Gender, sex steroids, and cerebral ischemic pathobiology

Abstract

Biological sex is an important genetic determinant of outcome from cerebral ischemia and clinical stroke. Emerging data suggest that sex, as well as reproductive steroids, shapes ischemic cell death in brain. Female sex steroids, the estrogens and progesterone, provide robust neuroprotection in a variety of experimental settings and strongly contribute to sex-specific responses to ischemia. The purpose of this chapter is: (1) to review the importance of biological sex to ischemic outcome and mechanisms of brain injury, (2) to evaluate the role of female sex steroids as endogenous or exogenous ischemic neuroprotectants, and (3) to review most likely mechanisms by which female sex steroids act to interrupt ischemic cell death pathways. © 2007 Springer-Verlag US.