Gibson Claire L, Coomber Ben, Rathbone James
School of Psychology, University of Leicester, Leicester, United Kingdom.
Neuroscientist. 2009 Aug;15(4):324-32. doi: 10.1177/1073858409333069. Epub 2009 Apr 9.
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.
中风预后的性别差异表明甾体激素可能是潜在的神经保护候选物。然而，尚无关于缺血性中风后激素替代疗法对预后影响的临床试验研究过仅使用孕酮治疗的效果。在这篇综述中，作者研究了孕酮具有神经保护潜力的实验证据，并深入探讨了缺血性中风后的潜在作用机制。迄今为止，有17项实验研究从减少细胞损失和改善功能预后两方面研究了孕酮对缺血性中风的神经保护潜力。在这17项已发表的研究中，大多数报告了有益效果，三项研究报告无效果，只有一项研究报告了负面效果。然而，作者在这篇综述中针对与STAIR建议相关的研究方法质量提出了重要问题。就孕酮神经保护的潜在机制而言，我们表明孕酮具有多种作用，可作用于多个靶点以促进神经元存活并将细胞损伤和损失降至最低。大量实验证据表明，孕酮是缺血性中风的神经保护候选物；然而，要推进到临床试验，仍有一些关键的实验研究有待完成。
