“…The microbiome also exhibits significant and well-studied sex differences, which have been proposed to impact the gut-brain axis leading to sex differences in disease phenotype and drug ADME (Jašarević et al, 2016;Hokanson et al, 2023). For intranasal dosing, drugs first encounter the nasal passageways and mucosal barriers, for which mucous pH, secretion, and clearance have been shown to be sex-dependent (England et al, 1999;Hallschmid, 2021;Luberti et al, 2021;Marjan, 2023). Additional sex differences have been observed for drug ADME through ocular (Nakamura et al, 2005), intravascular (Kunio et al, 2018), and subcutaneous (Sloan, 2000) dosing paradigms; physiological considerations for these parenteral routes of administration are reviewed elsewhere (Donovan, 2005).…”