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Progesterone Protective Effects in Neurodegeneration and Neuroinflammation

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TLDR
The effects of progesterone in models of motoneurone degeneration and neuroinflammation and the results represent a starting point for testing the usefulness of neuroactive steroids in neurological disorders.
Abstract
Progesterone is a neuroprotective, promyelinating and anti-inflammatory factor for the nervous system. Here, we review the effects of progesterone in models of motoneurone degeneration and neuroinflammation. In neurodegeneration of the Wobbler mouse, a subset of spinal cord motoneurones showed increased activity of nitric oxide synthase (NOS), increased intramitochondrial NOS, decreased activity of respiratory chain complexes, and decreased activity and protein expression of Mn-superoxide dismutase type 2 (MnSOD2). Clinically, Wobblers suffered several degrees of motor impairment. Progesterone treatment restored the expression of neuronal markers, decreased the activity of NOS and enhanced complex I respiratory activity and MnSOD2. Long-term treatment with progesterone increased muscle strength, biceps weight and survival. Collectively, these data suggest that progesterone prevented neurodegeneration. To study the effects of progesterone in neuroinflammation, we employed mice with experimental autoimmune encephalomyelitis (EAE). EAE mice spinal cord showed increased mRNA levels of the inflammatory mediators tumour necrosis factor (TNF)α and its receptor TNFR1, the microglial marker CD11b, inducible NOS and the toll-like receptor 4. Progesterone pretreatment of EAE mice blocked the proinflammatory mediators, decreased Iba1+ microglial cells and attenuated clinical signs of EAE. Therefore, reactive glial cells became targets of progesterone anti-inflammatory effects. These results represent a starting point for testing the usefulness of neuroactive steroids in neurological disorders.

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Progesterone and allopregnanolone in the central nervous system: response to injury and implication for neuroprotection.

TL;DR: The neuroprotective effects of progesterone on the nervous system via PR, and of allopregnanolone via its modulation of GABAA receptors are discussed, as well as their effects in different experimental models including stroke and spinal cord injury.
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Role of Estrogen and Other Sex Hormones in Brain Aging. Neuroprotection and DNA Repair

TL;DR: Estrogen anti-aging and neuroprotective mechanisms, which are currently an area of intense study, are reviewed together with the effect they may have on the DNA repair capacity in the brain.
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Progesterone for acute traumatic brain injury

TL;DR: This updated review did not find evidence that progesterone could reduce mortality or disability in patients with acute TBI, and the quality of the evidence was assessed as low, due to the substantial inconsistency across studies.
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Role of astrocytes in the neuroprotective actions of 17β-estradiol and selective estrogen receptor modulators.

TL;DR: Selective estrogen receptor modulators (SERMs) represent therapeutic alternatives to estradiol for the activation of astroglia-mediated neuroprotective mechanisms.
References
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Journal ArticleDOI

Steroid Hormone Metabolites are Barbiturate-Like Modulators of the GABA Receptor

TL;DR: Two metabolites of the steroid hormones progesterone and deoxycorticosterone are potent barbiturate-like ligands of the gamma-aminobutyric acid (GABA) receptor-chloride ion channel complex and potentiated the inhibitory actions of GABA in cultured rat hippocampal and spinal cord neurons, which may explain the ability of certain steroid hormones to rapidly alter neuronal excitability.
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A Controlled Trial of Riluzole in Amyotrophic Lateral Sclerosis

TL;DR: The antiglutamate agent riluzole appears to slow the progression of amyotrophic lateral sclerosis, and it may improve survival in patients with disease of bulbar onset, according to a prospective, double-blind, placebo-controlled trial in 155 outpatients with Amyotrophicateral sclerosis.
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Developmental cell death: morphological diversity and multiple mechanisms.

TL;DR: This review concentrates on an aspect of developmental cell death that has tended to be neglected, the manner in which the cells are dismantled, which appears to be achieved primarily by heterophagy, by autophagy and by non-lysosomal degradation, respectively.
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Multiple Sclerosis: An Immune or Neurodegenerative Disorder?

TL;DR: Data that support neurodegeneration as the major cause of irreversible neurological disability in MS patients are reviewed and it is questioned whether inflammatory demyelination is primary or secondary in the disease process.
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Rate of Pregnancy-Related Relapse in Multiple Sclerosis

TL;DR: This study studied 254 women with multiple sclerosis during 269 pregnancies in 12 European countries to determine the rate of relapse per trimester and the score on the Kurtzke Expanded Disability Status Scale.
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