{"id":54227,"date":"2010-12-27T21:54:21","date_gmt":"2010-12-27T20:54:21","guid":{"rendered":"https:\/\/laindependent.cat\/farmacologia-de-genere\/"},"modified":"2010-12-27T21:54:21","modified_gmt":"2010-12-27T20:54:21","slug":"farmacologia-de-genere","status":"publish","type":"post","link":"https:\/\/laindependent.cat\/en\/farmacologia-de-genere\/","title":{"rendered":"Farmacologia de g\u00e8nere"},"content":{"rendered":"<p style=\"text-align: left;\"><strong><span style=\"font-size: 10pt; font-family: trebuchet ms,geneva;\">Les reaccions adverses als f\u00e0rmacs apareixen m\u00e9s vegades en dones que en homes<\/span><\/strong><\/p>\n<p style=\"text-align: left;\"><span style=\"font-size: 10pt; font-family: trebuchet ms,geneva;\">\u201cEls homes i les dones, malgrat que estiguin subjectes a les mateixes patologies, presenten s\u00edmptomes, progressi\u00f3 de les malalties i respostes als tractaments molt diferents entre elles\u201d, subratlla la introducci\u00f3 de <i>Farmacologia de g\u00e8nere<\/i> (SEEd, 2010)<i>, <\/i>el primer llibre d\u2019aquest tipus publicat a nivell mundial sobre el tema. Una de les seves autores (conjuntament amb Simona Montilla i Stefano Vella) \u00e9s Flavia Franconi, de la Universitat de Sassari, la fundadora del Grup de Farmacologia de G\u00e8nere de la Societat Italiana de Farmacologia i la coordinadora del primer posgrau de farmacologia de g\u00e8nere d\u2019Europa. <\/span><\/p>\n<p style=\"text-align: left;\">\u00a0<\/p>\n<p style=\"text-align: left;\"><span style=\"font-size: 10pt; font-family: trebuchet ms,geneva;\"><\/span><\/p>\n<p style=\"text-align: left;\"><span style=\"font-size: 10pt; font-family: trebuchet ms,geneva;\"><br \/><\/span><\/p>\n<p style=\"text-align: center;\">\u00a0<\/p>\n<p><!--more--><\/p>\n<p>\u00a0<\/p>\n<p style=\"text-align: left;\"><span style=\"font-size: 10pt; font-family: trebuchet ms,geneva;\">El llibre, que es va publicar aquesta tardor, t\u00e9 l\u2019objectiu de \u201cposar de manifest les problem\u00e0tiques m\u00e9s importants relatives a la Farmacologia de G\u00e8nere mitjan\u00e7ant el tractament dels aspectes farmacocin\u00e8tics (relatius al recorregut d\u2019un f\u00e0rmac per l\u2019organisme per arribar al seu lloc d\u2019acci\u00f3 i per ser eliminat) i farmacodin\u00e0mics (resposta del cos al f\u00e0rmac), que condicionen l\u2019acci\u00f3 dels f\u00e0rmacs, aix\u00ed com la rellev\u00e0ncia del g\u00e8nere com a factor de risc per a les reaccions adverses.<\/span><\/p>\n<p style=\"text-align: left;\"><span style=\"font-size: 10pt; font-family: trebuchet ms,geneva;\">La primera vegada que es va comen\u00e7ar a parlar de Medicina de G\u00e8nere va ser a finals del segle passat, quan Bernardine Healy, la primera dona en liderar el nord-americ\u00e0 National Institute of Health (NIH) va publicar al <i>New England Journal of Medicine <\/i>l\u2019estudi \u201cThe Yentl syndrome\u201d, on assenyala que a les dones no se\u2019ls d\u00f3na el mateix tractament per a les malalties card\u00edaques que als homes. Encara avui, segons estudis recents com el del neurocient\u00edfic comportamental de la Universitat de Berkeley, Irving Zucker, i de la investigadora Annaliese Beery sobre els resultat de 2.000 estudis sobre animals mam\u00edfers, publicats a la premsa especialitzada, en 8 de 10 disciplines biol\u00f2giques existeix un biaix mascul\u00ed, m\u00e9s pronunciat a les neuroci\u00e8ncies (5.5 mascles per a 1 femella), farmacologia (5 mascles per a 1 femella) i fisiologia (3.7 mascles per a 1 femella). \u201cTot i que vam identificar un biaix femen\u00ed en estudis sobre reproducci\u00f3 i en alguns reports immunol\u00f2gics que indicaven el sexe dels animals\u201d, afirmen els investigadors, \u201cel 75% dels estudis en tres prestigioses revistes d\u2019immunologia no especificaven si els animals utilitzats eren mascles o femelles\u201d. La