TERAPIA DE REEMPLAZO HORMONAL Y ENFERMEDAD NEURODEGENERATIVA

Hay todavía mucho por entender sobre el papel de la terapia de reemplazo hormonal (TRH) en la prevención y el tratamiento de la neurodegeneración. Sin embargo, algunos de los hallazgos más recientes ofrecen fundamentos científicos y epidemiológicos convincentes que permiten tener en cuenta la TRH tanto para el tratamiento sintomático como neuroprotector de las enfermedades de Alzheimer y de Parkinson y la demencia asociada con VIH.

Autor:
Andrew j. Levine
Columnista Experto de SIIC

Institución:
University of California

Artículos publicados por Andrew j. Levine

Coautores
Karen J. Miller* Elyse J. Singer** James Sutton***
PhD, University of California, Los Angeles, EE.UU.*
MD, University of California, Los Angeles, EE.UU.**
MD, Pacific Neuroscience Medical Group, Oxnard, EE.UU.***

Recepción del artículo
18 de Julio, 2007

Aprobación
31 de Agosto, 2007

Primera edición
6 de Mayo, 2008

Segunda edición, ampliada y corregida
7 de Junio, 2021

TERAPIA DE REEMPLAZO HORMONAL Y ENFERMEDAD NEURODEGENERATIVA

Resumen
En los últimos años se han dado controversias importantes acerca de los efectos de la estrogenoterapia sustitutiva y, en términos más generales, la terapia de reemplazo hormonal (TRH) sobre la enfermedad de Alzheimer (EA) y otras enfermedades neurodegenerativas. Esta revisión presenta algunos de los hallazgos y aportes más recientes en estudios de ciencias básicas, ensayos clínicos aleatorizados e investigación epidemiológica relacionada con los efectos neuroprotectores potenciales de la TRH en EA, demencia asociada con VIH y enfermedad de Parkinson (EP). Ha ido ganado más adeptos la convicción acerca de la capacidad de la TRH de reducir el riesgo de EA y mejorar el funcionamiento cognitivo de las mujeres posmenopáusicas, sobre todo cuando se consideran también las limitaciones del Women's Health Initiative Memory Study de 2002. También se está prestando mayor atención a los efectos sintomáticos y neuroprotectores de la TRH en el tratamiento de la EP, así como al papel de la TRH como estrategia novedosa en la prevención y el tratamiento de la demencia asociada con VIH. Existen limitaciones importantes en la investigación actual, pero también razones convincentes para volver a examinar el modo en que algunas formas de TRH pueden ayudar a preservar las capacidades cognitivas en mujeres posmenopáusicas y evitar las enfermedades neurodegenerativas.

Palabras clave
terapia de reemplazo hormonal, estrógenos, 17beta-estradiol, demencia asociada con VIH, enfermedad de Parkinson, enfermedad de Alzheimer, demencia frontotemporal

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Hormone Replacement Therapy and Risk for Neurodegenerative Diseases

Abstract
In the past several years, there has been a significant amount of controversy about the effects of estrogen replacement therapy (ERT) and, more generally, hormone replacement therapy (HRT) on Alzheimer's (AD) and other neurodegenerative conditions. This review presents some of the more recent findings and developments in basic science studies, randomized clinical trials, and epidemiological research regarding the potential neuroprotective effects of HRT in AD, HIV-associated dementia (HAD), and Parkinson's disease (PD). Increased support is continuing to emerge for HRT's ability to reduce the risk of AD and improve the cognitive functioning of postmenopausal women, particularly when considered alongside the limitations of the 2002 Women's Health Initiative Memory Study. Greater attention is also being given to the symptomatic and neuroprotective effects of HRT in the management of PD, as well as the role of HRT as a novel strategy in the prevention and treatment of HAD. There are important limits to the existing research, but there are also persuasive reasons for reexamining how some forms of HRT may help preserve cognitive abilities in post-menopausal women and stave off neurodegenerative diseases.

Key words
hormone replacement therapy, estrogen, 17ß-estradiol, HIV-associated dementia, Parkinson's disease, Alzheimer's disease, frontotemporal dementia

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Clasificación en siicsalud
Artículos originales > Expertos del Mundo >
página www.siicsalud.com/des/expertocompleto.php/

Especialidades
Principal: Farmacología, Neurología
Relacionadas: Bioquímica, Diagnóstico por Laboratorio, Obstetricia y Ginecología

Enviar correspondencia a:
Andrew J. Levine, University of California David Geffen School of Medicine National Neurological AIDS Bank Department of Neurology, CA 90025, 11645 Wilshire Blvd., Suite 770, Los Angeles, EE.UU.

Patrocinio y reconocimiento:
Agradecimiento: Los Dres. Singer y Levine recibieron una beca de NINDS (NS-38841). El Dr. Levine también recibió la beca ID06-LA-187 del California HIV/AIDS Research Program (CHRP). El Dr. Miller agradece al Dr. Steve Rogers su ayuda en la investigación y la redacción de este artículo.

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