Progesterone's role in neuroprotection, a review of the evidence

Deutsch, Eric; Espinoza, Tamara R.; Atif, Fahim; Woodall, Elise; Kaylor, Jordan; Wright, David W.

doi:10.1016/j.brainres.2013.07.014

Cited by 94 publications

(66 citation statements)

References 192 publications

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“…Progesterone has been tested in multiple animal models of stroke (global vs. focal ischemia, permanent vs. temporary occlusion, multiple species, senescent and young animals, with and without tissue plasminogen activator [tPA]) and found to reduce neuronal damage and improve behavioral outcomes in all of these settings. 10 More recently, progesterone has been shown to reduce hemorrhagic conversion after tPA, a problem that has limited thrombolytic therapy adoption. 13 The preclinical data showing progesterone's mitigating effects after ischemia are compelling and support further exploration as a novel treatment for stroke.…”

Section: Translational Research Strategiesmentioning

confidence: 99%

See 1 more Smart Citation

Gender Differences in Neurologic Emergencies Part I: A Consensus Summary and Research Agenda on Cerebrovascular Disease

Madsen

Seigel²,

Mackenzie

et al. 2014

Acad Emerg Med

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Cerebrovascular neurologic emergencies including ischemic and hemorrhagic stroke, subarachnoid hemorrhage (SAH), and migraine are leading causes of death and disability that are frequently diagnosed and treated in the emergency department (ED). Although sex and gender differences in neurologic emergencies are beginning to become clearer, there are many unanswered questions about how emergency physicians should incorporate sex and gender into their research initiatives, patient evaluations, and overall management plans for these conditions. After evaluating the existing gaps in the literature, a core group of ED researchers developed a draft of future research priorities. Participants in the 2014 Academic Emergency Medicine consensus conference neurologic emergencies working group then discussed and approved the recommended research agenda using a standardized nominal group technique. Recommendations for future research on the role of sex and gender in the diagnosis, treatment, and outcomes pertinent to ED providers are described for each of three diagnoses: stroke, SAH, and migraine. Recommended future research also includes investigation of the biologic and pathophysiologic differences between men and women with neurologic emergencies as they pertain to ED diagnoses and treatments.ACADEMIC EMERGENCY MEDICINE 2014;21:1403-1413 by the Society for Academic Emergency Medicine C erebrovascular neurologic emergencies such as ischemic and hemorrhagic stroke, subarachnoid hemorrhage (SAH), and migraine are among the most lethal and disabling conditions presenting to the emergency department (ED). We have made great strides in understanding and treating these conditions, and our efforts have led to improved outcomes for these patients. Sex-and gender-based distinctions, however, are only recently becoming clearer, and much work is needed to explain the differences observed between men and women. After a focused review of the current literature on preclinical, clinical, and outcomes differences between women and men, and then the consensus process, we propose a research agenda in the areas of stroke, SAH, and headache/migraine. METHODSAfter evaluating the current literature, the authors, all emergency medicine (EM) researchers, proposed an agenda for future research. Consensus was reached using an iterative process through the four-part nominal group technique as already described in the executive summary. 1 A multidisciplinary group of participants (EM, critical care medicine, internal medicine, physical and rehabilitation medicine) prioritized the final iteration of themes/questions using the Poll Everywhere Web-based voting method. Descriptive statistics were calculated to tabulate the final list of questions presented below. The proposed research questions were then discussed and voted on by participants in the Academic Emergency Medicine consensus conference neurologic emergencies working group (see footnote for listing) at the meeting in May 2014. STROKE Epidemiology/OutcomesStroke is the fourth leading ca...

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Section: Translational Research Strategiesmentioning

confidence: 99%

“…10 Progesterone is produced in the brains of both men and women in roughly equal quantities by neurons and glial cells. 11,12 It rapidly crosses the blood-brain barrier and reaches high concentrations in the brain shortly after administration.…”

Section: Translational Research Strategiesmentioning

confidence: 99%

Gender Differences in Neurologic Emergencies Part I: A Consensus Summary and Research Agenda on Cerebrovascular Disease

Madsen

Seigel²,

Mackenzie

et al. 2014

Acad Emerg Med

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“…11 A total of 20 research groups working with four species and 22 different models have found neuroprotective effects of progesterone in more than 180 experimental pharmacologic studies. 12 In addition, two phase 2 randomized, controlled clinical trials with progesterone showed a clinical benefit. 13,14 On the basis of these collective data, two phase 3 trials were initiated at around the same time: the Study of a Neuroprotective Agent, Progesterone, in Severe Traumatic Brain Injury (SYNAPSE) and the Progesterone for the Treatment of Traumatic Brain Injury (PROTECT III) trial.…”

mentioning

confidence: 99%

A Clinical Trial of Progesterone for Severe Traumatic Brain Injury

Skolnick¹,

et al. 2014

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“…The presence of low molecule peptide in progesterone structure allows easy penetration through hematoencephalic barrier to reach directly nervous cells (Deutsch et al, 2013). …”

Section: Irina Vasilivna Tsyganenko Vasil Vasilyovich Simrok Katerimentioning

confidence: 99%

Micronized progesterone as a neuroprotector in pregnant women with post-trauma brain syndrome

Tsyganenko¹,

Симрок²,

Ruban³

2014

EMHPJ

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Progesterone's role in neuroprotection, a review of the evidence

Cited by 94 publications

References 192 publications

Gender Differences in Neurologic Emergencies Part I: A Consensus Summary and Research Agenda on Cerebrovascular Disease

Gender Differences in Neurologic Emergencies Part I: A Consensus Summary and Research Agenda on Cerebrovascular Disease

A Clinical Trial of Progesterone for Severe Traumatic Brain Injury

Micronized progesterone as a neuroprotector in pregnant women with post-trauma brain syndrome

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