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Wilson LAB, Zajitschek SRK, Lagisz M, Mason J, Haselimashhadi H, Nakagawa S. Sex differences in allometry for phenotypic traits in mice indicate that females are not scaled males. Nat Commun 2022; 13:7502. [PMID: 36509767 PMCID: PMC9744842 DOI: 10.1038/s41467-022-35266-6] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2022] [Accepted: 11/24/2022] [Indexed: 12/14/2022] Open
Abstract
Sex differences in the lifetime risk and expression of disease are well-known. Preclinical research targeted at improving treatment, increasing health span, and reducing the financial burden of health care, has mostly been conducted on male animals and cells. The extent to which sex differences in phenotypic traits are explained by sex differences in body weight remains unclear. We quantify sex differences in the allometric relationship between trait value and body weight for 363 phenotypic traits in male and female mice, recorded in >2 million measurements from the International Mouse Phenotyping Consortium. We find sex differences in allometric parameters (slope, intercept, residual SD) are common (73% traits). Body weight differences do not explain all sex differences in trait values but scaling by weight may be useful for some traits. Our results show sex differences in phenotypic traits are trait-specific, promoting case-specific approaches to drug dosage scaled by body weight in mice.
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Affiliation(s)
- Laura A. B. Wilson
- grid.1005.40000 0004 4902 0432Evolution & Ecology Research Centre, UNSW Data Science Hub, and School of Biological, Earth and Environmental Sciences, University of New South Wales, Sydney, NSW 2052 Australia ,grid.1001.00000 0001 2180 7477School of Archaeology and Anthropology, The Australian National University, Canberra, ACT 2600 Australia
| | - Susanne R. K. Zajitschek
- grid.1005.40000 0004 4902 0432Evolution & Ecology Research Centre, UNSW Data Science Hub, and School of Biological, Earth and Environmental Sciences, University of New South Wales, Sydney, NSW 2052 Australia ,grid.4425.70000 0004 0368 0654School of Biological and Environmental Sciences, Liverpool John Moores University, Byrom Street, Liverpool, L3 3AF UK
| | - Malgorzata Lagisz
- grid.1005.40000 0004 4902 0432Evolution & Ecology Research Centre, UNSW Data Science Hub, and School of Biological, Earth and Environmental Sciences, University of New South Wales, Sydney, NSW 2052 Australia
| | - Jeremy Mason
- Melio Healthcare Ltd., City Tower, 40 Basinghall Street, London, EC2V 5DE UK ,European Molecular Biology Laboratory, European Bioinformatics Institute (EMBL-EBI), Wellcome Genome Campus, Hinxton, Cambridgeshire CB10 1SD UK
| | - Hamed Haselimashhadi
- European Molecular Biology Laboratory, European Bioinformatics Institute (EMBL-EBI), Wellcome Genome Campus, Hinxton, Cambridgeshire CB10 1SD UK
| | - Shinichi Nakagawa
- grid.1005.40000 0004 4902 0432Evolution & Ecology Research Centre, UNSW Data Science Hub, and School of Biological, Earth and Environmental Sciences, University of New South Wales, Sydney, NSW 2052 Australia
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Madla CM, Gavins FKH, Merchant HA, Orlu M, Murdan S, Basit AW. Let's talk about sex: Differences in drug therapy in males and females. Adv Drug Deliv Rev 2021; 175:113804. [PMID: 34015416 DOI: 10.1016/j.addr.2021.05.014] [Citation(s) in RCA: 61] [Impact Index Per Article: 20.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Revised: 05/04/2021] [Accepted: 05/15/2021] [Indexed: 12/13/2022]
Abstract
Professor Henry Higgins in My Fair Lady said, 'Why can't a woman be more like a man?' Perhaps unintended, such narration extends to the reality of current drug development. A clear sex-gap exists in pharmaceutical research spanning from preclinical studies, clinical trials to post-marketing surveillance with a bias towards males. Consequently, women experience adverse drug reactions from approved drug products more often than men. Distinct differences in pharmaceutical response across drug classes and the lack of understanding of disease pathophysiology also exists between the sexes, often leading to suboptimal drug therapy in women. This review explores the influence of sex as a biological variable in drug delivery, pharmacokinetic response and overall efficacy in the context of pharmaceutical research and practice in the clinic. Prospective recommendations are provided to guide researchers towards the consideration of sex differences in methodologies and analyses. The promotion of disaggregating data according to sex to strengthen scientific rigour, encouraging innovation through the personalisation of medicines and adopting machine learning algorithms is vital for optimised drug development in the sexes and population health equity.
