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Gender Medicine: Pharmacometabolomics and Personalized Medicine
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Gender Medicine: Pharmacometabolomics and Personalized Medicine

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Pharmacology".

Deadline for manuscript submissions: closed (10 December 2021) | Viewed by 14974

Special Issue Editors

Prof. Dr. Flavia Franconi

E-Mail Website
Guest Editor
Laboratory of Sex-Gender Medicine, National Institute of Biostructures and Biosystems, Sassari, Italy
Interests: sex; gender; cardiovascular drugs; metabolomics
Special Issues, Collections and Topics in MDPI journals
Dr. Ilaria Campesi

E-Mail Website
Guest Editor
Dipartimento di Scienze Biomediche, Università di Sassari, Sassari, Italy
Interests: sex-gender pharmacology; biomarkers; metabolism; cell signalling; autophagy and apoptosis
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

There is an urgent need to optimize pharmacological therapy due to high inter-individual variability and economic costs. Indeed, sex and gender differences are evident in the epidemiology, presentation, mechanisms, outcomes, and treatments of a multitude of diseases. However, until a few years ago, medications were developed and studied without taking into account sex and gender and without any consideration of the context of where the person lives. The omics represent fundamental steps to arrive at personalized medicine and therapy; however, they do not cover the multiple aspects of a person, such as environmental, psychological, cultural religious, and psychosocial factors, that may alter gene expression, limiting the predictions of drug responses based only on genomic differences. Therefore, to achieve real personalized medicine, the collection and integration of data should occur from the molecule to the person and consider the context of where they live. Ignorance of the sex- and gender-related variability in research attenuates the scientific rigor of research and in clinical practice leads to a decrease in appropriateness and an increase in economic and social costs. Furthermore, sex and gender medicine and pharmacology play a protagonist role in the application of real personalized care, beginning from biological differences and concluding with the social and cultural implications for outcomes and therapeutic approaches. They utilize all known omics, including “personomics”, to support the importance of life experiences and to underline their relevance in health and medicine. Biological omics plus personomics represent the way forward to conceptualize and ultimately operationalize personalized medicine for all.

The focus of this Special Issue is on how many factors one has to consider to achieve real gender medicine, which is essential to arrive at real personalized medicine, as well as potential novel advances in the care of all.

Prof. Flavia Franconi
Dr. Ilaria Campesi
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Journal of Clinical Medicine is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • sex
  • gender
  • pharmacological therapy
  • metabolomics
  • personalized medicine

Published Papers (4 papers)

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Research

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17 pages, 693 KiB  
Article
Gender Differences among Sardinians with Alcohol Use Disorder
by Roberta Agabio, Claudia Pisanu, Luigi Minerba, Gian Luigi Gessa and Flavia Franconi
J. Clin. Med. 2021, 10(20), 4688; https://doi.org/10.3390/jcm10204688 - 13 Oct 2021
Cited by 2 | Viewed by 1502
Abstract
Sardinia is an Italian island in the Mediterranean characterized by secular isolation and the singular genetic characteristics of its inhabitants. Findings obtained in populations with diverse genetic make-up and cultural background indicate gender differences and/or similarities in drinking characteristics of patients with alcohol [...] Read more.
Sardinia is an Italian island in the Mediterranean characterized by secular isolation and the singular genetic characteristics of its inhabitants. Findings obtained in populations with diverse genetic make-up and cultural background indicate gender differences and/or similarities in drinking characteristics of patients with alcohol use disorder (AUD). Knowledge of these characteristics in AUD patients is useful to improve access to treatments. This paper investigated the drinking characteristics of 66 female and 282 male outpatients with AUD, born from 1937 to 1991, living in Sardinia, and compared their characteristics with those of AUD patients living in other countries. Most Sardinian patients were men, approximately 3 years younger than women; women consumed lower amounts of alcohol than men but did not differ from men in the severity of AUD. Men were more often single than women, while a higher proportion of women reported that their mother or spouse was affected by AUD. Anxiety and depression were more prevalent among women while a higher proportion of men were affected by substance use disorders. Women were older than men at the age of first drink, regular drinking, and onset of AUD, and progressed faster than men from regular use to AUD onset. Women did not differ from men in age at first request for care, and in the lapse from AUD onset to first request for care. Women and men waited for more than 8 and 9 years, respectively, before receiving medical treatment. Gender differences progressively decreased among younger patients. Although the scarce number of women in some cohorts limits the strength of these findings, drinking characteristics of Sardinian patients did not vary significantly from those of AUD patients living in other countries. These results suggest that the number of Sardinian women with AUD is increasing and services for treatment of AUD should (a) consider women’s specific needs, and (b) realize effective policies to reduce latency prior to accessing medical treatment for both men and women with AUD. Full article
(This article belongs to the Special Issue Gender Medicine: Pharmacometabolomics and Personalized Medicine)
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Review

