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Sex-Genetic Interaction in the Risk for Cerebrovascular Disease
Donatella Pastore1, Francesca Pacifici1, Barbara Capuani1
1Department of Systems Medicine, School of Medicine, University of Rome Tor Vergata, Rome. Italy.
Insights
Sex influences cerebrovascular disease (CeVD) risk, with genetic and hormonal factors playing key roles. Understanding these sex-specific mechanisms is crucial for developing targeted prevention and treatment strategies for CeVD.
Area of Science:
- Neurology
- Genetics
- Epidemiology
Background:
- Cerebrovascular disease (CeVD) is a leading cause of death and disability globally.
- Sex is a significant risk factor for CeVD, particularly ischemic stroke, with distinct incidence patterns in men and women.
- Hormonal influences alone do not fully explain sex-based differences in CeVD risk.
Purpose of the Study:
- To review sex-specific processes in CeVD.
- To discuss the hormonal impact on CeVD risk.
- To explore genetic factors and potential biomarkers for CeVD.
Main Methods:
- Review of existing literature on sex-specific CeVD.
- Analysis of hormonal and genetic mechanisms.
- Examination of studies in transgenic animals and human genetics.
- Discussion of heritability and biomarker identification.
Main Results:
- Sex-specific genetic factors contribute to varying risks for atherosclerosis and CeVD.
- Hormonal effects are important but do not entirely account for sex differences in CeVD.
- Heritability of ischemic stroke differs between sexes.
Conclusions:
- Complex interactions between hormonal and genetic factors underlie sex-specific CeVD risk.
- Identifying sex-specific biomarkers is essential for CeVD.
- New sex-specific treatment and prevention strategies are needed for CeVD.
Abstract:
Cerebrovascular disease (CeVD) is one of the major causes of death and a leading cause of disability worldwide. CeVD is a complex and multifactorial disease caused by the interaction of environment and genetic factors. Women have lower CeVD incidence than men until an advanced age, when the incidence of CeVD rises dramatically in women. Therefore, sex has been validated as an important risk factor in the etiology of CeVD, especially ischemic stroke. Although the importance of sex steroids have been heavily studied in the mechanism of neuronal injury, the experimental and clinical data suggest that hormones do not fully account for male versus female CeVD patterns. Sex-specific genetic processes have been implicated in the different rate of risk for atherosclerosis and CeVD. In this review, we discuss sex-specific CeVD processes, describe the hormonal impact on the risk for CeVD, the results from studies in transgenic animals, and from human genetic studies. Moreover, heritability of ischemic stroke in women and men as well as identification of possible sex-specific biomarkers for CeVD are discussed. Understanding the complex interactions between hormonal and genetic mechanisms in the CeVD risk will allow for new sex-specific approaches in disease treatment and prevention in clinical practice.