Interview with Roman Fischer – How sex matters in drug development

November 26, 2020

In the “Diversity promotes intelligence” idea workshop held as part of Diversity Day in May 2020, Dr. Roman Fischer spoke about the role of sex in the development of drugs. In the interview after the event he talks about his research and its significance for the topic of "diversity".

Participants in the Diversity Day at the University of Stuttgart this year were invited to take part in the “Diversity promotes Intelligence” idea workshop. One of the speakers was Dr. Roman Fischer. Fischer is the leader of a working group at the Institute of Cell Biology and Immunology (IZI) at the University of Stuttgart. Before returning to Stuttgart a year ago, he spent three years as an assistant professor at Drexel University in Philadelphia. There he worked on a topic which was his contribution to the “Diversity promotes intelligence” idea workshop as part of the Diversity Day in May 2020: “How sex matters in drug development”. The focus of his research is on the development of new drugs for the treatment of degenerative and inflammatory diseases such as multiple sclerosis, Parkinson’s disease and Alzheimer’s. The results of preclinical studies have been shown to be promising.

In an interview with Nicole Bitter from the Vice Rectorate for Early Career Researchers and Diversity, Fischer speaks about his research and looks back on the German Diversity Day event.

The idea workshop which you took part in with a presentation on the role of sex in the development of drugs took place in May as part of the German Diversity Day. How important is diversity for your research?

Dr. Roman Fischer (RF): Diversity wasn’t a big part of my research until about four years ago. In preclinical development we work with certain cells which either come from a male or female organism. Tests are often only carried out on one sex to obtain clearer results due to lower variability.

Now in America though, when a study has been given funding by the National Institute of Health (NIH) all tests must be carried out on both male and female animals. Because of this, we discovered in the early stages of developing one drug that it worked very well on male animals but had no effect on female animals. It turned out that estrogen was blocking the therapeutic effect of the drug.

The next step would now be to find out whether this study could actually be transferred to humans. Since I came back to the University of Stuttgart we have continued to pursue this line of research and are trying to use tests to make predictions about the efficiency of therapeutic agents on both sexes

ZOn display is a minmap on language barriers for foreign students, an example of diversity as discussed in the idea workshop.
Example from the idea workshop on Diversity Day

One issue in the idea workshop was how to classify intersex individuals in this context. Can you perhaps give a short explanation?

RF: In German, the word “Geschlecht”refers to both the biological and the socially interpreted meaning. In English, the words “sex” and “gender” have two different meanings. That was also unusual for us when we looked into the subject and used the direct translation from German, i.e. “gender”. However, our research is actually about biological sex, in other words "sex".

With intersex individuals, the effectiveness of drugs depends on their biological sex and which sex hormones they produce. Men have an X and a Y chromosome, which means they produce testosterone, and women have two X chromosomes, which means they produce estrogen. Intersex individuals may differ in this respect and may have a hormonal imbalance. This may mean that there are different phases of hermaphroditism or different biological phases. This makes it difficult to classify intersex individuals from a biological perspective. If you already know that a therapeutic effect is blocked by estrogen though, like in the study I mentioned earlier, the next step is to look at whether or not the body produces estrogen, and in what concentration in particular. Based on this it becomes possible to predict how likely that person is to react to the therapeutic agent.

What was it like for you to share ideas with people in the idea workshop who mostly don’t specialize in your area, and also to take part in discussions where you weren’t the expert yourself?

RF: I found it very interesting, because diversity wasn’t just only discussed from a scientific perspective but was lit up from all possible angles. After all, diversity means much more than just the sex-specific characteristics which I talked about.

In the USA, diversity is in principle the foundation of the whole. At my laboratory at the university there were people from Europe, Asia and America. No more than 50% of professors were Americans. It was exciting to be reminded again on Diversity Day of the differences that exist between students in particular, and to see how individual topics are communicated and how they are accepted. It was an extra bonus for me that my pharmacology course took part in the Diversity Day as well, which meant that I could give my lecture as part of the event.

It was interesting to see how the students with a pharmacology background approached the topic compared to the students without a pharmacology background. Overall, the Diversity Day was a very interesting experience for me, and I also picked up important feedback from students with different backgrounds.

Two young women and two young men look at a computer screen together.
Example of Diversity in the team based on the LH² working group

You just mentioned that American universities are already increasingly putting together various teams. Do you also make sure that you have a diverse team around you?

RF: Absolutely! My team is mostly made up of women at the moment, but I make sure that there is a variety of characters. It is important how a team interacts. If you have a lot of extroverts who clash with one another, it can be just as much of a problem as when a lot of introverts work together.

Therefore, it’s important to have a good mixture. When filling vacancies I take particular care to ensure that the team dynamic is optimized for productive cooperation.

Just one more question – what does diversity mean to you personally?

RF: Diversity is very important in a lot of ways, for me both in terms of my research like the example I gave earlier, but also because of the experiences I had in America. The cultural diversity was one of the reasons why I went to America in the first place. Compared to Germany it was a profound experience to learn all about the diversity of the area, particularly in a university city like Philadelphia. In particular, it was a very positive experience to see how loosely different ethnic backgrounds were dealt with in the city. I had a lot of positive experiences from my stay abroad that will stay with me for the rest of my life.

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