Progesterone for TBI

[Guest guest]

http://ts-si.org/content/view/2236/992/

Interesting article. I have another one somewhere that talks about a recent

study in humans showing a decrease in mortality rate of TBIs from 30% to 13%

following progesterone administration. We're actually interested in trying this

out on our neural networks cultures in the Center for Network Neuroscience.

Does anyone have any more insight into the use of progesterone with TBI, or its

neuroprotective properties?

Blake-

TX LP, NREMT-P, TX EMSI

AIM: SinaptiK

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[Guest guest]

>>> Does anyone have any more insight into the use of progesterone

with TBI, or its neuroprotective properties? <<<

,

The trial described in the article is a Phase II trial. These trials

are generally designed to evaluate the effectiveness of the drug and

to determine the common short-term side effects and risks. Phase II

trials are not designed to evaluate the overall benefit-risk

relationship of the drug nor to provide an adequate basis for

physician labeling.

The single clinical trial investigating progesterone to date was

limited to closed head blunt trauma with moderate to severe damage in

100 male and female patients ( et al., 2007). Patients

received state-of-the-art emergency treatment plus progesterone

versus placebo. The progesterone group received 3 days of post-injury

continuous intravenous drip.

At 30 days post-injury, the severely injured patients showed a

statistically significant reduction in mortality compared to those

receiving placebo (13.4% versus 33.6%) but no improvement in

neurological outcome. The moderate TBI/progesterone patients, on the

other hand, had significantly better functional outcome (Disability

Rating Scale) scores than the placebo group.

Preclinical studies have produced consistent results across species

(mice, rats, cats, rabbits) and a number of injury models (TBI,

stroke, spinal cord injury, demyelination). Progesterone's most

beneficial effect in TBI may be to reduce cerebral edema which

reduces the secondary loss of vulnerable nerve cells. The literature

also indicates that progesterone is a potent anti-inflammatory and

anti-apoptotic agent with some anti-oxidant properties which enable

it to protect against the breakdown of cell membranes that leads to

the death of neurons and glia.

Progesterone's mechanisms for neuroprotection are not yet completely

understood, but it clearly does not target a single class of

receptors or one cell type (the reason so many

other " neuroprotective " agents fail).

Hope this helps.

Kenny Navarro

UT Southwestern Medical Center at Dallas

References

, D. W., Kellermann, A. L., Hertzberg, V. S., , P. L.,

el, M., Goldstein, F. C., et. al. (2007). ProTECT: a randomized

clinical trial of progesterone for acute traumatic brain injury. Ann

Emerg Med, 49, 391–402.