New Steps Forward in the Neuroactive Steroid Field

The document from 2015 reviews the complex roles of neuroactive steroids in the nervous system, emphasizing their potential as therapeutic agents for neuroprotection but also noting the possibility of detrimental effects. It explains that neuroactive steroid levels in the brain do not always correlate with plasma levels and that their effects can vary depending on factors such as sex, dosage, and disease state. The paper highlights the rapid and reversible metabolism of these steroids, their classical and membrane receptor signaling, and the sex-specific nature of their levels, which could influence sex-oriented treatments. It also points out that while neuroactive steroids can be neuroprotective, they can sometimes impair memory or worsen brain injury. The document suggests that modulating steroidogenesis in the nervous system may be a safer therapeutic strategy than systemic treatment, to avoid endocrine side effects. It concludes that a deeper understanding of the complex metabolism and action of neuroactive steroids in the brain is necessary before they can be developed into safe and effective therapies.