ra\u00f3 d\u2019aquesta falta d\u2019animals femelles a la investigaci\u00f3 b\u00e0sica dep\u00e8n, en gran part, dels costos que significa fer servir uns animals que tenen, com els rosegadors \u2013els models utilitzats per a moltes malalties- un cicle d\u2019ovulaci\u00f3 de 4 dies i que per ser analitzats amb efic\u00e0cia han de ser molt m\u00e9s nombrosos que els mascles. No obstant aix\u00f2, avui sabem que, juntament amb els cromosomes i l\u2019epigen\u00e8tica (influ\u00e8ncia de l\u2019ambient sobre els gens), els efectes de les hormones en l\u2019expressi\u00f3 dels gens s\u00f3n les principals raons de les difer\u00e8ncies entre els g\u00e8neres en la manifestaci\u00f3 dels s\u00edmptomes, en la progressi\u00f3 de les malalties i en les respostes als tractaments, i que les malalties cardiovasculars, l\u2019obesitat, el carcinoma de pulm\u00f3, l\u2019osteoporosi, les malalties infeccioses, els disturbis de l\u2019humor i del sistema immunitari s\u00f3n les \u00e0rees on es manifesten les majors difer\u00e8ncies entre els g\u00e8neres.<\/span><\/p>\n<p style=\"text-align: left;\">\u00a0<\/p>\n<p style=\"text-align: left;\"><span style=\"font-size: 10pt; font-family: trebuchet ms,geneva;\">Tot i aix\u00f2, a la investigaci\u00f3 cl\u00ednica el percentatge de dones tampoc \u00e9s molt m\u00e9s alt. Una an\u00e0lisi d\u2019estudis cl\u00ednics publicats el 2004 en nou revistes m\u00e8diques de prestigi van trobar que nom\u00e9s el 37% dels participants eren dones (24% quan restringit a les proves dels f\u00e0rmacs) i nom\u00e9s el 13% dels estudis analitzaven les dades per sexe, i la majoria d\u2019elles eren nom\u00e9s dones al voltant dels 40 anys.<\/span><\/p>\n<p style=\"text-align: left;\">\u00a0<\/p>\n<p style=\"text-align: left;\"><span style=\"font-size: 10pt; font-family: trebuchet ms,geneva;\">\u201cL\u2019estereotip que permet la discriminaci\u00f3 de sexe i de g\u00e8nere a la investigaci\u00f3 biom\u00e8dica \u00e9s que som tots i totes mascles cauc\u00e0sics d\u20191,75 metres i de 70 quilos\u201d, diu Franconi. \u201cAra que sabem que la \u2018variabilitat femenina\u2019 no nom\u00e9s dep\u00e8n de les variacions hormonals fisiol\u00f2giques que es manifesten en funci\u00f3 de l\u2019edat, cicle menstrual, embar\u00e0s i puerperi, sin\u00f3 tamb\u00e9 de les relacionades a l\u2019\u00fas de les associacions estroprogest\u00edniques \u2013contraceptius i ter\u00e0pia hormonal substitutiva en postmenopausa- tamb\u00e9 gr\u00e0cies a una \u2018lent de g\u00e8nere\u2019 podr\u00edem i haur\u00edem de preveure, valorar i possiblement mesurar els diversos impactes dels determinant socioecon\u00f2mics i culturals sobre les dones i els homes a la salut\u201d.<\/span><\/p>\n<p style=\"text-align: left;\">\u00a0<\/p>\n<p style=\"text-align: left;\"><span style=\"font-size: 10pt; font-family: trebuchet ms,geneva;\">El cam\u00ed esta signat, per\u00f2 en pujada. De moment no existeix cap directriu <i>(guideline)<\/i> sobre investigaci\u00f3 b\u00e0sica que tingui en compte les difer\u00e8ncies de sexe ni als Estats Units d\u2019Am\u00e8rica ni a Europa, mentre que a la investigaci\u00f3 cl\u00ednica nom\u00e9s existeix als Estats Units d\u2019Am\u00e8rica, per\u00f2 no a Europa. A m\u00e9s, \u201cno \u00e9s nom\u00e9s el fet que s\u2019utilitzin animals femelles\u201d, assenyala Franconi. \u201cTamb\u00e9 hem de trobar els models animals adequats per a cada malaltia. Per a la trombosi, la diabetis de tipus 2 i la isqu\u00e8mia del cor, per exemple, estem fent servir al voltant de 30 models de rates femelles, de les quals nom\u00e9s un es posa malalt, per\u00f2 les dones moren molt m\u00e9s dels homes per elles\u201d.<\/span><\/p>\n<p style=\"text-align: left;\">\u00a0<\/p>\n<p style=\"text-align: left;\"><span style=\"font-size: 10pt; font-family: trebuchet ms,geneva;\">Les dones viuen de mitjana m\u00e9s anys que als homes, per\u00f2 es posen malaltes m\u00e9s sovint i tenen un major nombre d\u2019anys de salut dolenta.