回顧發(fā)現(xiàn)：在疼痛研究中存在男性偏見

Review finds persistent male bias in pain research

回顧發(fā)現(xiàn)：在疼痛研究中存在男性偏見

It is increasingly clear that male and female humans and rodents process pain in different ways. And that there are important differences in the underlying mechanisms involved at genetic, molecular, cellular, and physiological levels. Despite this fact, according to a review paper from McGill University published today in Nature Reviews Neuroscience, most pain research remains overwhelmingly based on the study of male rodents, continuing to test hypotheses derived from earlier experiments on males. This points to an important blind spot in pain research, particularly as it relates to advancing research into new pain medications. This is especially troublesome given that it is well-documented that most chronic pain sufferers are female.

越來越明顯的是，男性和女性以及嚙齒動物處理疼痛的方式不同。在遺傳、分子、細(xì)胞和生理水平上的潛在機(jī)制存在重大差異。盡管如此，根據(jù)麥吉爾大學(xué)今天在《自然評論神經(jīng)科學(xué)》上發(fā)表的一篇綜述論文，大多數(shù)關(guān)于疼痛的研究仍然絕大多數(shù)基于對雄性嚙齒動物的研究，繼續(xù)測試來自早期男性實(shí)驗(yàn)的假設(shè)。這指出了疼痛研究中一個(gè)重要的盲點(diǎn)，尤其是當(dāng)它涉及到新止痛藥的研究進(jìn)展時(shí)。考慮到大多數(shù)慢性疼痛患者都是女性，這一點(diǎn)尤其麻煩。

Canadian funding agencies began recognizing sex as a biological variable and asking pain researchers to include female rodents in their experiments in 2006. In the US, a similar shift took place in 2016. Indeed, of the more than 1000 scholarly articles that Mogil reviewed published between January 2015 and December 2019 in Pain, the leading journal in the field, starting in 2016 more and more papers featured testing of both female and male rodents, with male-only studies dropping from 80% of the total in 2015 to only 50% of the total in 2019.

2006年，加拿大的資助機(jī)構(gòu)開始認(rèn)識到性別是一個(gè)生物變量，并要求疼痛研究人員將雌性嚙齒動物納入他們的實(shí)驗(yàn)中。在美國，2016年也發(fā)生了類似的轉(zhuǎn)變。事實(shí)上,莫吉爾對2015年1月至2019年12月發(fā)表在《疼痛》(Pain)——該領(lǐng)域的權(quán)威期刊——的1000多名學(xué)術(shù)文章進(jìn)行了回顧發(fā)現(xiàn),從2016年開始,其中越來越多的論文同時(shí)對雌性和雄性嚙齒動物進(jìn)行了測試，僅對雄性的研究從2015年的80%下降到2019年的50%。

At first glance, the presence of these articles may represent a promising shift in research design. But when Mogil looked more closely at the existing sex differences in pain literature, he found clear evidence of a persistent male bias.

乍一看，這些文章的出現(xiàn)可能代表了研究設(shè)計(jì)的一個(gè)有希望的轉(zhuǎn)變。但當(dāng)Mogil更仔細(xì)地研究疼痛文獻(xiàn)中存在的性別差異時(shí)，他發(fā)現(xiàn)了男性偏見存在的明顯證據(jù)。

"The very ideas we come up with for experiments, are based on experiments in males and therefore they work in males and not in females. I discovered that in those papers where both sexes were actually tested and results reported on the differences by sex, the experiments "worked out", meaning the scientific hypothesis being tested was found to be true, in males 72.4% of the time and in females only 27.6%," said Mogil. "If there were no bias in the literature and there were a number of papers were the experiment worked in one sex and not the other, it should work in females just as often as in males. Why has this happened? Because the hypothesis that that experiment tested out was generated based on prior data from experiments on only males. So, of course, it only worked in males."

“我們?yōu)閷?shí)驗(yàn)提出的想法，是基于對男性的實(shí)驗(yàn)，因此它們在男性身上起作用，而不是在女性身上。”莫吉爾說:“我發(fā)現(xiàn)，在那些對兩性進(jìn)行實(shí)際測試并報(bào)告性別差異結(jié)果的論文中，實(shí)驗(yàn)“成功了”，這意味著被測試的科學(xué)假設(shè)是正確的，男性的72.4%和女性只有27.6%。”“如果在文獻(xiàn)中沒有偏見，并且有很多論文證明這個(gè)實(shí)驗(yàn)只適用于一種性別而不適用另一種性別，那么這個(gè)實(shí)驗(yàn)在女性身上的效果應(yīng)該和在男性身上一樣。為什么會這樣?因?yàn)閷?shí)驗(yàn)驗(yàn)證的假設(shè)是基于之前只對男性的實(shí)驗(yàn)數(shù)據(jù)。所以，當(dāng)然，它只對男性有效。”

According to Mogil, the conclusion that can be reached from this overview is that researchers are still some way away from developing analgesics that will work in women.

莫吉爾認(rèn)為，從這一綜述中可以得出的結(jié)論是，研究人員距離開發(fā)出適用于女性的止痛劑還有一段距離。

"This research suggests that lots of what's in the pipeline right now, if it works in anyone at all, will largely be men. Whereas the clear majority of chronic pain patients have been and continue to be women."

“這項(xiàng)研究表明，目前正在進(jìn)行的許多研究，如果對任何人都奏效的話，將主要指的是男性。然而，絕大多數(shù)慢性疼痛患者過去及將來都是女性。”