Progress in progestin-based therapies for neurological disorders
Hormone therapy, primarily progesterone and progestins, for central nervous system (CNS) disorders represents an emerging field of regenerative medicine. Following a failed clinical trial of progesterone for traumatic brain injury treatment, attention has shifted to the progestin Nestorone for its ability to potently and selectively transactivate progesterone receptors at relatively low doses, resulting in robust neurogenetic, remyelinating, and anti-inflammatory effects. That CNS disorders, including multiple sclerosis (MS), amyotrophic lateral sclerosis (ALS), spinal cord injury (SCI), and stroke, develop via demyelinating, cell death, and/or inflammatory pathological pathways advances Nestorone as an auspicious candidate for these disorders. Here, we assess the scientific and clinical progress over decades of research into progesterone, progestins, and Nestorone as neuroprotective agents in MS, ALS, SCI, and stroke. We also offer recommendations for optimizing timing, dosage, and route of the drug regimen, and identifying candidate patient populations, in advancing Nestorone to the clinic.
Sitruk-Ware, Régine, Brooke Bonsack, Roberta Diaz Brinton, Michael Schumacher, Narender Kumar, Jea-Young Lee, Vanessa Castelli, Sydney Corey, Alexandreya Coats, Nadia Sadanandan, Bella Gonzales-Portillo, Matt Heyck, Alex Shear, Cozene Blaise, Henry Zhang, Michael Sheyner, Julián García-Sánchez, Lisset Navarro, Martine El-Etr, Alejandro De Nicola, and Cesario V. Borlongan. 2021. "Progress in progestin-based therapies for neurological disorders," Neuroscience & Biobehavioral Reviews, https://doi.org/10.1016/j.neubiorev.2020.12.007.
Nestorone® for Patients with Multiple Sclerosis