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Affiliation(s)
- Christine M Madla
- Department of Pharmaceutics, UCL School of Pharmacy, University College London, 29 - 39 Brunswick Square, London WC1N 1AX, United Kingdom
| | - Francesca K H Gavins
- Department of Pharmaceutics, UCL School of Pharmacy, University College London, 29 - 39 Brunswick Square, London WC1N 1AX, United Kingdom
| | - Hamid A Merchant
- Department of Pharmacy, School of Applied Sciences, University of Huddersfield, Queensgate, Huddersfield HD1 3DH, United Kingdom
| | - Mine Orlu
- Department of Pharmaceutics, UCL School of Pharmacy, University College London, 29 - 39 Brunswick Square, London WC1N 1AX, United Kingdom
| | - Sudaxshina Murdan
- Department of Pharmaceutics, UCL School of Pharmacy, University College London, 29 - 39 Brunswick Square, London WC1N 1AX, United Kingdom
| | - Abdul W Basit
- Department of Pharmaceutics, UCL School of Pharmacy, University College London, 29 - 39 Brunswick Square, London WC1N 1AX, United Kingdom.
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Tamargo J, Rosano G, Walther T, Duarte J, Niessner A, Kaski JC, Ceconi C, Drexel H, Kjeldsen K, Savarese G, Torp-Pedersen C, Atar D, Lewis BS, Agewall S. Gender differences in the effects of cardiovascular drugs. EUROPEAN HEART JOURNAL - CARDIOVASCULAR PHARMACOTHERAPY 2017; 3:163-182. [DOI: 10.1093/ehjcvp/pvw042] [Citation(s) in RCA: 184] [Impact Index Per Article: 26.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/30/2023]
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Gender-based personalized pharmacotherapy: a systematic review. Arch Gynecol Obstet 2017; 295:1305-1317. [PMID: 28378180 DOI: 10.1007/s00404-017-4363-3] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2016] [Accepted: 03/29/2017] [Indexed: 01/03/2023]
Abstract
PURPOSE In general, male and female are prescribed the same amount of dosage even if most of the cases female required less dosage than male. Physicians are often facing problem on appropriate drug dosing, efficient treatment, and drug safety for a female in general. To identify and synthesize evidence about the effectiveness of gender-based therapy; provide the information to patients, providers, and health system intervention to ensure safety treatment; and minimize adverse effects. METHODS We performed a systematic review to evaluate the effect of gender difference on pharmacotherapy. Published articles from January 1990 to December 2015 were identified using specific term in MEDLINE (PubMed), EMBASE, and the Cochrane library according to search strategies that strengthen the reporting of observational and clinical studies. RESULTS Twenty-six studies fulfilled the inclusion criteria for this systematic review, yielding a total of 6309 subjects. We observed that female generally has a lower the gastric emptying time, gastric PH, lean body mass, and higher plasma volume, BMI, body fat, as well as reduce hepatic clearance, difference in activity of Cytochrome P450 enzyme, and metabolize drugs at different rate compared with male. Other significant factors such as conjugation, protein binding, absorption, and the renal elimination could not be ignored. However, these differences can lead to adverse effects in female especially for the pregnant, post-menopausal, and elderly women. CONCLUSION This systematic review provides an evidence for the effectiveness of dosage difference to ensure safety and efficient treatment. Future studies on the current topic are, therefore, recommended to reduce the adverse effect of therapy.
