Annals of the New York Academy of Sciences, The Future of Hormone Therapy: What Basic Science and Clinical Studies Teach Us / Edition 1

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This volume brings together contributions from basic scientists, epidemiologists, and practicing clinicians whose expertise or clinical practice involves the study or administration of gonadal hormones. Our current knowledge of the biology of gonadal hormones is assessed, and the question is explored of the gaps in knowledge that need to be addressed through additional research.

Other questions explored include the following: What is the appropriate population to study? What is the therapeutic window for hormone therapy and/or estrogen therapy? What are the appropriate formulations of HT and ET? What should be considered the most appropriate design for clinical trials that address the efficacy of HT/ET? What are appropriate surrogate markers of neurological decline/impairment? What are the best in vitro and in vivo models to address the efficacy of postmenopausal HT or ET?

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Table of Contents

Introduction. (Meharvan Singh and James W. Simpkins).

Part I: What Is the Appropriate Population of Women to Study/Treat When Considering Hormone/Estrogen Therapy?.

1. Surgical Menopause, Estrogen, and Cognitive Function in Women: What Do the Findings Tell Us? (Barbara B. Sherwin).

2. Menopausal Hot Flashes and Development of Cognitive Impairment. (Anna Ratka).

3. Depression, the Perimenopause, and Estrogen Therapy. (Peter J. Schmidt).

Part II: What Is the Ideal Therapeutic Window for Hormone/Estrogen Therapy?.

4. Is the Estrogen Controversy Over? Deconstructing the Women's Health Initiative Study: A Critical Evaluation of the Evidence. (S Mitchell Harman, Frederick Naftolin, Eliot A. Brinton, and Debra R. Judelson).

5. Investigative Models for Determining Hormone Therapy-Induced Outcomes in Brain: Evidence in Support of a Healthy Cell Bias of Estrogen Action. (Roberta Diaz Brinton).

6. Estrogen: A Neuroprotective or Proinflammatory Hormone? Emerging Evidence from Reproductive Aging Models. (Farida Sohrabji).

Part III: What Are Appropriate Formulations of Hormone/Estrogen Therapy?.

7. Clinical Pharmacology and Differential Cognitive Efficacy of Estrogen Preparations. (Carey E. Gleason, Cynthia M. Carlsson, Sterling Johnson, Craig Atwood, and Sanjay Asthana).

8. Development of 17-Estradiol as a Neuroprotective Therapeutic Agent: Rationale and Results from a Phase I Clinical Study. (James A. Dykens, Walter H. Moos, and Neil Howell).

9. Estrogen and the Brain: Beyond ER-, ER-ß, and 17ß-Estradiol. (C Dominique Toran-Allerand).

10. Mechanisms of Progesterone-Induced Neuroprotection. (Meharvan Singh).

11. The Case for Progesterone. (Donald G. Stein).

Part IV: What Is the Most Appropriate Design for Clinical Trials That Address the Efficacy of Hormone/Estrogen Therapy?.

12. Methodological Issues in Estrogen Treatment Trials for Alzheimer's Disease. (Ruth A. Mulnard).

13. A Systematic Review of Clinical Trials of Hormone Therapy on Cognitive Function: Effects of Age at Initiation and Progestin Use. (Pauline M. Maki).

Part V: What Are Appropriate Surrogate Markers of Neurological Decline and What Experimental Models Are Best to Assess the Efficacy of Hormone/Estrogen Therapy?.

14. Estrogen Bows to a New Master: The Role of Gonadotropins in Alzheimer Pathogenesis. (Kate M. Webber, Gemma Casadesus, Michael W. Marlatt, George Perry, Clive R. Hamlin, Craig S. Atwood, Richard L. Bowen, and Mark A. Smith).

15. Estradiol Prevents Neural Tau Hyperphosphorylation Characteristic of Alzheimer's Disease. (Margarita Alvarez-De-La-Rosa, Ivaldo Silva, Jon Nilsen, M M Pérez, Luis Miguel García-Segura, Jesús Ávila, and Frederick Naftolin).

16. Estrogens and Cerebrovascular Stroke: What Do Animal Models Teach Us? (Phyllis M. Wise).

17. Role of Nonfeminizing Estrogens in Brain Protection from Cerebral Ischemia: An Animal Model of Alzheimer's Disease Neuropathology. (James W. Simpkins, Yi Wen, Evelyn Perez, Shaohua Yang, and Xiaofei Wang).

18. Impact of Metabolism on the Safety of Estrogen Therapy. ( Katalin Prokai-Tatrai and Laszlo Prokai).

19. Summary. (Meharvan Singh and James W. Simpkins).

Index. of Contributors.

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