Institute of Epidemiology, Social Medicine and Health System Research, Hannover Medical School, OE 5410, Carl-Neuberg-Strasse 1, 30623 Hannover, Germany.
Respir Med. 2009 May;103(5):637-49. doi: 10.1016/j.rmed.2009.01.006. Epub 2009 Jan 31.
An increasing number of studies confirm that pathogenesis and prevalence of bronchial asthma are age and sex dependent. Detailed physiological mechanisms of the changing sex ratios with age are not fully known, however, the gender (socio-cultural) factors are also imperative. Although multiple factors definitely influence the pathogenesis of asthma, only individual or few combinations of these have been investigated.
The terms 'sex', 'gender' and plausible combinations of both were systematically researched in selected databases (Medline, Scopus) or other sources, including publications from January 2000 to June 2007. Generated articles were categorized, either as endogenous or exogenous factors influencing the pathogenesis of asthma, and divided into the following subgroups: genetic, immunological, hormonal, gynaecological, nutritional, and environmental parameters.
An increasing number of studies investigate the influence of sex and gender in the aetiology, therapy and prevention of asthma. While their results are still debatable, others regarding its initiation, perpetuation and cessation have been clarified. Recent insights into interactions at biomolecular and immunological levels greatly contribute to clarifying sex-specific influences. Despite occasional oversimplifications, a trend for explanations considering the complex interplay of different factors can be observed. This work is in line with this trend and offers explanation models from our point of view.
Some disagreements regarding the patho-physiology, diagnosis, treatment and prevention of asthma still prevail. Nevertheless, in order to better appreciate its complexity, openness to and persistent consideration for interdisciplinary as well as sex- and gender-related factors is required of the medical-research community in future investigations.
越来越多的研究证实，支气管哮喘的发病机制和流行情况与年龄和性别有关。然而，我们并不完全了解年龄相关性别比变化的详细生理机制，性别（社会文化）因素也至关重要。虽然许多因素肯定会影响哮喘的发病机制，但只有个体或少数几种因素的组合得到了研究。
本研究系统地检索了选定数据库（Medline、Scopus）或其他来源（包括 2000 年 1 月至 2007 年 6 月的出版物）中的“性别”、“性别”和两者可能的组合术语。生成的文章进行了分类，要么是影响哮喘发病机制的内源性或外源性因素，并分为以下亚组：遗传、免疫、激素、妇科、营养和环境参数。
越来越多的研究调查了性别和性别在哮喘病因学、治疗和预防中的影响。虽然其结果仍存在争议，但其他方面，如发病、持续和停止，已经得到了阐明。最近在生物分子和免疫水平上相互作用的研究为阐明性别特异性影响提供了重要依据。尽管偶尔会出现过度简化，但可以观察到一种考虑到不同因素复杂相互作用的解释趋势。这项工作符合这一趋势，并从我们的角度提供了解释模型。
关于哮喘的病理生理学、诊断、治疗和预防仍然存在一些分歧。然而，为了更好地理解其复杂性，未来的医学研究需要对跨学科以及性别和性别相关因素持开放和持续的态度。
