Global Cerebral Ischemia Induces Short-Term Changes to Estrous Cycle Regularity and Alters Hypothalamic-Pituitary-Gonadal Axis Function

Abstract

Global cerebral ischemia (GCI), which mimics cardiac arrest in humans, induces numerous functional alterations throughout the brain, but its impact on the hypothalamic-pituitary-gonadal (HPG) axis remains largely unknown. Importantly, the HPG axis modulates sex hormones and neuropeptides, such as estrogen and kisspeptin, as well as estrous cycle regularity. The goals of this study were to determine if estrous cycle regularity is affected by GCI and to characterize HPG axis functionality post-ischemia. Adult female Wistar rats underwent vaginal lavage for 2 weeks to confirm estrous cycle regularity before being subjected to GCI for 10 minutes or sham surgery. Estrous cycle regularity was monitored for 4 weeks following surgery, after which rats were euthanized. Immunofluorescence was used to detect kisspeptin receptors (Kiss1) and estrogen receptors alpha (ERα) and beta (ERβ) expression in the arcuate nucleus (ARC) of the hypothalamus, as well as the CA1 and dentate gyrus (DG) of the hippocampus. Following surgery, all sham subjects maintained a regular estrous cycle, whereas two thirds of ischemic rats presented a disrupted cycle following GCI (persistent diestrus, average length 13 days), before resuming regular cycling. T-test revealed a significant increase in Kiss1 receptors in the ARC of GCI rodents, as well as a trend for higher ERα expression in the CA1 of ischemic rats. Overall, our results highlight that while estrous cycle disruptions resolve within 2 weeks after the ischemic event, HPG axis dysregulation persists up to one month after GCI, hinting at possible long-term impacts on the reproductive axis.