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19 pages, 649 KiB  
Review
The Person’s Care Requires a Sex and Gender Approach
by Ilaria Campesi, Andrea Montella, Giuseppe Seghieri and Flavia Franconi
J. Clin. Med. 2021, 10(20), 4770; https://doi.org/10.3390/jcm10204770 - 18 Oct 2021
Cited by 11 | Viewed by 2269
Abstract
There is an urgent need to optimize pharmacology therapy with a consideration of high interindividual variability and economic costs. A sex–gender approach (which considers men, women, and people of diverse gender identities) and the assessment of differences in sex and gender promote global [...] Read more.
There is an urgent need to optimize pharmacology therapy with a consideration of high interindividual variability and economic costs. A sex–gender approach (which considers men, women, and people of diverse gender identities) and the assessment of differences in sex and gender promote global health, avoiding systematic errors that generate results with low validity. Care for people should consider the single individual and his or her past and present life experiences, as well as his or her relationship with care providers. Therefore, intersectoral and interdisciplinary studies are urgently required. It is desirable to create teams made up of men and women to meet the needs of both. Finally, it is also necessary to build an alliance among regulatory and ethic authorities, statistics, informatics, the healthcare system and providers, researchers, the pharmaceutical and diagnostic industries, decision makers, and patients to overcome the gender gap in medicine and to take real care of a person in an appropriate manner. Full article
(This article belongs to the Special Issue Gender Medicine: Pharmacometabolomics and Personalized Medicine)
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29 pages, 1954 KiB  
Review
Gender and Sex Are Key Determinants in Osteoarthritis Not Only Confounding Variables. A Systematic Review of Clinical Data
by Matilde Tschon, Deyanira Contartese, Stefania Pagani, Veronica Borsari and Milena Fini
J. Clin. Med. 2021, 10(14), 3178; https://doi.org/10.3390/jcm10143178 - 19 Jul 2021
Cited by 68 | Viewed by 5812
Abstract
Many risk factors for osteoarthritis (OA) have been noted, while gender/sex differences have been understated. The work aimed to systematically review literature investigating as primary aim the relationship between gender/sex related discriminants and OA. The search was performed in PubMed, Science Direct and [...] Read more.
Many risk factors for osteoarthritis (OA) have been noted, while gender/sex differences have been understated. The work aimed to systematically review literature investigating as primary aim the relationship between gender/sex related discriminants and OA. The search was performed in PubMed, Science Direct and Web of Knowledge in the last 10 years. Inclusion criteria were limited to clinical studies of patients affected by OA in any joints, analyzing as primary aim gender/sex differences. Exclusion criteria were review articles, in vitro, in vivo and ex vivo studies, case series studies and papers in which gender/sex differences were adjusted as confounding variable. Of the 120 records screened, 42 studies were included. Different clinical outcomes were analyzed: morphometric differences, followed by kinematics, pain, functional outcomes after arthroplasty and health care needs of patients. Women appear to use more health care, have higher OA prevalence, clinical pain and inflammation, decreased cartilage volume, physical difficulty, and smaller joint parameters and dimensions, as compared to men. No in-depth studies or mechanistic studies analyzing biomarker differential expressions, molecular pathways and omic profiles were found that might drive preclinical and clinical research towards sex-/gender-oriented protocols. Full article
(This article belongs to the Special Issue Gender Medicine: Pharmacometabolomics and Personalized Medicine)
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13 pages, 652 KiB  
Review
Sex-Related Differences in Drugs with Anti-Inflammatory Properties
by André Farkouh, Christoph Baumgärtel, Roman Gottardi, Margit Hemetsberger, Martin Czejka and Alexandra Kautzky-Willer
J. Clin. Med. 2021, 10(7), 1441; https://doi.org/10.3390/jcm10071441 - 01 Apr 2021
Cited by 23 | Viewed by 4109
Abstract
There is increasing evidence of sex differences in the action of anti-inflammatory drugs, with women being at significantly higher risk of adverse effects. Nevertheless, clinicians’ awareness of the implications of these sex differences on dosing and adverse event monitoring in routine practice is [...] Read more.
There is increasing evidence of sex differences in the action of anti-inflammatory drugs, with women being at significantly higher risk of adverse effects. Nevertheless, clinicians’ awareness of the implications of these sex differences on dosing and adverse event monitoring in routine practice is still in need of improvement. We reviewed the literature evaluating sex differences in terms of pharmacokinetics and pharmacodynamics of anti-inflammatory drugs. The anti-thrombotic activity of selective and non-selective COX-inhibitors tends to be stronger in men than women. Side effect profiles differ with regards to gastro-intestinal, renal and hepatic complications. Glucocorticosteroids were found to be more effective in men; women were more sensitive to corticosteroids when their oestradiol levels were high, a finding important for women taking hormonal contraception. TNF-alpha inhibitors have a longer half-life in men, leading to stronger immunosuppression and this a higher incidence of infections as side effects. Although research on sex differences in the effectiveness and safety of drugs is increasing, findings are often anecdotal and controversial. There is no systematic sex-differentiated reporting from clinical trials, and women are often under-represented. As personalized medicine is gaining in importance, sex, and gender aspects need to become integral parts of future research and policy making. Full article
(This article belongs to the Special Issue Gender Medicine: Pharmacometabolomics and Personalized Medicine)
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