Thu. Feb 20th, 2020

“We need to study heart disease with female models”

Sara Cogliati (Milan, 1982) has been working at the National Cardiovascular Research Center (CNIC), in Madrid, for more than six years. This doctor in Cell Biology studies how mitochondria – organs of cells responsible for supplying them with the energy they need – behave differently in men and women, which determines a different response during heart failure. Your project has been awarded in the last edition of the program For Women in Science L’Oréal-Unesco.

In his opinion, it is a key approach because, according to SINC, women are dying more than men for these diseases and the reason is that until now the symptoms and treatments have been studied, especially in male models .

What have you been investigating so far at the CNIC?

In our group we are focused on the study of mitochondria. We investigate its basic functioning and morphology. Specifically, I work on the structure of the respiratory chain.[Amongtheachievementsofhisteamhighlightsthediscoveryofthe[Entreloslogrosdesuequipodestacaeldescubrimientodelosmechanisms that regulate it, which was published in Nature].

Our focus is to apply this knowledge to pathological situations such as, for example, cardiovascular diseases, aging and also metabolism.

Why have you chosen this project to study the specific characteristics of sex in cardiovascular diseases?

The latest data on the incidence of cardiovascular diseases in women are very worrying. In Europe, one in five women suffer from these diseases. It is a very serious problem that I am interested in studying, especially considering that these diseases have a more negative prognosis in women than in men.

And why is this so?

For the simple reason that so far heart and other diseases have been studied using male animal models, and there are many biological differences, based on which chromosomally and hormonally we are different. Thus, these fundamental differences generate biological differences when it comes to experiencing a disease and also in the way of responding to treatments, which often do not work as well in women as in men.

In fact, the data suggest that mortality from cardiovascular diseases is higher in women than in men.

Yes, exactly. In Europe it is estimated that mortality affects 52% of women suffering from cardiovascular diseases, compared to 42% of men, according to data from the Spanish Heart Foundation.

But this is not talked about, we have much more information about breast cancer, why?

No, it is not spoken and it is not said that in Spain the first cause of mortality among women is cardiovascular disease.

I think there is a lack of general awareness. Until now, it is true that it called much more attention to breast cancer because many women can develop it – one in six – but it is specific to women, while heart disease had traditionally been more related to men and was missing Statistics Now that we have the numbers in hand, we can understand the problem in its fullness.

In addition, before some deaths from cardiovascular problems were not well diagnosed. A woman was dying and the cause was not well known because a heart attack has different characteristics in men and women.

Sara Cogliati in the laboratory. / CNIC

Sara Cogliati in the laboratory. / CNIC

And what are these differences?

For example, the typical symptoms of chest and arm pain are very prevalent in men, but in women it manifests more with a lack of air or nausea. Now that we are discovering these differences, cases that previously went unnoticed can be included in the statistics.

Errors in diagnosis and treatments have as a starting point the fact that female animal models have not been included in basic research. All these shortcomings come from the lack of specific study of how these diseases behave in female biology. So, once again, it is a problem of inequality, of discrimination.

This approach sounds very novel, but I don’t know if other centers are already trying to study heart disease specifically in women.

Very recent works are beginning to emerge that investigate whether the problem of gender differences in many pathologies, for example in liver cancer. There are some who have identified some genetic pathways in some cancers. The scientific community is realizing.

What is the approach of the project you are going to develop and for which you have been awarded in the program For Women in Science L’Oréal-Unesco?

My study will be focused on mitochondrial functionality because – as we have already shown with male animals – mitochondria are involved in heart failure. And besides, knowing that estrogen influences mitochondrial functionality, I will link these two aspects using female animals. That is, that estrogens modulate mitochondrial activity and that mitochondria are involved in heart failure.

I believe, and my preliminary results support it, that I will identify what are the mitochondrial differences between males and females in heart failure and find out what are the basic molecular mechanisms that modulate these differences.

What is the next step? The contribution of the scholarship is quite humble – they are 15,000 euros. I don’t know if it gives you much.

I am now in an intermediate phase. I have a Ramón y Cajal contract and I am looking for the possibility of starting with a new group and with my own project. I am also looking for an institution to do it, which would not be the CNIC. This little financing will allow me to start something of mine, start with what I have in my heart.

Are you noticing any change by the funding agencies to promote projects that take into account female disease models?

There is still much to do. It is very necessary to introduce the aspect of sexual differences in basic research, but we are beginning to perceive some change. For example, the European Financing Agency and other entities are calling for more and more female animal models to be included in the research.

Why did you come to Spain?

Because I met the work of the CNIC group that I later joined and loved. Before coming I had the opportunity to collaborate with them. So I decided, after my doctorate at the University of Padua, to come to do the post doctorate here, in the group of Antonio Enriquez.

Your daughters were born here.

Yes. The oldest is three years old and the smallest is four months. The two were born in Madrid.

And how do you take to be a mother and investigate?

I get along very well because I can reconcile. Motherhood has given me the possibility of being more focused. When I am in the laboratory I work hard because I know that at some time I have to go to pick up the girls and it has made me even more effective in my work. Then, of course, I have been fortunate to be in an institution that has allowed me to combine my work and motherhood in a work environment where I have felt supported in all aspects.

This question is not usually asked of a man.

Exactly, this question is not asked of men and hopefully one day we can ask them also because it will mean that they are more involved in family tasks.


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