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The environmental toxicant lead (Pb) has long been known to induce neurological deficits. The 1st century Greek physician Pedanius Dioscorides noted that “lead makes the mind give way”. Current studies are suggesting the effects of Pb on behaviors may involve the immune system and conversely some immunomodulatory changes may be due to Pb effects in the central nervous system. Although Pb-induced disorders do not appear to discriminate among females and males, this report discusses the differences observed in human and animal studies regarding differential gender effects on gene expression after Pb exposure. The overall ill health outcomes are apparent with variant levels of Pb exposure and exposures at different times in development. However, the consensus is that doses leading to blood lead levels > 5 μg/dl and prenatal exposures are most pathogenic. Although the general detriments induced by Pb may be similar in females and males, there are sex specific outcomes on health and behavior. It is suggested that Pb induces more oxidative stress in females and more upregulation of genes responding to oxidative stress, while males have more proteolytic destruction; but in both cases, there is generation of altered/denatured self-constituents causing inflammation and loss of homeostasis of neuronal and immune functions. The higher estrogen levels of females are indicated as the reason for more Pb-induced reactive oxygen species in females. This review describes some of the different genes involved in female and male responses to Pb exposure and involved pathways.