; pre-clinical; response; transcriptome sequencing

ABSTRACT Delirium is frequently precipitated by urinary tract infection (UTI), a condition that disproportionately affects older women and contributes to increased mortality, prolonged length of stay, and accelerated long-term cognitive decline. Existing treatments for delirium center largely on treatment of the precipitating cause, modification of environmental contributors, and avoidance of deliriogenic medications; however, do not address the underlying pathobiology of the condition. We have developed a novel mouse model of UTI-induced delirium and generated compelling preliminary data that demonstrate a potential role for exogenously administered 17β-estradiol in mitigating UTI-induced delirium. These findings may explain, at least in part, why older women, who after menopause have reduced levels of 17β-estradiol, are particularly susceptible to developing delirium. In this R21 application, we propose to use our novel mouse model of urinary tract infection- induced delirium, oophorectomized mice, state-of-the-art behavioral testing, and genetically modified mice to determine whether 17β-estradiol ameliorates the structural and functional phenotypes of delirium via the G protein-coupled estrogen receptor 1. Given the lack of evidence-based pharmacological treatments for delirium, the findings from this research could have widespread clinical implications, including providing novel pre-clinical justification for clinical trials using a short-term application of an existing drug, 17β-estradiol, to ameliorate UTI- induced delirium and quality of life for millions of older women around the world.

摘要 谵妄通常由尿路感染（UTI）引起，这种疾病 对老年妇女的影响尤其严重，导致死亡率上升， 并加速长期认知能力下降。谵妄中心的现有治疗 很大程度上取决于对突发原因的治疗，对环境因素的改变， 避免致谵妄药物;然而，没有解决潜在的病理生物学 病情 我们已经开发了一种新的UTI诱导谵妄小鼠模型，并产生了令人信服的结果。 初步数据表明外源性给予17β-雌二醇在 减轻尿路感染引起的谵妄这些发现可以解释，至少部分解释，为什么老年妇女， 绝经后17β-雌二醇水平降低的妇女，特别容易患 出现精神错乱 在这个R21应用中，我们建议使用我们的新型尿路感染小鼠模型- 诱导谵妄，卵巢切除小鼠，最先进的行为测试，和遗传学 改良小鼠以确定17β-雌二醇是否改善了 通过G蛋白偶联雌激素受体1的谵妄表型。由于缺乏 基于证据的药物治疗谵妄，这项研究的结果可以 具有广泛的临床意义，包括提供新的临床前依据， 使用现有药物17β-雌二醇短期应用改善UTI的临床试验， 导致谵妄和世界各地数百万老年妇女的生活质量。