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      Bridging the Gap” Everything that Could Have Been Avoided If We Had Applied Gender Medicine, Pharmacogenetics and Personalized Medicine in the Gender-Omics and Sex-Omics Era

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          Abstract

          Gender medicine is the first step of personalized medicine and patient-centred care, an essential development to achieve the standard goal of a holistic approach to patients and diseases. By addressing the interrelation and integration of biological markers (i.e., sex) with indicators of psychological/cultural behaviour (i.e., gender), gender medicine represents the crucial assumption for achieving the personalized health-care required in the third millennium. However, ‘sex’ and ‘gender’ are often misused as synonyms, leading to frequent misunderstandings in those who are not deeply involved in the field. Overall, we have to face the evidence that biological, genetic, epigenetic, psycho-social, cultural, and environmental factors mutually interact in defining sex/gender differences, and at the same time in establishing potential unwanted sex/gender disparities. Prioritizing the role of sex/gender in physiological and pathological processes is crucial in terms of efficient prevention, clinical signs’ identification, prognosis definition, and therapy optimization. In this regard, the omics-approach has become a powerful tool to identify sex/gender-specific disease markers, with potential benefits also in terms of socio-psychological wellbeing for each individual, and cost-effectiveness for National Healthcare systems. “ Being a male or being a female” is indeed important from a health point of view and it is no longer possible to avoid “ sex and gender lens” when approaching patients. Accordingly, personalized healthcare must be based on evidence from targeted research studies aimed at understanding how sex and gender influence health across the entire life span. The rapid development of genetic tools in the molecular medicine approaches and their impact in healthcare is an example of highly specialized applications that have moved from specialists to primary care providers (e.g., pharmacogenetic and pharmacogenomic applications in routine medical practice). Gender medicine needs to follow the same path and become an established medical approach. To face the genetic, molecular and pharmacological bases of the existing sex/gender gap by means of omics approaches will pave the way to the discovery and identification of novel drug-targets/therapeutic protocols, personalized laboratory tests and diagnostic procedures (sex/gender-omics). In this scenario, the aim of the present review is not to simply resume the state-of-the-art in the field, rather an opportunity to gain insights into gender medicine, spanning from molecular up to social and psychological stances. The description and critical discussion of some key selected multidisciplinary topics considered as paradigmatic of sex/gender differences and sex/gender inequalities will allow to draft and design strategies useful to fill the existing gap and move forward.

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                Author and article information

                Journal
                Int J Mol Sci
                Int J Mol Sci
                ijms
                International Journal of Molecular Sciences
                MDPI
                1422-0067
                31 December 2019
                January 2020
                : 21
                : 1
                : 296
                Affiliations
                [1 ]Department of Biomedical & Specialty Surgical Sciences, and Centre Haemostasis & Thrombosis, University of Ferrara, 44121 Ferrara, Italy
                [2 ]University Center for Studies on Gender Medicine, University of Ferrara, 44121 Ferrara, Italy; katia.varani@ 123456unife.it (K.V.); barbara.bramanti@ 123456unife.it (B.B.); roberta.piva@ 123456unife.it (R.P.); gloria.bonaccorsi@ 123456unife.it (G.B.); alessandra.care@ 123456iss.it (A.C.); tiziana.bellini@ 123456unife.it (T.B.)
                [3 ]Department of Medical Sciences, University of Ferrara, 44121 Ferrara, Italy
                [4 ]Department of Biomedical & Specialty Surgical Sciences, University of Ferrara, 44121 Ferrara, Italy; alessandro.trentini@ 123456unife.it (A.T.); mmc@ 123456unife.it (M.C.M.)
                [5 ]Department of Morphology, Surgery and Experimental Medicine, and Menopause and Osteoporosis Centre, University of Ferrara, 44124 Ferrara, Italy
                [6 ]Department of Morphology, Surgery and Experimental Medicine, and LTTA Centre, University of Ferrara, 44121 Ferrara, Italy; veronica.tisato@ 123456unife.it
                [7 ]Center for Gender-specific Medicine, Istituto Superiore di Sanita’ (I.S.S.), 00161 Rome, Italy
                Author notes
                [* ]Correspondence: d.gemmati@ 123456unife.it ; Tel.: +39-0532-455-841
                Author information
                https://orcid.org/0000-0001-6213-6120
                https://orcid.org/0000-0002-5433-663X
                https://orcid.org/0000-0001-5005-0274
                https://orcid.org/0000-0003-3579-7921
                https://orcid.org/0000-0001-8448-066X
                https://orcid.org/0000-0003-4106-3342
                Article
                ijms-21-00296
                10.3390/ijms21010296
                6982247
                31906252
                7c115705-4747-42df-bece-e8b8859b819b
                © 2019 by the authors.

                Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license ( http://creativecommons.org/licenses/by/4.0/).

                History
                : 06 November 2019
                : 30 December 2019
                Categories
                Review

                Molecular biology
                gender medicine,sex disparities,genetics/molecular biomarkers,complex diseases,pharmacogenetics,personalized medicine,tailored drug therapy,omics,sexomics and genderomics

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