孕激素与认知功能及阿尔茨海默病关系研究进展

Progress in the relationship between progestin and cognitive function or Alzheimer＇s disease

背景 内源性孕激素黄体酮不但是性激素,也是神经类固醇激素的一种,对神经发育、修复及相关疾病[如阿尔茨海默病（alzheimer＇s diseage,AD）]有重要影响.而越来越多的合成孕激素对神经系统的影响也渐受到研究人员的关注.目的 综述近年来孕激素与AD及认知功能关系相关文献,并阐释其可能机制,为研究合成的孕激素提供思路.内容 大量文献数据提示,黄体酮对AD发生发展及认知功能有积极作用,而合成的孕激素乙酸甲氧基孕酮则不然.现从细胞、动物实验及临床研究3个层面,从分子水平和功能研究,从学习记忆基础和AD发病成因等方面阐述其可能机制.趋向 越来越多的合成孕激素应用于临床,它们对AD发病和认知功能的影响有待于进一步阐明.

Background Endogenous progestin, progesterone, is not only a gonadal hormone, but also one of the neurosteroids, which exerts profound effects on neurogenesis, repair and central nervous system related diseases, such as Alzheimer＇s disease （AD）. As more and more synthetic progestins are being introduced into clinical application, their effects on nervous system are attracting researchers＇ concern. Purpose Recent literature on the relationship between progestins and Alzheimer＇s disease or cognitive function was reviewed to provide some mechanism-based ideas for further research on artificial progestins. Content A great amount of literature suggested that progesterone had beneficial effects on AD and cognitive function, while the synthetic progestin methoxyprogesterone acetate （MPA） had adverse effects. The possible mechanisms are elucidated in this review based upon the results of cell culture, animal experiment and clinic research, from different aspects of molecular mechanism, functional research, basis oflearning and memory and pathogenesis of AD. Trend More and more artificial progestins are being used in the clinic, however, their impacts on AD development and cognitive functions still need to be further expounded.