Sexes don’t feel pain same way + Woman has novel gene mutation lives almost pain free

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Why the sexes don’t feel pain the same way
https://www.nature.com/articles/d41586-019-00895-3

EXCERPT: . . . Today, inspired in part by Robert Sorge and Jeffrey Mogil’s work and spurred on by funders, pain researchers are opening their eyes to the spectrum of responses across sexes. Results are starting to trickle out, and it’s clear that certain pain pathways vary considerably, with immune cells and hormones having key roles in differing responses. [...] The discoveries in pain research are among the most exciting to emerge, says Cara Tannenbaum, scientific director ... in Montreal ... And of Sorge and Mogil’s work, she adds, “To my knowledge, no other field of science has identified this type of sex difference.”

[...] Today, the pharmaceutical market offers the same pain drugs to everyone. But if the roots of pain are different, some drugs might work better in some people than in others. Moreover, people might require different pain medications when hormone levels fluctuate through life. And a person’s sex doesn’t always fit clearly into the categories of male and female: it is determined by a spectrum of characteristics, including genetics, anatomical development and hormone levels, each of which might affect a person’s needs in pain therapy. The picture is a long way from complete, and studies — most in rodents — have so far focused on biological sex, as opposed to gender, a psychosocial concept that doesn’t necessarily match sex.

[...] Iain Chessel, vice-president and head of neuroscience at AstraZeneca in Cambridge, UK, predicts that future pain medications will be tailored to individuals — and that sex will be a key factor in those personalized prescriptions. “But we don’t understand it yet,” he adds. [...] many drug trials [...] usually include men and women, but the numbers of each often aren’t high enough to suss out differences. There’s a real possibility that pain drugs that failed clinical trials in the past might have succeeded if they had been tested separately by sex, says [neuropharmacologist Ted] Price. “It seems really obvious,” he adds, “but nobody was really doing it.”

Chessel, at AstraZeneca, would be happy to develop a pain drug that works only in people of a certain sex. But the sex of study participants and animal subjects is driven by practicality, ethical concerns and government regulations, he says. AstraZeneca uses female rodents in most of its preclinical pain research because they’re less aggressive and easier to house and handle than males. In early clinical trials, safety is the focus, so companies often exclude people who could become pregnant. As a result, drugs are mostly trialled on men and on women who are past menopause.

Even if scientists develop drugs that are targeted to male- or female-specific pain pathways, these might not be enough. It might be best to customize drugs more closely, to take into account the spectrum of genetics, hormone levels and anatomical development. [...] Little research has been done on pain mechanisms in people who don’t fit into a binary definition of sex and gender. In one study, researchers in Italy surveyed transgender people undergoing hormone treatment. They found that 11 out of 47 people who transitioned from male to female reported pain issues that arose after the transition... (MORE - details)



Woman with novel gene mutation lives almost pain-free
https://www.ucl.ac.uk/news/2019/mar/woma...-pain-free

EXCERPT: A woman in Scotland can feel virtually no pain due to a mutation in a previously-unidentified gene, according to a research paper co-led by UCL. She also experiences very little anxiety and fear, and may have enhanced wound healing due to the mutation, which the researchers say could help guide new treatments for a range of conditions, they report in the British Journal of Anaesthesia. [...] The researchers say that it’s possible there are more people with the same mutation, given that this woman was unaware of her condition until her 60s. “People with rare insensitivity to pain can be valuable to medical research as we learn how their genetic mutations impact how they experience pain, so we would encourage anyone who does not experience pain to come forward,” said Dr Cox. The research team is continuing to work with the woman in Scotland, and are conducting further tests in cell samples, in order to better understand the novel pseudogene... (MORE - details)
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