title: Progestins and estrogens and Alzheimer's disease.
abstract: Sex-specific incidence rates for Alzheimer's disease (AD) are higher in women than men. Many fundamental researches and some clinical investigations have reported therapeutic and preventive effects of estrogens on AD. But WHIMS [S.A. Shumaker, C. Legault, S.R. Rapp, L. Thal, R.B. Wallace, J.K. Ockene, S.L. Hendrix, B.N. Jones IIIrd, A.R. Assaf, R.D. Jackson, J.M. Kotchen, S. Wabertheil-Smoller, J. Wactawsk-Wende, WHIMS investigators, Estrogen plus progestin and the incidence of dementia and mild cognitive impairment in postmenopausal women. The women's health initiative memory study: a randomized controlled trial, JAMA 289 (2003) 2651-2662], which used daily continuous hormone replacement therapy (HRT), reported that the hazard ratio of the HRT for probable dementia was 2.05. Effect of progestins, and continuous (not cyclically) HRT, even only with estrogen should be reconsidered. In our clinical study, conjugated equine estrogen (CEE) alone showed good changes of psychiatric tests for AD on the 3rd week, but addition of medroxyprogesterone acetate (MPA) or norethindrone since 4th week suppressed these tests. Using human umbilical vein epithelial cell (HUVEC), levonorgestrel (LNG), norethindrone acetate (NETA), MPA increased intercellular adhesion molecule-1 (ICAM-1), vascular cell adhesion molecule-1 (VCAM-1) and E-secretin but dienogest (DNG) showed no effect. In vitro flow system, estradiol (E2), suppressed adhesion of white cell, but LNG, NETA, MPA increased the adhesions. DNG showed less effect. Non-feminizing estrogen J 861, which has delta8,9 double bond and straight in its structure and has less effect on sexual organs. J 861 has shown ameliorative effects on central nervous system (CNS) (increasing of cholineacetyltransferase immunoreactive cells in substantia innominata (SI), etc.) like E2. More investigations about progestins and estrogens and AD should be done.
authors.affiliation: Department of Gynecology, Kyoto Prefectural University of Medicine, Graduate School of Medical Science, Kawaramachi, Hirokoji, Kamigyo-ku, Kyoto 602-8566, Japan. honjo@koto.kpu-m.ac.jp
authors.forename: Hideo
authors.initials: H
authors.lastname: Honjo
authors.forename: Koichi
authors.initials: K
authors.lastname: Iwasa
authors.forename: Mitsuhiro
authors.initials: M
authors.lastname: Kawata
authors.forename: Shinji
authors.initials: S
authors.lastname: Fushiki
authors.forename: Tetsuya
authors.initials: T
authors.lastname: Hosoda
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Tatsumi
authors.forename: Naochika
authors.initials: N
authors.lastname: Oida
authors.forename: Masaya
authors.initials: M
authors.lastname: Mihara
authors.forename: Yoshiichiro
authors.initials: Y
authors.lastname: Hirasugi
authors.forename: Hiroki
authors.initials: H
authors.lastname: Yamamoto
authors.forename: Noriko
authors.initials: N
authors.lastname: Kikuchi
authors.forename: Jo
authors.initials: J
authors.lastname: Kitawaki
mesh_terms: D000544:Alzheimer Disease / Q000188:drug therapy* / Q000523:psychology; D016229:Amyloid beta-Peptides / Q000494:pharmacology; D000818:Animals; D017209:Apoptosis / Q000187:drug effects; D002448:Cell Adhesion / Q000187:drug effects; D002478:Cells, Cultured; D003071:Cognition / Q000187:drug effects; D004958:Estradiol / Q000008:administration & dosage; D045166:Estradiol Congeners / Q000008:administration & dosage; D004967:Estrogens / Q000008:administration & dosage*; D004966:Estrogens, Conjugated (USP) / Q000008:administration & dosage; D005260:Female; D006801:Humans; D016912:Levonorgestrel / Q000008:administration & dosage; D008297:Male; D017258:Medroxyprogesterone Acetate / Q000008:administration & dosage; D009277:Nandrolone / Q000008:administration & dosage / Q000031:analogs & derivatives*; D009640:Norethindrone / Q000008:administration & dosage; D045167:Progesterone Congeners / Q000008:administration & dosage*; D051381:Rats
chemical_list: D016229:Amyloid beta-Peptides; D045166:Estradiol Congeners; D004967:Estrogens; D004966:Estrogens, Conjugated (USP); D045167:Progesterone Congeners; C023635:dienogest; D004958:Estradiol; D016912:Levonorgestrel; D009277:Nandrolone; D017258:Medroxyprogesterone Acetate; D009640:Norethindrone