Progesterone receptor polymorphisms and clinical response to 17-alpha-hydroxyprogesterone caproate

Abstract The synthetic progestin, 17α-hydroxyprogesterone caproate, is increasingly used for the prevention of premature birth in at-risk women, despite little understanding of the potential effects on the developing brain. Rodent models suggest that many regions of the developing brain are sensitive to progestins, including the mesocortical dopamine pathway, a neural circuit important for complex cognitive behaviors later in life. Nuclear progesterone receptor is expressed during perinatal development in dopaminergic cells of the ventral tegmental area that project to the medial prefrontal cortex. Progesterone receptor is also expressed in the subplate and in pyramidal cell layers II/III of medial prefrontal cortex during periods of dopaminergic synaptogenesis. In the present study, exposure to 17α-hydroxyprogesterone caproate during development of the mesocortical dopamine pathway in rats altered dopaminergic innervation of the prelimbic prefrontal cortex and impaired cognitive flexibility with increased perseveration later in life, perhaps to a greater extent in males. These studies provide evidence for developmental neurobehavioral effects of a drug in widespread clinical use and highlight the need for a reevaluation of the benefits and potential outcomes of prophylactic progestin administration for the prevention of premature delivery.

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Clinical Response to Questions Regarding Outcomes and Therapy Efficacy

Perspectives on Fluency and Fluency Disorders ◽

10.1044/ffd20.3.76 ◽

2010 ◽

Vol 20 (3) ◽

pp. 76-83 ◽

Cited By ~ 1

Author(s):

Joseph Donaher ◽

Tom Gurrister ◽

Irving Wollman ◽

Tim Mackesey ◽

Michelle L. Burnett

Keyword(s):

Risk Factors ◽

Clinical Response ◽

Speech Language Pathologists ◽

Specific Therapy ◽

Therapy Efficacy ◽

Therapy Program ◽

Adults Who Stutter ◽

Cure Rates

Parents of children who stutter and adults who stutter frequently ask speech-language pathologists to predict whether or not therapy will work. Even though research has explored risk-factors related to persistent stuttering, there remains no way to determine how an individual will react to a specific therapy program. This paper presents various clinicians’answers to the question, “What do you tell parents or adults who stutter when they ask about cure rates, outcomes, and therapy efficacy?”

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Primary chemoprevention of familial adenomalous polyposis: Stratification of clinical response to sulindac by mucosal prostanoid levels

Gastroenterology ◽

10.1016/s0016-5085(01)81251-8 ◽

2001 ◽

Vol 120 (5) ◽

pp. A253-A253

Author(s):

V YANG ◽

R CASERO ◽

D GEIMAN ◽

W HUBBARD ◽

L HYLIND ◽

...

Keyword(s):

Clinical Response

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Estrogen receptor α and progesterone receptor A and B concentration and localization in the lower uterine segment in term parturition

Journal of the Society for Gynecologic Investigation ◽

10.1016/s1071-5576(02)00156-9 ◽

2002 ◽

Vol 9 (4) ◽

pp. 226-232 ◽

Cited By ~ 9

Author(s):

M Winkler

Keyword(s):

Estrogen Receptor ◽

Progesterone Receptor ◽

Estrogen Receptor Α ◽

Lower Uterine Segment

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Progesterone receptor polymorphisms and clinical response to 17-alpha-hydroxyprogesterone caproate

Progesterone Receptor Polymorphisms and Clinical Response to 17-α-hydroxyprogesterone Caproate

38: The relationship between polymorphisms in the human progesterone receptor and clinical response to 17 alpha-hydroxyprogesterone caproate for the prevention of recurrent spontaneous preterm birth