Sex and gender differences in pain and inflammation: a rapidly maturing field

Berkley, Karen J.; Zalcman, Steven S.; Simon, Viviana R.

doi:10.1152/ajpregu.00287.2006

Cited by 76 publications

(55 citation statements)

References 25 publications

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“…This finding seems to be pertinent with the current literature suggesting that female gender is characterized by higher inflammatory levels than men. [42] There is growing interest in effective therapies to counteract the catabolic effect of chronic inflammation even if it is still limited to animal and in vitro models. Rieu and colleagues showed that the development of low grade inflammation may be controlled by an NSAID and the muscle protein synthesis restored in the postprandial state in old rats [43].…”

Section: Discussionmentioning

confidence: 99%

Inflammation and sarcopenia: A systematic review and meta-analysis

et al. 2017

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Nicola.Inflammation and sarcopenia: A systematic review and meta-analysis.Maturitas http://dx.doi.org/10.1016/j.maturitas. 2016.11.006 This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain. Highlights Sarcopenia is associated with functional impairment and adverse outcomes.  Highly inflammatory cytokines are negatively related to muscle strength and mass.  Sarcopenia is associated with higher serum inflammatory parameters.  Chronic inflammation could play a role in sarcopenia. AbstractInflammatory cytokines have been shown to prompt muscle wasting, ultimately stimulating protein catabolism and suppressing muscle synthesis. However, the possible association between inflammatory parameters and sarcopenia is poorly understood. We therefore aimed to summarize the current evidence about this topic with a meta-analysis of studies reporting serum inflammatory parameters in patients with sarcopenia vs. people without sarcopenia (controls). An electronic PubMed and Scopus search through to 09/01/2016 and meta-analysis of cross-sectional studies comparing serum levels of inflammatory cytokines between patients with sarcopenia and controls was made, calculating random-effects standardized mean differences (SMDs) ±95% confidence intervals (CIs) as the effect size. Out of 1370 initial hits, 17 studies with a total of 11249 participants (3072 with sarcopenia and 8177 without) were meta-analysed. Sarcopenic participants had significantly higher levels of CRP (SMD=0.51; 95%CI 0.26, 0.77; p<0.0001; I 2 =96%) than controls. Conversely, serum IL6 levels were not significantly different (SMD=0.35; 95%CI: -0.19, 0.89; p=0.21; I 2 =97%) in people with sarcopenia versus controls. Sarcopenic people did not have higher levels of TNF-than controls (SMD=0.28; 95%CI -0.26, 0.83; p=0.31; I 2 =97%). In conclusion, sarcopenia seems to be associated with elevated serum CRP levels; future longitudinal studies are needed to clarify this relationship.

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Section: Discussionmentioning

confidence: 99%

Inflammation and sarcopenia: A systematic review and meta-analysis

et al. 2017

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“…Immune responses also differ between the sexes [21], which may contribute to sex differences in response to chronic inflammatory and neuropathic pain. The activity level of female rodents varies dramatically across the estrous cycle [24,74], which may introduce a confound on pain tests that allow subjects to locomote freely, such as the hot-plate test.…”

Section: Experimental Study Of Sex Differences In Pain and Analgesiamentioning

confidence: 99%

“…Given the substantially greater prevalence of many clinical pain conditions in women vs. men [20,199], and growing evidence for sex differences in sensitivity to experimental pain and to analgesics [21,41,213], we recommend that all pain researchers consider testing their hypotheses in both sexes, or if restricted by practical considerations, only in females. It is invalid to assume that data obtained in male subjects will generalize to females, and the best non-human model of the modal human pain sufferer -a woman -is a female animal.…”

Section: The Case For Studying Sex and Gender Differences In Pain Andmentioning

confidence: 99%

“…This sexual dimorphism can affect the distribution of highly lipophilic drugs, and therefore influence analgesic drug potency, efficacy, and duration of action. Other aspects of pharmacokinetics, including liver metabolism and membrane transport, may differ between the sexes [139,144], possibly affecting analgesic potency, efficacy, and duration of action.Immune responses also differ between the sexes [21], which may contribute to sex differences in response to chronic inflammatory and neuropathic pain. The activity level of female rodents varies dramatically across the estrous cycle [24,74], which may introduce a confound on pain tests that allow subjects to locomote freely, such as the hot-plate test.…”

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confidence: 99%

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Studying sex and gender differences in pain and analgesia: A consensus report

