Using Basic Science to Design a Clinical Trial: Baseline Characteristics of Women Enrolled in the Kronos Early Estrogen Prevention Study (KEEPS)

Observational and epidemiological studies suggest that menopausal hormone therapy (MHT) reduces cardiovascular disease (CVD) risk. However, results from prospective trials showed neutral or adverse effects most likely due to differences in participant demographics, such as age, timing of initiation of treatment, and preexisting cardiovascular disease, which reflected in part the lack of basic science information on mechanisms of action of hormones on the vasculature at the time clinical trials were designed. The Kronos Early Estrogen Replacement Study (KEEPS) is a prospective, randomized, controlled trial designed, using findings from basic science studies, to test the hypothesis that MHT when initiated early in menopause reduces progression of atherosclerosis. KEEPS participants are younger, healthier, and within 3 years of menopause thus matching more closely demographics of women in prior observational and epidemiological studies than women in the Women’s Health Initiative hormone trials. KEEPS will provide information relevant to the critical timing hypothesis for MHT use in reducing risk for CVD

Mass Spectrometry

International audienceFor twenty years or so now, mass spectrometry has been used to get exact measurements of the mass of biological molecules such as proteins, nucleic acids,oligosaccharides, and so on. Over the past ten years, this technology has followed the trend toward miniaturisation and the samples required can be much smaller. In particular, the nanoelectrospray source (online or by needle) allow one to work at flow rates of a few tens of nanolitres/min. There are many applications, both in the field of proteomics and in the analysis of protein structure, dynamics, and interactions. Combining this source with nanoHPLC, complex mixtures only available in small quantities can be separated and analysed online. There are also some advantages over conventional HPLC, despite a set of constraints related to the small dimensions and low flow rates. Combining capillary electrophoresis with the electrospray source also gives useful results, with its own set of advantages and constraints. Finally, developments are currently underway to combine this source with chips, providing a means of separation and analysis online