BIH Excellence Award for Sex and Gender Aspects in Health Research 2017
In early December 2017, a jury of international experts selected two winners from the pool of internationally renowned applicants who stood out with their different research approaches.
Berlin Institute of Health awarded the 2017 BIH Excellence Award for Sex and Gender Aspects in Health Research to Louise Pilote (McGill University and from the Research Institute of the McGill University Health Centre (RI-MUHC) in Montreal, Canada) and Rhonda Voskuhl (University of California, USA). Both scientists strongly incorporate gender aspects into their biomedical research. The researchers will share the €20,000 award and will come to Berlin for guest stays at BIH.
The award ceremony took place on March 16, 2018 during the BIH Symposium 2018 in Berlin.
Louise Pilote | McGill University, Canada
Award Project: Enhancing sex and gender research in two German cohorts
Project Partners: Prof. Vera Regitz-Zagrosek (Charité), PD Dr. Ilja Demuth (Charité), Dr. Denis Gerstorf (Charité)
Louise Pilote is one of the few physicians to have specialized in social gender differences in cardiovascular research. To date, most research approaches have focused exclusively on biological sex differences, neglecting the impact of cultural gender roles. Pilote considers these criteria in her research, using a “gender score” she developed to investigate the possible effects of gender differences when it comes to medical issues such as cardiovascular diseases and to develop therapeutic approaches.
Louise Pilote holds a James McGill chair and is a Professor of Medicine at McGill University and a researcher at Research Institute of the McGill University Health Centre (RI-MUHC). She completed her medical degree and residency in internal medicine at McGill University. She completed an MPH at the Harvard School of Public Health and a PhD in epidemiology at the University of California at Berkeley. Dr. Pilote's interests include cardiovascular epidemiology, outcomes research and health services research. She has published several studies answering questions on the effectiveness of cardiovascular care. Her research focuses on women and vascular diseases through the lifespan. She applies health services, outcomes, clinical trials and comparative effectiveness methods to answer questions about sex differences in the safety and effectiveness of drugs and procedures.
The prize 2017 was an initial spark for a closer cooperation between Pilote and the Institute for Gender Research at Charité. They developed ideas on how to transfer the concepts from Canada to Europe, and from the original cardiovascular cohort to other medical fields. This resulted in the BMBF-funded project Gendage, which looked at gender differences in aging, GeSeMS, a project on gender differences in multiple sclerosis , together with Professor Stefan Gold in neurology at Charité, and a project on gender differences in frailty and tumors, which was supported by the DZHK. And of course, thoughts on sex and gender were brought into research at COVID.
Rhonda Voskuhl | University of California, USA
Award Project: Sex differences in neurodegeneration and resilience to complex human brain disorders
Project Partners: Prof. Dr. Stefan Gold (Charité) and Prof. Dr. Friedemann Paul (Charité)
The research conducted by neurologist Rhonda Voskuhl stands out through its strong translational focus or, in other words, its focus on transferring basic and clinical research into medical practice. Voskuhl investigates biological sex differences in chronic degenerative diseases such as multiple sclerosis. She researches molecular mechanisms in preclinical studies and uses the findings to develop gender-specific biomarkers for new approaches to treatment.
Rhonda Voskuhl attended Phillips University in Enid, Oklahoma, on full basketball and academic scholarships. She received her M.D. from Vanderbilt University and completed a neurology residency at the University of Texas Southwestern where she twice received the Texas Neurological Society Research Award. She did a five-year fellowship at the National Institutes of Health (NIH) focusing on multiple sclerosis and its animal model, where she received a Public Health Citation for Excellence in Research. Dr. Voskuhl joined UCLA as Assistant Professor of Neurology in 1995, was promoted to Associated Professor in 2000 and Professor in 2004, and has been the Director of the UCLA MS Program for over 20 years. She received the Jack H. Skirball Endowed Chair in Multiple Sclerosis Research in 2006. Dr. Voskuhl sees MS patients in her clinic, while her laboratory is focused on understanding the pathogenesis of multiple sclerosis (MS) through use of mouse models. She employs a “Bedside to Bench to Bedside” approach where research is based on clinical observations, molecular mechanisms are revealed, and lead findings are translated into novel clinical trials. A major clinical observation of focus is sex differences in disease. Dr. Voskuhl is a pioneer in sex differences research, examining effects of sex hormones and sex chromosomes in autoimmune and neurodegenerative diseases. This has included being the Principle Investigator on four clinical trials in MS, two of which were multicenter trials at several sites across the United States. Another clinical area of interest is the heterogeneity of disabilities in MS. This entails examining cell-specific and region-specific gene expression in the brain to discover disability-specific neuroprotective treatments as well as developing disability-specific biomarkers for use in clinical trials of novel treatments for neurodegenerative diseases. The Berlin Institute of Health Award in 2017 aligns with Dr. Voskuhl’s vision of developing neuroprotective treatments tailored for each disability in each sex.
The study of sex differences in disease reveals important clues into naturally occurring disease modifying factors. Understanding these sex differences and what causes them can lead to new treatment targets for novel therapies for each disease.
In multiple sclerosis for example, women are affected about three times more often than men. Voskuhls lab recently identified X chromosome effects that can lead to increased susceptibility to autoimmunity in women as compared to men. One paper (JCI) shows an effect of an X chromosome gene Kdm6a and the other paper (PNAS) shows a role of imprinting of X genes due to parental-of-origin effects, each on autoimmunity. These papers will be discussed in the context of each other and other sex chromosome effects during first symposium of this year’s annual meeting of the Organization for the Study of Sex Differences (OSSD Virtual 2021).
Also in multiple sclerosis, while women are more susceptible to developing disease, when men get MS, they demonstrate worse disability and worse brain atrophy.
A study was recently published as a collaboration between Charite (Friedemann Paul, Stefan Gold, Claudia Chien) and UCLA (Rhonda Voskuhl, Allan MacKenzie-Graham, Kevin Patel) which shows more atrophy of regional gray matter in MS men compared to healthy men versus that observed in MS women compared to healthy women.
A key aspect off this work was that since there are known sex differences in brain regions in healthy people. Previous studies compared brain region volumes in MS females versus MS males, so were confounded by known sex differences in volumes of brain regions during health. Instead our group removed this confound by comparing MS versus healthy within each sex to reveal the effect of disease on atrophy within each sex. This study was made possible by imaging data from Charite from both MS and healthy individuals.
This approach can now also be applied to other neurodegenerative diseases with a sex difference including Alzheimer’s disease and Parkinson’s disease.