Department of Allergy, Chonnam National University Medical School, Gwangju, Korea.
Allergy Asthma Immunol Res. 2011 Apr;3(2):74-80. doi: 10.4168/aair.2011.3.2.74. Epub 2010 Nov 8.
Because genetic characteristics vary among subjects, the therapeutic effects of a certain drug differ among patients with the same disease. For this reason, special interest has focused on tailored treatments. Although it is well known that sex is genetically determined, little attention has been paid to sex differences in the clinical features and treatment of asthma. Females are more likely to suffer allergic asthma, to have difficulty controlling asthma symptoms, and to show adverse effects to drugs. As asthma symptoms show cyclic changes depending on female hormone levels in many women of child-bearing age, the use of contraceptives may specifically help to treat female patients with asthma such as those with perimenstrual asthma and severe asthma. Generally, testosterone seems to suppress asthma, and dehydroepiandrosterone (DHEA), a less virilizing androgen, may be effective for treating asthma. Evidence exists for a therapeutic and steroid-sparing effect of DHEA. However, further studies on the optimal dose and route of DHEA for each sex are needed. Monitoring of the serum DHEA-S level is necessary for patients with asthma on inhaled steroid treatment, and at minimum, replacement therapy for patients with a low level of DHEA may be helpful for treating their asthma.
由于个体间存在遗传特征差异，同一疾病患者使用同一药物的治疗效果也存在差异。出于这个原因，人们特别关注个体化治疗。尽管众所周知，性别是由基因决定的，但人们对哮喘的临床特征和治疗中的性别差异关注甚少。女性更容易患过敏性哮喘，难以控制哮喘症状，并且对药物有不良反应。由于许多育龄妇女的哮喘症状会根据女性激素水平呈周期性变化，因此使用避孕药具可能特别有助于治疗女性哮喘患者，如经期哮喘和严重哮喘患者。一般来说，睾丸酮似乎可以抑制哮喘，而具有较弱雄性化作用的脱氢表雄酮（DHEA）可能对治疗哮喘有效。有证据表明 DHEA 具有治疗和减少类固醇用量的作用。然而，仍需要针对每种性别进行 DHEA 的最佳剂量和给药途径的进一步研究。对于接受吸入性类固醇治疗的哮喘患者，需要监测血清 DHEA-S 水平，对于 DHEA 水平较低的患者，至少进行替代治疗可能有助于治疗其哮喘。