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Kreiberg M, Becker V, Jessen S, Rzeppa S, Hemmersbach P, Backer V, Hostrup M. Influence of exercise in normal and hot ambient conditions on the pharmacokinetics of inhaled terbutaline in trained men. Scand J Med Sci Sports 2016; 27:692-703. [DOI: 10.1111/sms.12697] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/11/2016] [Indexed: 01/17/2023]
Affiliation(s)
- M. Kreiberg
- Respiratory Research Unit; Bispebjerg University Hospital; Copenhagen Denmark
| | - V. Becker
- Respiratory Research Unit; Bispebjerg University Hospital; Copenhagen Denmark
| | - S. Jessen
- Respiratory Research Unit; Bispebjerg University Hospital; Copenhagen Denmark
- Department of Nutrition; Exercise and Sports; University of Copenhagen; Copenhagen Denmark
| | - S. Rzeppa
- Norwegian Doping Control Laboratory; Oslo University Hospital; Oslo Norway
| | - P. Hemmersbach
- Norwegian Doping Control Laboratory; Oslo University Hospital; Oslo Norway
| | - V. Backer
- Respiratory Research Unit; Bispebjerg University Hospital; Copenhagen Denmark
- IOC Sports Medicine; Copenhagen Denmark
| | - M. Hostrup
- Respiratory Research Unit; Bispebjerg University Hospital; Copenhagen Denmark
- Department of Nutrition; Exercise and Sports; University of Copenhagen; Copenhagen Denmark
- IOC Sports Medicine; Copenhagen Denmark
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Cadeddu C, Franconi F, Cassisa L, Campesi I, Pepe A, Cugusi L, Maffei S, Gallina S, Sciomer S, Mercuro G. Arterial hypertension in the female world. J Cardiovasc Med (Hagerstown) 2016; 17:229-36. [DOI: 10.2459/jcm.0000000000000315] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
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Anti-inflammatory activity of curcumin-loaded solid lipid nanoparticles in IL-1β transgenic mice subjected to the lipopolysaccharide-induced sepsis. Biomaterials 2015; 53:475-83. [DOI: 10.1016/j.biomaterials.2015.02.116] [Citation(s) in RCA: 123] [Impact Index Per Article: 13.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2014] [Revised: 02/23/2015] [Accepted: 02/27/2015] [Indexed: 12/14/2022]
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Dingemanse J, Nicolas L. Age and sex effects on the single- and multiple-dose safety and pharmacokinetics of the new renin inhibitor ACT-178882. Cardiovasc Ther 2014; 31:307-13. [PMID: 23311732 DOI: 10.1111/1755-5922.12022] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/30/2023] Open
Abstract
AIM To investigate the effect of age and sex on the single- and multiple-dose safety and pharmacokinetics of ACT-178882, a new direct renin inhibitor. METHODS In the single-dose, open-label part of the study, healthy young and elderly male and female subjects received a dose of 300 mg ACT-178882. In the multiple-dose, double-blind, placebo-controlled part of the study, healthy elderly male and female subjects received ACT-178882 (300 or 600 mg) or placebo once-a-day for 14 days. RESULTS Mild headache and diarrhea were the most common adverse events in the single- and multiple-dose parts, respectively. The frequency of diarrhea increased dose dependently, and no placebo subjects reported this adverse event. Administration of ACT-178882 did not result in any clinically relevant changes in ECG, vial signs, clinical laboratory, body weight, or physical examination. In the single-dose part and independent of sex, values for Cmax and AUC0-∞ were about 85% higher in elderly compared with young subjects, and t1/2 was about 5 h longer (29.3 vs. 24.1 h). In both age groups, plasma ACT-178882 concentrations were slightly higher in female versus male subjects. Following multiple-dose administration to elderly subjects, accumulation of ACT-178882 was moderate, about 1.8-fold, t1/2 was unchanged as compared with single-dose administration, sex effects were minimal, and the increase in the exposure with increasing dose appeared less than dose proportional. CONCLUSION Overall, single- and multiple-dose administration of ACT-178882 was well tolerated. No dose adaptation based on sex is necessary, whereas a dose reduction based on age could be considered.
