Many neurological and psychiatric maladies originate from the deprivation of the human brain from
estrogens. However, current
hormone therapies cannot be used safely to treat these conditions commonly associated with menopause because of detrimental side effects in the periphery. The latter also prevents the use of the
hormone for neuroprotection. We show that a small-molecule bioprecursor
prodrug, 10β,17β-dihydroxyestra-1,4-dien-3-one (
DHED), converts to 17β-estradiol in the brain after systemic administration but remains inert in the rest of the body. The localized and rapid formation of
estrogen from the
prodrug was revealed by a series of in vivo bioanalytical assays and through in vivo imaging in rodents.
DHED treatment efficiently alleviated symptoms that originated from brain
estrogen deficiency in animal models of surgical menopause and provided neuroprotection in a rat
stroke model. Concomitantly, we determined that 17β-estradiol formed in the brain from
DHED elicited changes in gene expression and neuronal morphology identical to those obtained after direct 17β-estradiol treatment. Together, complementary functional and mechanistic data show that our approach is highly relevant therapeutically, because administration of the
prodrug selectively produces
estrogen in the brain independently from the route of administration and treatment regimen. Therefore, peripheral responses associated with the use of systemic
estrogens, such as stimulation of the uterus and
estrogen-responsive
tumor growth, were absent. Collectively, our brain-selective
prodrug approach may safely provide
estrogen neuroprotection and medicate neurological and psychiatric symptoms developing from
estrogen deficiency, particularly those encountered after surgical menopause, without the adverse side effects of current
hormone therapies.