Exogenous progesterone: a potential therapeutic candidate in CNS injury and neurodegeneration

The role of progesterone (PROG) in the regulation of reproductive behavior is well understood, but a large and growing body of evidence indicates that this hormone also exerts neuroprotective effects on the central nervous system (CNS), i.e. in spinal cord injuries, traumatic brain injuries and in the age-related pathological process. Its neuroprotective actions, now well documented by experimental studies, make it a particularly promising therapeutic agent for neuroinjury and neurodegenerative diseases. The purpose of this article is to review recent preclinical and epidemiological evidences that exogenous administration of PROG or its metabolites plays an important role in the CNS. The diverse signaling mechanisms and the dose- dependent neuroprotective actions of PROG are also summarized. Awareness of the pleiotropic effects of PROG may open a novel perspective for the treatment of injuries and diseases in the nervous system. PROG could be produced in the brain by neurons and glial cells in the CNS of both male and female. Laboratories around the world have reported that administering relatively large doses of PROG during the first few hours or even days after injury significantly limits CNS damage, reduces loss of neuronal tissue and improves functional recovery. PROG appears to exert its protective effects by protecting or rebuilding the blood-brain barrier, decreasing the development of cerebral edema, down-regulating the inflammatory cascade, and limiting cellular necrosis and apoptosis. All these are plausible mechanisms of neuroprotection.