“Bridging the Gap” Everything that Could Have Been Avoided If We Had Applied Gender Medicine, Pharmacogenetics and Personalized Medicine in the Gender-Omics and Sex-Omics Era

International Journal of Molecular Sciences - Tập 21 Số 1 - Trang 296
Donato Gemmati1,2, Katia Varani3,2, Barbara Bramanti4,2, Roberta Piva4,2, Gloria Bonaccorsi5,2, Alessandro Trentini4, Maria Cristina Manfrinato4, Veronica Tisato6, Alessandra Carè7,2, Tiziana Bellini4,2
1Department of Biomedical & Specialty Surgical Sciences, and Centre Haemostasis & Thrombosis, University of Ferrara, 44121 Ferrara, Italy
2University Center for Studies on Gender Medicine, University of Ferrara, 44121 Ferrara, Italy;
3Department of Medical Sciences, University of Ferrara, 44121 Ferrara, Italy
4Department of Biomedical & Specialty Surgical Sciences, University of Ferrara, 44121 Ferrara, Italy;
5Department of Morphology, Surgery and Experimental Medicine, and Menopause and Osteoporosis Centre, University of Ferrara, 44124 Ferrara, Italy
6Department of Morphology, Surgery and Experimental Medicine and LTTA Centre, University of Ferrara, 44121 Ferrara, Italy
7Center for Gender-specific Medicine, Istituto Superiore di Sanita' (I.S.S.), 00161 Rome, Italy

Tóm tắt

Gender medicine is the first step of personalized medicine and patient-centred care, an essential development to achieve the standard goal of a holistic approach to patients and diseases. By addressing the interrelation and integration of biological markers (i.e., sex) with indicators of psychological/cultural behaviour (i.e., gender), gender medicine represents the crucial assumption for achieving the personalized health-care required in the third millennium. However, ‘sex’ and ‘gender’ are often misused as synonyms, leading to frequent misunderstandings in those who are not deeply involved in the field. Overall, we have to face the evidence that biological, genetic, epigenetic, psycho-social, cultural, and environmental factors mutually interact in defining sex/gender differences, and at the same time in establishing potential unwanted sex/gender disparities. Prioritizing the role of sex/gender in physiological and pathological processes is crucial in terms of efficient prevention, clinical signs’ identification, prognosis definition, and therapy optimization. In this regard, the omics-approach has become a powerful tool to identify sex/gender-specific disease markers, with potential benefits also in terms of socio-psychological wellbeing for each individual, and cost-effectiveness for National Healthcare systems. “Being a male or being a female” is indeed important from a health point of view and it is no longer possible to avoid “sex and gender lens” when approaching patients. Accordingly, personalized healthcare must be based on evidence from targeted research studies aimed at understanding how sex and gender influence health across the entire life span. The rapid development of genetic tools in the molecular medicine approaches and their impact in healthcare is an example of highly specialized applications that have moved from specialists to primary care providers (e.g., pharmacogenetic and pharmacogenomic applications in routine medical practice). Gender medicine needs to follow the same path and become an established medical approach. To face the genetic, molecular and pharmacological bases of the existing sex/gender gap by means of omics approaches will pave the way to the discovery and identification of novel drug-targets/therapeutic protocols, personalized laboratory tests and diagnostic procedures (sex/gender-omics). In this scenario, the aim of the present review is not to simply resume the state-of-the-art in the field, rather an opportunity to gain insights into gender medicine, spanning from molecular up to social and psychological stances. The description and critical discussion of some key selected multidisciplinary topics considered as paradigmatic of sex/gender differences and sex/gender inequalities will allow to draft and design strategies useful to fill the existing gap and move forward.

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