INVESTIGADORES
GARGIULO MONACHELLI Gisella Mariana
artículos
Título:
Exposure to endogenous and exogenous sex hormones and reproductive history influence prognosis in women with ALS
Autor/es:
GONZALEZ DENISELLE, MARIA CLAUDIA; BETTINI MARIELA; GARRIDO ROSA; MEYER MARIA; LARA AGUSTINA; GARAY LAURA; CASAS SEBASTIAN; FULGENZI ERNESTO; NUÑEZ MYRIAM; RUGIERO, MARCELO; DE NICOLA AF.; GARGIULO MONACHELLI GM
Revista:
Muscle and Nerve
Editorial:
John Wiley and Sons Inc
Referencias:
Año: 2023 vol. 68 p. 414 - 421
Resumen:
Introduction/aims: Amyotrophic lateral sclerosis (ALS) is a fatal neurodegenerative disease with a higher incidence in men suggesting an influence of sex steroids. Our objective was to investigate past exposure to endogenous and synthetic steroids in female ALS patients and controls.Methods: We administered a questionnaire to 158 postmenopausal women (75 ALS patients and 83 controls). We calculated reproductive time span (RTS), lifetime endogenous estrogen (LEE) and progesterone exposures (LPE), oral contraceptive pill (OCP) use, and reproductive history.Results: ALS patients showed shorter LEE and LPE, a lower proportion of breast cancer, and 11% showed no history of pregnancies vs. 4% of controls. Odds ratios (ORs) showed that 13 y) constitute risk factors for ALS [OR = 2.1 (95% confidence interval {CI}, 1.08-4.2); and OR = 2.4 (95% CI, 1.1-5.1) respectively]. According to Cox survival analysis, for each year the LEE increased over 17 y, it was independently associated with longer survival [hazard ratio (HR) = 0.37 (95% CI, 0.16-0.85)] after adjusting for smoking, age and site of onset. Multivariate regression analysis demonstrated that for each month using OCP for longer than 40 mo increased the risk of ALS [adjusted OR = 4.1 (95% CI, 1.2-13.8)].Discussion: Thus, longer exposure to endogenous female sex steroids increased survival and reduced ALS susceptibility. In contrast, longer exposure to synthetic sex steroids showed a negative impact by reducing the production of endogenous female sex steroids or due to crossover with other steroid receptors. Given the neuroprotective effects of sex steroids, we suggest that abnormalities of neuroendocrine components may alter motor function in women with ALS.