Sex Differences in the Exocrine Pancreas and Associated DiseasesSummary
Differences in pancreatic anatomy, size, and function exist in men and women. The anatomical differences could contribute to the increase in complications associated with pancreatic surgery in women. Although diagnostic criteria for pancreatitis are the same in men and women, major sex differences i...
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| Format: | Article |
| Language: | English |
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Elsevier
2021-01-01
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| Series: | Cellular and Molecular Gastroenterology and Hepatology |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2352345X2100076X |
| _version_ | 1818891053302808576 |
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| author | Melinda Wang Fred Gorelick Aditi Bhargava |
| author_facet | Melinda Wang Fred Gorelick Aditi Bhargava |
| author_sort | Melinda Wang |
| collection | DOAJ |
| description | Differences in pancreatic anatomy, size, and function exist in men and women. The anatomical differences could contribute to the increase in complications associated with pancreatic surgery in women. Although diagnostic criteria for pancreatitis are the same in men and women, major sex differences in etiology are reported. Alcohol and tobacco predominate in men, whereas idiopathic and obstructive etiologies predominate in women. Circulating levels of estrogens, progesterone, and androgens contribute significantly to overall health outcomes; premenopausal women have lower prevalence of cardiovascular and pancreatic diseases suggesting protective effects of estrogens, whereas androgens promote growth of normal and cancerous cells. Sex chromosomes and gonadal and nongonadal hormones together determine an individual’s sex, which is distinct from gender or gender identity. Human pancreatic disease etiology, outcomes, and sex-specific mechanisms are largely unknown. In rodents of both sexes, glucocorticoids and estrogens from the adrenal glands influence pancreatic secretion and acinar cell zymogen granule numbers. Lack of corticotropin-releasing factor receptor 2 function, a G protein–coupled receptor whose expression is regulated by both estrogens and glucocorticoids, causes sex-specific changes in pancreatic histopathology, zymogen granule numbers, and endoplasmic reticulum ultrastructure changes in acute pancreatitis model. Here, we review existing literature on sex differences in the normal exocrine pancreas and mechanisms that operate at homeostasis and diseased states in both sexes. Finally, we review pregnancy-related pancreatic diseases and discuss the effects of sex differences on proposed treatments in pancreatic disease. |
| first_indexed | 2024-12-19T17:34:41Z |
| format | Article |
| id | doaj.art-b90d36ef707c495d9f35fb2ec2e974e2 |
| institution | Directory Open Access Journal |
| issn | 2352-345X |
| language | English |
| last_indexed | 2024-12-19T17:34:41Z |
| publishDate | 2021-01-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Cellular and Molecular Gastroenterology and Hepatology |
| spelling | doaj.art-b90d36ef707c495d9f35fb2ec2e974e22022-12-21T20:12:22ZengElsevierCellular and Molecular Gastroenterology and Hepatology2352-345X2021-01-01122427441Sex Differences in the Exocrine Pancreas and Associated DiseasesSummaryMelinda Wang0Fred Gorelick1Aditi Bhargava2Department of Internal Medicine, Yale University School of Medicine, New Haven, ConnecticutDepartment of Internal Medicine, Yale University School of Medicine, New Haven, Connecticut; Correspondence Address correspondence to: Fred Gorelick, MD, 950 Campbell Avenue, West Haven, Connecticut 06515. fax: (203) 937-3852.Center for Reproductive Sciences, Department of Obstetrics, Gynecology and the Reproductive Sciences, University of California, San Francisco, California; or Aditi Bhargava, PhD, 513 Parnassus Avenue, Room HSE1636, Box 0556, UCSF, San Francisco, California 94143.Differences in pancreatic anatomy, size, and function exist in men and women. The anatomical differences could contribute to the increase in complications associated with pancreatic surgery in women. Although diagnostic criteria for pancreatitis are the same in men and women, major sex differences in etiology are reported. Alcohol and tobacco predominate in men, whereas idiopathic and obstructive etiologies predominate in women. Circulating levels of estrogens, progesterone, and androgens contribute significantly to overall health outcomes; premenopausal women have lower prevalence of cardiovascular and pancreatic diseases suggesting protective effects of estrogens, whereas androgens promote growth of normal and cancerous cells. Sex chromosomes and gonadal and nongonadal hormones together determine an individual’s sex, which is distinct from gender or gender identity. Human pancreatic disease etiology, outcomes, and sex-specific mechanisms are largely unknown. In rodents of both sexes, glucocorticoids and estrogens from the adrenal glands influence pancreatic secretion and acinar cell zymogen granule numbers. Lack of corticotropin-releasing factor receptor 2 function, a G protein–coupled receptor whose expression is regulated by both estrogens and glucocorticoids, causes sex-specific changes in pancreatic histopathology, zymogen granule numbers, and endoplasmic reticulum ultrastructure changes in acute pancreatitis model. Here, we review existing literature on sex differences in the normal exocrine pancreas and mechanisms that operate at homeostasis and diseased states in both sexes. Finally, we review pregnancy-related pancreatic diseases and discuss the effects of sex differences on proposed treatments in pancreatic disease.http://www.sciencedirect.com/science/article/pii/S2352345X2100076XAdrenal SteroidsCorticotropin-Releasing Factor Receptor 2EstradiolExocrine PancreasSex DifferencesSex Hormones |
| spellingShingle | Melinda Wang Fred Gorelick Aditi Bhargava Sex Differences in the Exocrine Pancreas and Associated DiseasesSummary Cellular and Molecular Gastroenterology and Hepatology Adrenal Steroids Corticotropin-Releasing Factor Receptor 2 Estradiol Exocrine Pancreas Sex Differences Sex Hormones |
| title | Sex Differences in the Exocrine Pancreas and Associated DiseasesSummary |
| title_full | Sex Differences in the Exocrine Pancreas and Associated DiseasesSummary |
| title_fullStr | Sex Differences in the Exocrine Pancreas and Associated DiseasesSummary |
| title_full_unstemmed | Sex Differences in the Exocrine Pancreas and Associated DiseasesSummary |
| title_short | Sex Differences in the Exocrine Pancreas and Associated DiseasesSummary |
| title_sort | sex differences in the exocrine pancreas and associated diseasessummary |
| topic | Adrenal Steroids Corticotropin-Releasing Factor Receptor 2 Estradiol Exocrine Pancreas Sex Differences Sex Hormones |
| url | http://www.sciencedirect.com/science/article/pii/S2352345X2100076X |
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