Epidemiological studies point to a beneficial influence of the female reproductive hormones on stroke risk in that women have a lower incidence of stroke prior to the menopause compared with men, but this difference weakens with age and stroke risk in women rises after the menopause. However, recent Women's Health Initiative trials in post-menopausal women report an increased stroke risk on hormone replacement therapy. An influence of gender is also apparent on stroke outcome in animal models: female rats exposed to transient MCA (middle cerebral artery) occlusion sustain less brain damage than age-matched males, with loss of protection following ovariectomy. The major hormone thought to be responsible for beneficial influences on stroke incidence and outcome is oestrogen, and a large preclinical literature now exists where exogenously administered oestrogen has been studied in male and ovariectomized female rats using a range of stroke models and outcome measures. Most of these studies administer oestrogen prior to the stroke, use a model of transient ischaemia followed by reperfusion and report a significant oestrogen-induced neuroprotection. However, in some studies where the MCA is permanently occluded, oestrogen pre-treatment in ovariectomized female rats has been shown to significantly exacerbate ischaemic damage. Therefore preclinical results demonstrate harmful as well as beneficial influences of oestrogen on the ischaemic brain, highlighting the need for further study to elucidate the mechanisms responsible for both detrimental and beneficial influences. Ultimately, this could lead to the development of new classes of oestrogenic compounds with improved risk/benefit profiles, designed to selectively activate pathways inducing only the beneficial effects of oestrogen in vivo.
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Conference Article|
October 25 2006
Oestrogen and stroke: the potential for harm as well as benefit
I.M. Macrae;
I.M. Macrae
1
1Division of Clinical Neuroscience, Wellcome Surgical Institute, University of Glasgow, Garscube Estate, Glasgow G61 1QH, U.K.
1To whom correspondence should be addressed (email m.macrae@udcf.gla.ac.uk).
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H.V. Carswell
H.V. Carswell
1Division of Clinical Neuroscience, Wellcome Surgical Institute, University of Glasgow, Garscube Estate, Glasgow G61 1QH, U.K.
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Publisher: Portland Press Ltd
Received:
July 13 2006
Online ISSN: 1470-8752
Print ISSN: 0300-5127
© 2006 The Biochemical Society
2006
Biochem Soc Trans (2006) 34 (6): 1362–1365.
Article history
Received:
July 13 2006
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A correction has been published:
Oestrogen and stroke: the potential for harm as well as benefit
Citation
I.M. Macrae, H.V. Carswell; Oestrogen and stroke: the potential for harm as well as benefit. Biochem Soc Trans 1 December 2006; 34 (6): 1362–1365. doi: https://doi.org/10.1042/BST0341362
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