Gene editing and gender-specific medicine: a challenge for dementia research

Abstract

AbstractGender-specific medicine is a clinical discipline that studies the impact of sex and gender on physiology, pathophysiology, and diseases. Human genome modification of somatic cells could be useful for treating or preventing a range of diseases and for improving the safety and efficiency of existing gene therapy techniques currently in use or under development for clinical application. Sex and gender differences have been analysed in the incidence and prevalence of dementia. In fact, epidemiological studies have demonstrated that women are at a higher risk than men for developing dementia or Alzheimer’s disease (AD); however, the reasons for these differences are not completely known, and the debate is still underway. In recent years, in the effort to clarify the risk of developing dementia or AD, increasing attention has been devoted to the differences between men and women in the causes and manifestations of neurological diseases, as well as to their response to treatment and to outcomes. Through a conceptual analysis we will argue that an emphasis on gender-specific medicine in gene-editing research can contribute to the progress of medicine by introducing a relevant value-driven perspective on health and diseases. This is something we will do on the basis of a gender-specific strategy. In fact, focusing on the effect of sex on dementias and in particular AD may be essential in advancing our understanding, treatment and prevention of these disorders, considering that AD and other dementias disproportionately affect women, and it underlined the relevance of empirical data relating to sex differences and emerging sex-specific findings in dementias in order to assess the scientific approach to these diseases for the improvement of quality of life for both women and men. It may be helpful and suitable to consider how the interventions that modify the genome should include sex and gender as a crucially important variable accounting for the differences between men and women in the causes and manifestations of diseases, as well as in the response to treatment and to outcomes. Of course, gene editing cannot remove biological differences, but its potential harmful effects, on one group relative to another, can be prevented with a research strategy that properly takes them into account with a view to equity between genders.