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Cognitive impairment in patients with cardiac disease: implications for clinical practice

Monotherapy targeting single steps in this complicated cascade may explain disappointments in trials with agents affecting only one chain of this circulus vituosus

10.3389/fnins.2022.824888 62 GevezovaM.SbirkovY.SarafianV.PlaimasK.SurataneeA.MaesM

The molecular basis of lutealization and progesterone synthesis is the presence of core steroidogenic genes (STAR, CYP11A1, LHCGR, and PGR) and transcriptional regulators (SF-1, FOXO1 and LRH-1), whereas endocrine signaling (MAPK/ERK, PI3K/AKT, and WNT/-catenin) fine-tune luteal cell survival, angiogenesis, In addition to classical hormonal regulation, new evidence also indicates that metabolic-epigenetic integration is central in the process of defining luteal fate, where AMPK can serve as an important sensor of energy, PPAR can be a context-specific transcriptional regulator of lipid metabolism and cell fate choices, and H3K27me3, which is mediated by EZH2, is a stable manner in which steroidogenic genes are repressed in luteal regression