<\/span><\/p>\n<p style=\"text-align: left;\">\u00a0<\/p>\n<p style=\"text-align: left;\"><span style=\"font-size: 10pt; font-family: trebuchet ms,geneva;\">Un estudi de 2005 de 300 aplicacions de nous f\u00e0rmacs entre 1995 i 2000 va trobar que fins i tot aquells f\u00e0rmacs que mostraven difer\u00e8ncies substancials en com eren absorbits, metabolitzats i expulsats per homes i dones no tenien recomanacions de dosatge espec\u00edfic, segons el sexe en les seves etiquetes. Aquesta pot ser part de la ra\u00f3 per a la qual a les dones les reaccions adverses als f\u00e0rmacs apareixen 1.7 vegades m\u00e9s que als homes. \u201cLes raons d\u2019aquestes desigualtats de g\u00e8nere i el conseq\u00fcent impacte cl\u00ednic no s\u00f3n encara b\u00e9 enteses per\u00f2 s\u00f3n sense dubte degudes a difer\u00e8ncies morfol\u00f2giques, bioqu\u00edmiques i fisiol\u00f2giques entre homes i dones (dimensi\u00f3, aigua corporal, flux sanguini, massa muscular, funcions dels \u00f2rgans, cicle menstrual, embar\u00e0s i menopausa)\u201d, apunta Franconi al llibre. \u201cUna primera hip\u00f2tesi per la major ocurr\u00e8ncia de reaccions adverses a les dones t\u00e9 a veure amb la seva exposici\u00f3 m\u00e9s consistent als f\u00e0rmacs, dels quals s\u00f3n major consumidores, i a la freq\u00fcent politer\u00e0pia, que augmenta el risc d\u2019interacci\u00f3 entre els f\u00e0rmacs, aix\u00ed com entre f\u00e0rmacs i remeis bot\u00e0nics i entre f\u00e0rmacs i menjar. Finalment, la manca de representaci\u00f3 de les dones a l\u2019experimentaci\u00f3 cl\u00ednica dels f\u00e0rmacs i la car\u00e8ncia de l\u2019an\u00e0lisi de g\u00e8nere han portat a qu\u00e8 les difer\u00e8ncies farmacocin\u00e8tiques i farmacodin\u00e0miques no s\u2019hagin indagat suficientment i que, en nombrosos casos, els perfils de seguretat a la dona s\u2019hagin evidenciat nom\u00e9s despr\u00e9s de la comercialitzaci\u00f3 del f\u00e0rmac\u201d. La seguretat dels tractaments farmacol\u00f2gics en funci\u00f3 del g\u00e8nere \u00e9s, sense dubte, l\u2019\u00e0mbit al que la Farmacologia de g\u00e8nere concentra avui la majoria dels seus esfor\u00e7os, juntament amb la recerca d\u2019entesa i recolzament per part de la ind\u00fastria farmac\u00e8utica. L\u2019Agenas (Ag\u00e8ncia Italiana del F\u00e0rmac) acaba d\u2019ajuntar un grup d\u2019investigadores i investigadors al que pertany tamb\u00e9 Franconi, que escriur\u00e0 les primeres directrius sobre la recerca cl\u00ednica a nivell europeu que tinguin en compte la perspectiva de g\u00e8nere a la salut de tots i totes.<\/span>\u00a0<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Les reaccions adverses als f\u00e0rmacs apareixen m\u00e9s vegades en dones que en homes \u201cEls homes i les dones, malgrat que estiguin subjectes a les mateixes patologies, presenten s\u00edmptomes, progressi\u00f3 de les malalties i respostes als tractaments molt diferents entre elles\u201d, [&hellip;]<\/p>\n","protected":false},"author":77,"featured_media":26318,"comment_status":"open","ping_status":"","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[26563],"tags":[],"class_list":["post-54227","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-estudis"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v28.5 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>Farmacologia de g\u00e8nere | La Independent<\/title>\n<meta name=\"description\" content=\"Les reaccions adverses als f\u00e0rmacs apareixen m\u00e9s vegades en dones que en homes \u201cEls homes i les dones, malgrat que estiguin subjectes a les mateixes\" \/>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/laindependent.cat\/en\/farmacologia-de-genere\/\" \/>\n<meta property=\"og:locale\" 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