Biological sex and mechanisms of ischemic brain injury.
Cerebrovascular disease is a leading cause of death-from-disease and of disability worldwide, affecting some 15 million people. The incidence of stroke or "brain attack" is unlikely to recede for a decade at minimum by most predictions, despite large public health initiatives in stroke prevention. It has been well established that stroke is also one of the most strikingly sex-specific diseases in its epidemiology, and in some cases, in patient outcomes. For example, women sustain lower rates of ischemic stroke relative to men, even beyond their menopausal years. In contrast, outcomes are worse in women in many clinical studies. The biological basis for this sexual dimorphism is a compelling story, and both hormone-dependent and hormone-independent factors are involved, the latter of which is the subject of this brief review. Understanding the molecular and cell-based mechanisms underlying sex differences in ischemic brain injury is an important step toward personalized medicine and effective therapeutic interventions in patients of both sexes.
Departments of Anesthesiology and Pharmacology, University of Colorado, Denver.
Paco S
PS
Herson
Julie
J
Palmateer
Patricia D
PD
Hurn
D000818:Animals; D001095:Arachidonic Acids / Q000502:physiology; D002545:Brain Ischemia / Q000209:etiology*; D016923:Cell Death / Q000502:physiology; D002478:Cells, Cultured; D004195:Disease Models, Animal; D004851:Epoxide Hydrolases; D005260:Female; D006801:Humans; D008297:Male; D052250:Nitric Oxide Synthase Type III / Q000502:physiology; D011065:Poly(ADP-ribose) Polymerases / Q000502:physiology; D012727:Sex Characteristics; D015398:Signal Transduction; D020521:Stroke / Q000209:etiology*; D050053:TRPM Cation Channels / Q000502:physiology
D001095:Arachidonic Acids; D050053:TRPM Cation Channels; D052250:Nitric Oxide Synthase Type III; D011065:Poly(ADP-ribose) Polymerases; D004851:Epoxide Hydrolases
Cerebral ischemia; Gender; Sexual dimorphism; Stroke; Transient receptor potential M2