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Affiliation(s)
- Jasper Dingemanse
- Department of Clinical Pharmacology, Actelion Pharmaceuticals Ltd, Allschwil, Switzerland
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Franconi F, Campesi I. Pharmacogenomics, pharmacokinetics and pharmacodynamics: interaction with biological differences between men and women. Br J Pharmacol 2014; 171:580-94. [PMID: 23981051 PMCID: PMC3969074 DOI: 10.1111/bph.12362] [Citation(s) in RCA: 153] [Impact Index Per Article: 15.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2013] [Revised: 08/05/2013] [Accepted: 08/16/2013] [Indexed: 12/16/2022] Open
Abstract
Pharmacological response depends on multiple factors and one of them is sex-gender. Data on the specific effects of sex-gender on pharmacokinetics, as well as the safety and efficacy of numerous medications, are beginning to emerge. Nevertheless, the recruitment of women for clinical research is inadequate, especially during the first phases. In general, pharmacokinetic differences between males and females are more numerous and consistent than disparities in pharmacodynamics. However, sex-gender pharmacodynamic differences are now increasingly being identified at the molecular level. It is now even becoming apparent that sex-gender influences pharmacogenomics and pharmacogenetics. Sex-related differences have been reported for several parameters, and it is consistently shown that women have a worse safety profile, with drug adverse reactions being more frequent and severe in women than in men. Overall, the pharmacological status of women is less well studied than that of men and deserves much more attention. The design of clinical and preclinical studies should have a sex-gender-based approach with the aim of tailoring therapies to an individual's needs and concerns.
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Affiliation(s)
- Flavia Franconi
- Department of Biomedical Sciences, University of SassariSassari, Italy
- Laboratory of Sex-Gender Medicine, National Institute of Biostructures and BiosystemsOsilo, Italy
| | - Ilaria Campesi
- Laboratory of Sex-Gender Medicine, National Institute of Biostructures and BiosystemsOsilo, Italy
- Department of Surgical, Microsurgical and Medical Sciences, University of SassariSassari, Italy
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Seeland U, Regitz-Zagrosek V. Sex and gender differences in cardiovascular drug therapy. Handb Exp Pharmacol 2013:211-36. [PMID: 23027453 DOI: 10.1007/978-3-642-30726-3_11] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
This chapter outlines sex differences in pharmacokinetics and pharmacodynamics of the most frequently used drugs in cardiovascular diseases, e.g., coronary artery disease, hypertension, heart failure. Retrospective analysis of previously published drug trials revealed marked sex differences in efficacy and adverse effects in a number of cardiovascular drugs. This includes a higher mortality among women taking digoxin for heart failure, more torsade de pointes arrhythmia in QT prolonging drugs and more cough with ACE inhibitors. Trends towards a greater benefit for women and/or female animals have been observed in some studies for endothelin receptor antagonists, the calcium channel blocker amlodipine, the ACE-inhibitor ramipril and the aldosterone antagonist eplerenone. However, reproduction of these results in independent studies and solid statistical evidence is still lacking. Some drugs require a particularly careful dose adaptation in women: the beta-blocker metoprolol, the calcium channel blocker verapamil, loop-, and thiazide diuretics. In conclusion, sex differences in pharmacokinetics and pharmacodynamics have to be taken into account for cardiovascular drug therapy in women.
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Affiliation(s)
- Ute Seeland
- Institute of Gender in Medicine, Universitaetsmedizin Berlin Charité, Berlin, Germany
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Sex differences in drug disposition. J Biomed Biotechnol 2011; 2011:187103. [PMID: 21403873 PMCID: PMC3051160 DOI: 10.1155/2011/187103] [Citation(s) in RCA: 184] [Impact Index Per Article: 14.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2010] [Revised: 12/20/2010] [Accepted: 01/05/2011] [Indexed: 12/17/2022] Open
Abstract
Physiological, hormonal, and genetic differences between males and females affect the prevalence, incidence, and severity of diseases and responses to therapy. Understanding these differences is important for designing safe and effective treatments. This paper summarizes sex differences that impact drug disposition and includes a general comparison of clinical pharmacology as it applies to men and women.
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