title: 11Beta-hydroxysteroid dehydrogenase inhibition improves cognitive function in healthy elderly men and type 2 diabetics.
abstract: In aging humans and rodents, inter-individual differences in cognitive function have been ascribed to variations in long-term glucocorticoid exposure. 11beta-Hydroxysteroid dehydrogenase type 1 (11beta-HSD1) regenerates the active glucocorticoid cortisol from circulating inert cortisone, thus amplifying intracellular glucocorticoid levels in some tissues. We show that 11beta-HSD1, but not 11beta-HSD2, mRNA is expressed in the human hippocampus, frontal cortex, and cerebellum. In two randomized, double-blind, placebo-controlled crossover studies, administration of the 11beta-HSD inhibitor carbenoxolone (100 mg three times per day) improved verbal fluency (P < 0.01) after 4 weeks in 10 healthy elderly men (aged 55-75 y) and improved verbal memory (P < 0.01) after 6 weeks in 12 patients with type 2 diabetes (52-70 y). Although carbenoxolone has been reported to enhance hepatic insulin sensitivity in short-term studies, there were no changes in glycemic control or serum lipid profile, nor was plasma cortisol altered. 11beta-HSD1 inhibition may be a new approach to prevent/ameliorate cognitive decline.
authors.affiliation: Endocrinology Unit, School of Molecular and Clinical Medicine, University of Edinburgh, Molecular Medicine Centre, Western General Hospital, Edinburgh EH4 2XU, United Kingdom.
authors.forename: Thekkepat C
authors.initials: TC
authors.lastname: Sandeep
authors.forename: Joyce L W
authors.initials: JL
authors.lastname: Yau
authors.forename: Alasdair M J
authors.initials: AM
authors.lastname: MacLullich
authors.forename: June
authors.initials: J
authors.lastname: Noble
authors.forename: Ian J
authors.initials: IJ
authors.lastname: Deary
authors.forename: Brian R
authors.initials: BR
authors.lastname: Walker
authors.forename: Jonathan R
authors.initials: JR
authors.lastname: Seckl
mesh_terms: D042842:11-beta-Hydroxysteroid Dehydrogenases / Q000037:antagonists & inhibitors* / Q000235:genetics / Q000378:metabolism; D000368:Aged; D016022:Case-Control Studies; D003071:Cognition; D018592:Cross-Over Studies; D003924:Diabetes Mellitus, Type 2 / Q000201:enzymology / Q000503:physiopathology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010919:Placebos; D012333:RNA, Messenger / Q000235:genetics
chemical_list: D010919:Placebos; D012333:RNA, Messenger; D042842:11-beta-Hydroxysteroid Dehydrogenases