Greenspan

Craft

LeResche

et al. 2007

Pain

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871

633

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In September 2006, members of the Sex, Gender and Pain Special Interest Group of the International Association for the Study of Pain met to discuss the following: (1) what is known about sex and gender differences in pain and analgesia; (2) what are the "best practice" guidelines for pain research with respect to sex and gender; and (3) what are the crucial questions to address in the near future? The resulting consensus presented herein includes input from basic science, clinical and psychosocial pain researchers, as well as from recognized experts in sexual differentiation and reproductive endocrinology. We intend this document to serve as a utilitarian and thought-provoking guide for future research on sex and gender differences in pain and analgesia, both for those currently working in this field as well as those still wondering, "Do I really need to study females?" Keywords Sex differences; Gonadal hormones; Estrogens The case for studying sex and gender differences in pain and analgesiaThe pain field has moved from debating whether sex differences in pain exist to recognizing the importance of these differences. Attention is now directed toward understanding (1) what conditions lead to the expression of sex and gender differences in pain experience and reactivity, (2) what mechanisms underlie these differences, and (3) how these differences can inform clinical management of pain.As noted in a recent review, at least 79% of animal studies published in Pain over the preceding 10 years included male subjects only, with a mere 8% of studies on females only, and another 4% explicitly designed to test for sex differences (the rest did not specify) [142]. Given the substantially greater prevalence of many clinical pain conditions in women vs. men [20,199], and growing evidence for sex differences in sensitivity to experimental pain and to analgesics [21,41,213], we recommend that all pain researchers consider testing their hypotheses in both sexes, or if restricted by practical considerations, only in females. It is invalid to assume that data obtained in male subjects will generalize to females, and the best non-human model of the modal human pain sufferer -a woman -is a female animal. If only males are examined in a given study, it is important that a rationale for exclusion of females be provided and that the potential limitation in generalizability of the findings be addressed in the discussion, particularly when examining a pain phenomenon that occurs with greater prevalence or severity in females. In both preclinical and clinical studies, a comparison of both sexes will further our understanding of individual differences in sensitivity to pain and analgesia, thus improving our ability to treat and prevent pain in all people. General considerationsTwo issues of terminology are important. First, the term "sex" refers to biologically based differences, while the term "gender" refers to socially based phenomena. Although biological sex exerts a major influence on one's gender identity, sex and gender a...

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“…For example, the distribution of body fat in women is higher than that in men, and thus such a difference may influence the effectiveness of analgesic medications and their metabolism in the body (21,22). Furthermore, differences in immune-related responses among men and women as one of the other factors could cause differences in their reactions to inflammations and nerve pains (23,24). Other differences can also be found in terms of hormones such as estrogen, progesterone, and androgen which regulate the nervous system and affect its activity (25,26).…”

Section: Discussionmentioning

confidence: 99%

Pain Management and Its Related Factors in the Emergency Department of Besat Hospital in Sanadaj, 2016

Movahedi¹,

Khanlarzadeh

Azizkhani³

et al. 2017

IMMINV

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Background: A feeling horrible pain and discomfort as a result of stimulation of nerve endings and in particular create one of the most common reasons patients visit emergency departments (EDs). Pain can cause physiological changes such as increased heart rate and breathing, will be hypertension. That if not controlled, various effects on the lives and the different body systems, including the cardiovascular system, respiratory, creates. The aim of medical science to achieve and maintain health and at the same time reduce the suffering and the suffering of the disease. Methods: This cross-sectional study was performed on patients who referring to the ED of the hospital of Sanandaj with complain of pain as one of their compliance. Before and after the injection analgesia pain intensity is evaluated by a 10-point scoring system. Also, patients with pain and final diagnosis come in the form of a pre-designed questionnaire. Data were analyzed by SPSS20 software. Results: The majority of people have been admitted to the emergency caused by trauma with 54.3% and 57% of men and 43% women. The mean time to get analgesia in these patients was 26.4 minutes. There was no significant correlation between pain intensity and pain relief with age. There was no significant relationship between pain and sex. Also, reduces pain and relief pain to get analgesia in the patient's admission was significant. Apotel was the most analgesia agent that used in the ED. Conclusion: The study of proper pain may be more appropriate interventions to control pain and improve the quality of life.

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Sex and gender differences in pain and inflammation: a rapidly maturing field

Cited by 76 publications

References 25 publications

Inflammation and sarcopenia: A systematic review and meta-analysis

Inflammation and sarcopenia: A systematic review and meta-analysis

Studying sex and gender differences in pain and analgesia: A consensus report

Pain Management and Its Related Factors in the Emergency Department of Besat Hospital in Sanadaj, 2016

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