Sin Don D, Cohen Sigal Ben-Zaken, Day Anna, Coxson Harvey, Paré Peter D
University of British Columbia, Vancouver, British Columbia, Canada.
Proc Am Thorac Soc. 2007 Dec;4(8):671-4. doi: 10.1513/pats.200706-082SD.
There is a worldwide epidemic of chronic obstructive pulmonary disease (COPD) in women. Some large epidemiologic studies suggest that female smokers may have increased susceptibility to COPD. The biological mechanisms to explain these observations are far from certain. However, the susceptibility to the effects of cigarette smoke in women could be due to a greater deposition of toxic substances in the lung, impaired clearance of the toxins that are deposited, and/or an exaggerated biologic response to these toxins. The latter effect could be due to an increased ability to convert certain xenobiotics to more toxic metabolites or to a decreased ability to conjugate and excrete metabolites of these toxins. Female hormones, in particular estrogen, can up-regulate certain cytochrome P450 enzymes without altering detoxifying enzymes, leading to a disturbance in the balance between metabolism and conjugation. This article reviews this and other potential mechanisms that may confer increased susceptibility of COPD to female smokers.
慢性阻塞性肺疾病（COPD）在全球女性中呈流行态势。一些大型流行病学研究表明，女性吸烟者可能对COPD的易感性更高。解释这些观察结果的生物学机制尚远未明确。然而，女性对香烟烟雾影响的易感性可能是由于肺部有毒物质的沉积增加、沉积毒素的清除受损，和/或对这些毒素的生物反应过度。后一种效应可能是由于将某些外源性物质转化为毒性更强的代谢物的能力增强，或结合并排泄这些毒素代谢物的能力降低。女性激素，尤其是雌激素，可以上调某些细胞色素P450酶，而不改变解毒酶，从而导致代谢与结合之间的平衡紊乱。本文综述了这一机制以及其他可能使女性吸烟者对COPD易感性增加的潜在机制。
