Does estrogen enhance the antidepressant effects of fluoxetine?

BACKGROUND: While hormone replacement therapy (HRT) has not been shown to be an effective treatment for major depression, preliminary studies suggest that estrogen may potentiate the effect of selective serotonin reuptake inhibitors. METHOD: In an ongoing study, perimenopausal women diagnosed with major depression were randomly assigned to one of three treatment conditions: (1) fluoxetine 10-20 mg alone, (2) estradiol patch 0.1-0.2 mg alone or (3) the combination of fluoxetine 10-20 mg and estradiol patch 0.1-0.2 mg. RESULTS: In the five cases presented here, the combination of fluoxetine and estradiol was most effective, followed by fluoxetine alone and then estradiol alone. LIMITATIONS: These are selected cases from an ongoing study and do not represent statistically significant data. CONCLUSIONS: These preliminary cases suggest that estrogen can enhance the efficacy of antidepressant medication in menopausal women and this adjunctive treatment strategy may be superior to antidepressant or estrogen alone. Further research is needed in elucidating the mechanisms by which estrogen may enhance antidepressant action in perimenopausal women.

In vivo expression and immunological studies of the 42-kilodalton carboxyl-terminal processing fragment of Plasmodium falciparum merozoite surface protein 1 in the baculovirus-silkworm system.

The 42-kDa carboxyl-terminal processing fragment of Plasmodium falciparum merozoite surface protein 1 (MSP-1(42)) is an anti-erythrocytic stage malaria vaccine candidate. In this study, MSP-1(42) was expressed by using the Bombyx mori nuclear polyhedrosis virus-silkworm expression system, and the antigenicity and immmunogenicity of the recombinant protein, Bmp42, were evaluated. The average yield of Bmp42, as determined by a sandwich enzyme-linked immunosorbent assay (ELISA), was 379 microg/ml of infected silkworm hemolymph, which was >100-fold higher than the level attainable in cell culture medium. N-terminal amino acid sequencing revealed that Bmp42 was correctly processed in silkworm cells. Data from immunoblotting, as well as from the inhibition ELISA, suggested that the conformational B-cell epitopes of MSP-1(42) were recreated in Bmp42. Immunization of rabbits with Bmp42 in complete Freund's adjuvant generated high-titer antibody responses against the immunogen. Specificity analyses of the anti-Bmp42 antibodies using several recombinant MSP-1(19) proteins expressing variant and conserved B-cell epitopes suggested that the anti-Bmp42 antibodies recognized primarily conserved epitopes on MSP-1(19). Furthermore, the anti-Bmp42 antibodies were highly effective in inhibiting the in vitro growth of parasites carrying homologous or heterologous MSP-1(42). Our results demonstrated that the baculovirus-silkworm expression system could be employed to express biologically and immunologically active recombinant MSP-1(42) at elevated levels; thus, it is an attractive alternative for producing a protective MSP-1(42) vaccine for human use.