University of Southern California, 3715 McClintock Avenue, Los Angeles, California 90089-0191.
Endocrinology. 2010 Jun;151(6):2713-22. doi: 10.1210/en.2009-1487. Epub 2010 Apr 21.
Depletion of estrogens and progesterone at menopause has been linked to an increased risk for the development of Alzheimer's disease (AD) in women. A currently controversial literature indicates that although treatment of postmenopausal women with hormone therapy (HT) may reduce the risk of AD, several parameters of HT may limit its potential efficacy and perhaps, even exacerbate AD risk. One such parameter is continuous vs. cyclic delivery of the progestogen component of HT. Recent experimental evidence suggests that continuous progesterone can attenuate neural actions of estradiol (E(2)). In the present study, we compared the effects of continuous and cyclic progesterone treatment in the presence and absence of E(2) in ovariectomized 3xTg-AD mice, a transgenic mouse model of AD. We found that ovariectomy-induced hormone depletion increases AD-like pathology in female 3xTg-AD mice, including accumulation of beta-amyloid, tau hyperphosphorylation, and impaired hippocampal-dependent behavior. E(2) treatment alone prevents the increases in pathology. Continuous progesterone did not affect beta-amyloid levels when delivered alone but blocked the Abeta-lowering action of E(2). In contrast, cyclic progesterone significantly reduced beta-amyloid levels by itself and enhanced rather than inhibited the E(2) effects. These results provide new insight into the neural interactions between E(2) and progesterone that may prove valuable in optimizing HT regimens in postmenopausal women.
绝经后雌激素和孕激素的消耗与女性阿尔茨海默病 (AD) 发病风险增加有关。目前存在争议的文献表明,尽管激素替代疗法 (HT) 治疗绝经后妇女可能降低 AD 的风险,但 HT 的几个参数可能会限制其潜在疗效,甚至可能加剧 AD 的风险。其中一个参数是孕激素成分的连续给药与周期性给药。最近的实验证据表明,连续孕激素可以减弱雌二醇 (E(2)) 的神经作用。在本研究中,我们比较了在存在和不存在 E(2)的情况下连续和周期性孕激素治疗对去卵巢 3xTg-AD 小鼠(AD 的转基因小鼠模型)的影响。我们发现,去卵巢引起的激素耗竭会增加雌性 3xTg-AD 小鼠的 AD 样病理学,包括β-淀粉样蛋白的积累、tau 过度磷酸化以及海马依赖性行为受损。单独使用 E(2)治疗可预防病理学的增加。单独使用连续孕激素不会影响β-淀粉样蛋白水平,但会阻断 E(2)降低 Abeta 的作用。相比之下,周期性孕激素本身可显著降低β-淀粉样蛋白水平,并增强而不是抑制 E(2)的作用。这些结果为 E(2)和孕激素之间的神经相互作用提供了新的见解,这可能对优化绝经后妇女的 HT 方案具有重要意义。