Progesterone Improves Neurobehavioral Outcome in Models of Intracerebral Hemorrhage

Lei, Beilei; Wang, Haichen; Jeong, Seongtae; Hsieh, Justin T.; Majeed, Majid; Dawson, Hana N.; Sheng, Huaxin; Warner, David S.; James, Michael L.

doi:10.1159/000442204

Cited by 22 publications

(12 citation statements)

References 48 publications

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“…Reportedly, etifoxine is a potent enhancer of neurosteroid synthesis ( 8 ). Etifoxine-induced production of pregnenolone, progesterone, and allopregnanolone can confer neuroprotection ( 42 – 45 ). Progesterone treatment after ICH in rodents has, indeed, reduced brain edema, inflammatory response and cell death after ICH.…”

Section: Discussionmentioning

confidence: 99%

A TSPO ligand attenuates brain injury after intracerebral hemorrhage

Ren

Sheth

et al. 2017

FASEB j.

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Intracerebral hemorrhage (ICH) is a devastating disease without effective treatment. After ICH, the immediate infiltration of leukocytes and activation of microglia are accompanied by a rapid up-regulation of the 18-kDa translocator protein (TSPO). TSPO ligands have shown anti-inflammatory and neuroprotective properties in models of CNS injury. In this study, we determined the impact of a TSPO ligand, etifoxine, on brain injury and inflammation in 2 mouse models of ICH. TSPO was up-regulated in Iba1+ cells from brains of patients with ICH and in CD11b+CD45int cells from mice subjected to collagenase-induced ICH. Etifoxine significantly reduced neurodeficits and perihematomal brain edema after ICH induction by injection of either autologous blood or collagenase. In collagenase-induced ICH mice, the protection of etifoxine was associated with reduced leukocyte infiltration into the brain and microglial production of IL-6 and TNF-α. Etifoxine improved blood–brain barrier integrity and diminished cell death. Notably, the protective effect of etifoxine was abolished in mice depleted of microglia by using a colony-stimulating factor 1 receptor inhibitor. These results indicate that the TSPO ligand etifoxine attenuates brain injury and inflammation after ICH. TSPO may be a viable therapeutic target that requires further investigations in ICH.—Li, M., Ren, H., Sheth, K. N., Shi, F.-D., Liu, Q. A TSPO ligand attenuates brain injury after intracerebral hemorrhage.

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Section: Discussionmentioning

confidence: 99%

A TSPO ligand attenuates brain injury after intracerebral hemorrhage

Ren

Sheth

et al. 2017

FASEB j.

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“… 6 In addition, age affects sexual dimorphism in the brain, 7 , 8 and lack of gonadal hormones, such as that brought on by aging, significantly worsens recovery in preclinical models of ICH. 9 , 10 Given these results, we sought to determine whether sex and age interact to affect outcome after ICH.…”

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confidence: 99%

Assessment of the interaction of age and sex on 90-day outcome after intracerebral hemorrhage

et al. 2017

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Objective:Because age affects hormonal production differently in women compared with men, we sought to define sex and age interactions across a multiracial/ethnic population after intracerebral hemorrhage (ICH) to uncover evidence that loss of gonadal hormone production would result in loss of the known neuroprotective effects of gonadal hormones.Methods:Clinical and radiographic data from participants in the Ethnic/Racial Variations of Intracerebral Hemorrhage study and the Genetic and Environmental Risk Factors for Hemorrhagic Stroke study prior to December 2013 were used. Relationships among sex, age, and outcome after ICH in 616 non-Hispanic black, 590 Hispanic, and 868 non-Hispanic white participants were evaluated using multivariable logistic regression analysis. Poor outcome was defined as modified Rankin Scale score ≥3 at 90 days after ICH.Results:Sex differences were found in multiple variables among the racial/ethnic groups, including age at onset, premorbid neurologic status, and neurologic outcome after ICH. Overall, no sex–age interaction effect was found for mortality (p = 0.183) or modified Rankin Scale score (p = 0.378) at 90 days after ICH. In racial/ethnic subgroups, only the non-Hispanic black cohort provided possible evidence of a sex–age interaction on 90-day modified Rankin Scale score (p = 0.003).Conclusion:Unlike in ischemic stroke, there was no evidence that patient sex modified the effect of age on 90-day outcomes after ICH in a large multiracial/ethnic population. Future studies should evaluate biological reasons for these differences between stroke subtypes.Clinicaltrials.gov identifier:NCT01202864.

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“…Moreover, progesterone could reduce apoptosis in hippocampus and cortex; the hematoma volume, cerebral edema and proin lammatory recruitment. Progesterone seems to have bene icial effects on neurobehavioral recovery and modulate neuro-in lammation [22][23][24][25].…”

Section: Discussionmentioning

confidence: 99%

Intracerebral Hemorrhage of Brainstem in triple pregnancy after in vitro fertilization by receiving Ovum Donation: A case report and review

Winarno¹,

Schloesser²,

Dietzel³

et al. 2019

Clin J Obstet Gynaecol

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Deliveries prior to 28 weeks' gestation (extreme preterm birth) pose a global health concern, according to the World Health Organization (WHO). Extreme preterm birth is associated with several complications in the newborn and management in neonatal intensive care unit would incur high expenses. In parallel, advancements in in vitro fertilization will give an opportunity for women to conceive in cases of ovarian failure. At the same time, health providers also encourage patients to receive more than one embryo simultaneously during an embryo transfer. Here we report a case of a patient in coma condition of triplet pregnancy, post ovum donation with threeembryo transfer. Following stabilization, cranial computed tomography (CCT) was performed. The result showed bleeding in the brainstem and into intraventricular spaces at 25+4 gestation weeks. Furthermore, ICH during pregnancy is considered as a rare case in obstetrical fi eld, especially involving the brainstem. This could lead to life-threatening conditions and serious disability in the future. On the fi fth day of hospitalization, she suffered from pneumonia and pulmonary edema. On the eight day (26+5 gestations weeks), an emergency caesarean section was performed due to fully dilated of the cervix with breech presentation of all fetuses. Mother and the children survived with some non-life-threatening disabilities. This is the very fi rst case reported of intracerebral hemorrhage in the brainstem in triplet pregnancy after receiving ovum donation. Heterologous conception could be an iceberg phenomenon of gestational complications among the population. Reproductive tourism could still become greater in the future.

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Progesterone Improves Neurobehavioral Outcome in Models of Intracerebral Hemorrhage

Cited by 22 publications

References 48 publications

A TSPO ligand attenuates brain injury after intracerebral hemorrhage

A TSPO ligand attenuates brain injury after intracerebral hemorrhage

Assessment of the interaction of age and sex on 90-day outcome after intracerebral hemorrhage

Intracerebral Hemorrhage of Brainstem in triple pregnancy after in vitro fertilization by receiving Ovum Donation: A case report and review

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