Males and females respond differently to brain injury

Researchers at Children’s Hospital of Pittsburgh have found that males and females respond differently to brain injury and therefore, boys with brain injuries may require different life-saving treatments than girls.

Children’s researchers found in animal models that levels of glutathione – a molecule that protects brain cells from death when deprived of oxygen – remain constant in females who have suffered an injury to the brain but drop by as much as 80 percent in males with the same injury. When glutathione levels drop, brain cells die much more quickly.

Results of the study are being presented at the annual Pediatric Academic Societies meeting, held May 1-4, 2004, in San Francisco. This is the second year of five-year, $1.2 million study which is being funded by the National Institutes of Health and Children’s Hospital.

“There is a built-in difference at the brain cell level between males and females, said Robert Clark, MD, an intensivist at Children’s Hospital and the principal investigator of the study. “Injured brain cells may eventually die, but they take different pathways to get there in males and females. This means that we may need to develop or use gender-specific therapies for brain injury from any cause.”

The study results also suggest the possibility that boys with injuries could be treated with N-acetylcysteine (NAC), a drug already approved for use by the U.S. Food and Drug Administration, according to Dr. Clark.

“NAC already is being used to treat people who have overdosed on acetaminophen because acetaminophen causes glutathione levels to drop and NAC can restore them,” Dr. Clark said. “Now that we’ve identified low glutathione levels in males with brain injuries, we can begin looking at NAC as a live-saving treatment for those injuries.”

Dr. Clark said NAC potentially could be an effective treatment for any injury in a male in which the brain is deprived of oxygen, including cardiac arrest, drowning accidents and severe trauma. Children’s researchers including Dr. Clark, Hülya Bayýr, MD, and Ericka Fink, MD, will conduct further studies to evaluate the effectiveness of NAC in reducing brain damage after an injury.

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