In a clinical perspective article in the January 2010 issue of American Journal of Roentgenology, currently online, researchers at Emory University recommend that progesterone, a naturally occurring hormone found in both males and females that can protect damaged cells in the central and peripheral nervous systems, be considered a viable treatment option for traumatic brain injuries.
“Traumatic brain injury (TBI) is an important clinical problem in the United States and around the world,” says Donald G. Stein, PhD, Asa G. Candler Professor of Emergency Medicine at Emory School of Medicine and lead author of the article. “TBI has received more attention recently because of its high incidence among combat casualties in Iraq and Afghanistan.
“Current Department of Defense statistics indicated that as many as 30 percent of wounded soldiers seen at Walter Reed Army Hospital have suffered a TBI, a finding that has stimulated government interest in developing a safe and effective treatment for this complex disorder,” Stein continues.
“Growing evidence indicates that post-injury administration of progesterone in a variety of brain damage models can have beneficial effects, leading to substantial and sustained improvements in brain functionality.”
“Progesterone given to both males and females can cross the blood-brain barrier and reduce edema (swelling) levels after TBI,” adds Stein. “In different models of cerebral ischemia (restriction of blood supply) it can significantly reduce the area of necrotic cell death and improve behavioral outcomes. In addition, it can protect neurons distal to the injury that would normally die.”
The city of Atlanta will soon serve as the national epicenter for a groundbreaking NIH-sponsored Phase III trial for the treatment of traumatic brain injuries using the hormone progesterone.
The national study, coined ProTECT III, is multicenter, randomized, double-blind study, which will enroll 1,140 patients over five years at 17 medical centers in 15 states. Atlanta’s Grady Memorial Hospital will serve as the lead center, led by Emory University School of Medicine faculty researchers, as well as faculty from the Morehouse School of Medicine.
Every 15 seconds, someone in the United States sustains a significant traumatic brain injury. Approximately 2 million adults and children in the United States suffers from traumatic brain injuries each year – leading to 50,000 deaths and 80,000 new cases of long-term disability, according to the Centers for Disease Control and Prevention. Despite the enormity of the problem, scientists have failed to identify effective medications to improve outcomes following a traumatic brain injury.
“Given its relatively high safety profile, its ease of administration, its low cost and ready availability, PROG should be considered a viable treatment option — especially because, in brain injury, so little else is currently available,” says Stein.
Stein pioneered discoveries regarding the effect of progesterone following traumatic brain injury – first discovering the neuro-protective properties of progesterone in the laboratory.
Iqbal Sayeed, assistant professor of emergency medicine, Emory School of Medicine, is co-author of the American Journal of Roentgenology article.
For more information or to view a copy of the article online, please visit: http://www.ajronline.org/cgi/content/full/194/1/20.