This Article Full Text Full Text (PDF) All Versions of this Article: 36/2/193    most recent 01.STR.0000153064.41332.f6v1 Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Hurn, P. D. Articles by Hagberg, H. Search for Related Content PubMed PubMed Citation Articles by Hurn, P. D. Articles by Hagberg, H. Related Collections Acute coronary syndromes

(Stroke. 2005;36:193.)
© 2005 American Heart Association, Inc.

Advances in Stroke 2004

Adult or Perinatal Brain Injury

Does Sex Matter?

From Anesthesiology and Perioperative Medicine (P.D.H.), Oregon Health Sciences University, Portland, Ore; the Department of Pediatrics (S.J.V.), Columbia Presbyterian University, New York, NY; and the Perinatal Center (H.H.), Sahlgrenska University Hospital, Goteborg, Sweden.

Correspondence to Dr Patricia D. Hurn, Professor and Vice Chairman for Research, Anesthesiology and Perioperative Medicine, Oregon Health Sciences University, 3181 SW Sam Jackson Pk Rd, UHS-2, Portland OR 97239-3098. E-mail hurnp@ohsu.edu

Key Words: Advances in Stroke • hypoxia-ischemia, brain • ischemia • poly (ADP-ribose) polymerase • sex

An extract of the first 250 words of the full text is provided, because this article has no abstract.

	Introduction

 
Biological sex and sex-defining steroids are strikingly under-rated as modulators of cerebral ischemic cell death. In adults, male sex has been long identified as a risk factor for clinical stroke, yet the biology behind this fact remains veiled. We know that overall stroke incidence is lower in women than in men, across widely varying ethnic and cultural backgrounds.¹ Newer glimpses into this sexual dimorphism indicate that women continue to sustain lower stroke rates until beyond the menopausal years, suggesting that hormonal factors are not solely responsible. For example, stroke rates in female subjects of the Northern Manhattan Stroke Study did not exceed those of men until aged 85 years.² Importantly, data from sex-stratified preclinical studies indicate that stroke sensitivity (the damage resulting when an ischemic insult occurs) is also sexually dimorphic in adults. It is less clear if ischemic injury in the developing brain develops differently in males and females. However, provocative new evidence from cells cultured directly from fetal or newborn brain suggests that mechanisms of cell death are not identical in cells that are genetically male (XY) versus female (XX). This article evaluates linkages between sex, sex steroids, and neuroprotection throughout life.

	Adult Brain Injury Is Sexually Dimorphic

 
The presence of a male "ischemia-sensitive" phenotype has been suggested in a wide variety of animal studies. One of the most impressive early studies included >2000 animals.³ Yamori et al showed that life expectancy was longer in female spontaneously hypertensive stroke-prone rats, and the development of cerebral hemorrhage and vascular lesions was attenuated relative to male . . . [Full Text of this Article]

This article has been cited by other articles:

				A. M. Kaindl, G. Favrais, and P. Gressens Molecular Mechanisms Involved in Injury to the Preterm Brain J Child Neurol, September 1, 2009; 24(9): 1112 - 1118. [Abstract] [PDF]

				Q. Xue and L. Zhang Prenatal Hypoxia Causes a Sex-Dependent Increase in Heart Susceptibility to Ischemia and Reperfusion Injury in Adult Male Offspring: Role of Protein Kinase C{epsilon} J. Pharmacol. Exp. Ther., August 1, 2009; 330(2): 624 - 632. [Abstract] [Full Text] [PDF]

				M. Fisher, G. Feuerstein, D. W. Howells, P. D. Hurn, T. A. Kent, S. I. Savitz, E. H. Lo, and for the STAIR Group Update of the Stroke Therapy Academic Industry Roundtable Preclinical Recommendations Stroke, June 1, 2009; 40(6): 2244 - 2250. [Abstract] [Full Text] [PDF]

				H. Zhang, K. D. Meyer, and L. Zhang Fetal Exposure to Cocaine Causes Programming of Prkce Gene Repression in the Left Ventricle of Adult Rat Offspring Biol Reprod, March 1, 2009; 80(3): 440 - 448. [Abstract] [Full Text] [PDF]

				X. Wang, Y. Carlsson, E. Basso, C. Zhu, C. I. Rousset, A. Rasola, B. R. Johansson, K. Blomgren, C. Mallard, P. Bernardi, et al. Developmental Shift of Cyclophilin D Contribution to Hypoxic-Ischemic Brain Injury J. Neurosci., February 25, 2009; 29(8): 2588 - 2596. [Abstract] [Full Text] [PDF]

				S. Renolleau, S. Fau, and C. Charriaut-Marlangue Gender-Related Differences in Apoptotic Pathways After Neonatal Cerebral Ischemia Neuroscientist, February 1, 2008; 14(1): 46 - 52. [Abstract] [PDF]

				I. S. Balan, G. Fiskum, J. Hazelton, C. Cotto-Cumba, and R. E. Rosenthal Oximetry-Guided Reoxygenation Improves Neurological Outcome After Experimental Cardiac Arrest Stroke, December 1, 2006; 37(12): 3008 - 3013. [Abstract] [Full Text] [PDF]