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Estrogens and experimental ischemic stroke: a systematic review.

Claire L Gibson¹, Laura J Gray, Sean P Murphy

¹Institute of Cell Signalling, Queen's Medical Centre, University of Nottingham, Nottingham, UK. cg95@le.ac.uk

Journal of Cerebral Blood Flow and Metabolism : Official Journal of the International Society of Cerebral Blood Flow and Metabolism

|January 27, 2006

Summary

Estrogens show neuroprotective effects, reducing brain lesion volume after experimental ischemic stroke. This finding suggests potential therapeutic applications, though further research is needed.

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Area of Science:

Neuroscience
Endocrinology
Pharmacology

Background:

Estrogens are thought to protect females against cerebrovascular events.
Previous clinical trials on hormone replacement therapy have shown disappointing outcomes.
Experimental studies suggest estrogens may be neuroprotective following cerebral ischemia.

Purpose of the Study:

To systematically review controlled experimental studies on estrogen administration before or after cerebral ischemia.
To evaluate the impact of estrogens on lesion volume in experimental models of stroke.

Main Methods:

A systematic literature search was conducted using PubMed, Embase, and Web of Science.
Data from 27 controlled experimental studies involving 1,304 subjects were analyzed using Cochrane Review Manager.

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Lesion volume was the primary outcome measure.

Main Results:

Estrogens significantly reduced lesion volume in a dose-dependent manner after both transient and permanent ischemia (P<0.001).
Neuroprotection was observed when estrogens were administered up to 4 hours after ischemia onset.
The efficacy of estrogens was noted in ovariectomized females and young adult males, but not in intact females.

Conclusions:

Estrogens demonstrate a dose-dependent reduction in lesion volume following experimental ischemic stroke.
Estrogens are a potential candidate treatment for ischemic stroke.
Further preclinical investigations are warranted to fully elucidate the therapeutic potential of estrogens.