Responsible: Dr. Alessandra Carè
phone: (+39) 06 4990 2411
mail: alessandra.care@iss.it
Center activities
Gender medicine (GM) or, better, gender-specific medicine deals with the biological differences between the two sexes as well as the gender differences related to socio-economic and cultural conditions and their influence on the state of health and disease, representing a fundamental point of interest for the National Health Service (SSN). Differences between men and women, in fact, are observed both in the frequency and in the symptomatology and severity of numerous diseases, in the response to therapies and adverse reactions to drugs. In addition, differences are related in nutritional needs and in the responses to nutrients and chemicals present in the environment as well as in lifestyles, exposure to toxicants and access to treatment. A gender approach in clinical practice allows promoting the appropriateness and personalization of care by generating a virtuous circle with consequent savings for the National Health Service. International agencies and institutions, such as Food and Drug Administration (FDA), World Health Organization (WHO) and United Nations (UN), promoted this new approach toward medicine suggesting the adoption of policies aimed at developing new preventive, diagnostic, prognostic and therapeutic health strategies, taking into account the differences between men and women. Biological and clinical terms, but also cultural and socio-psychological aspects should be considered.
With the approval of the law 3/2018 “Delegation to the Government concerning clinical trials of medicinal products and provisions for the reorganization of the health professions and for the healthcare officials of the Ministry of Health”, published in the Official Gazette of 31-01-2018, for the first time in Europe, the insertion of "gender" is guaranteed in all medical specialties, in clinical trials (in art.1) and in the definition of diagnostic-therapeutic paths, in research, training and dissemination to all health professionals and citizens (in art.3). According to the healthcare plan, signed by the Ministry of Health in June 2019, the Italian National Institute of Health (ISS), and in particular the reference Center for Gender-specific medicine, together with the Ministry of Health, will be involved in monitoring actions and results obtained through the establishment of a national Observatory. The ISS, together with the other bodies supervised by the Ministry of Health, will act as guarantor of the reliability and appropriateness of the data collected, which will be reported annually by the Minister of Health to the Chambers.
Considering the indicated points, the reference Center for Gender medicine has these main objectives:
- developing educational and common activities dedicated to the diffusion of this innovative aspect of medicine
- developing a network of Italian centers that deal with GM and expansion of the same at a European level
- promoting research to identify the pathophysiological bases responsible for the observed gender differences
Organization of the center
The structure comprises two Sections: Gender-specific pathophysiology and Gender prevention and health that carry out institutional, research and educational as well as training activities within the GM.
Gender-specific pathophysiology section
Director: Dr. Elena Ortona
phone: (+39) 06 4990 2573
mail: elena.ortona@iss.it
Gender-specific pathophysiology represents a central aspect of gender medicine to be included in the new vision of a personalized medicine. The identification of the socio-cultural and biological mechanisms underlying the gender and sex related differences in pathophysiology represents a fundamental step to the development of more accurate and rapid diagnosis and more efficient sex-specific therapies with lower toxic effects.
The area includes about 26 staff units between researchers and technicians. The activities range from the identification of gender-specific biomarkers, to the study of the mechanisms underlying sex differences in cardiovascular, autoimmune, infectious diseases, and in tumors, as well as response to treatments and vaccines. The various research projects will benefit from the coordinated and complementary work of the different research units belonging to the Center and from the collaboration with some ISS units external to the Center, but already involved in gender medicine studies.
Gender Prevention and Health Section
Director: Dr. Roberta Masella
phone: (+39) 06 4990 2544
mail: roberta.masella@iss.it
The biological differences linked to sex determine different nutritional needs and different metabolic responses to nutrients and exogenous substances taken with food; at the same time, the socio-economic and cultural conditions, which define gender, influence the person's lifestyle, the exposure to environmental risk factors and the possibility of accessing to health care.
The Gender Prevention and Health Section includes 30 staff units, researchers and technicians, with proven experience in scientific and biomedical fields. These diversified and complementary skills allow basic and translational research to be carried out on nutritional and toxicological aspects, as well as communication, dissemination and training activities aimed at promoting healthy lifestyles and overcoming gender differences in the access to health care.
This Section studies the influences of gender and sex on the reciprocal interactions between nutrients and genes capable of modulating gene expression, intracellular signaling pathways and, consequently, tissue and organ functions. In particular, the relationships between diet, adipose tissue functionality and development of obesity, chronic-degenerative and immune-mediated diseases are studied.
Furthermore, the Section studies the effects of different diets on clinical, metabolic and inflammatory markers, both in plasma and in tissues, with the ultimate goal of expanding knowledge on molecular nutrition and defining diversified dietary interventions for women and men, in accordance with the principles of personalized medicine.
Finally, in the toxicological field, experimental models in vitro and in vivo study the mechanisms of action of chemicals and their interaction with genes, as well as the association between exposure and pathologies.
