儿科传染病中的性别差异。
Sex differences in pediatric infectious diseases.
机构信息
Department of Paediatrics, University of Oxford, United Kingdom.
Department of Paediatrics, University of Oxford, United Kingdom HIV Pathogenesis Programme, The Doris Duke Medical Research Institute, University of KwaZulu-Natal, Durban, South Africa.
出版信息
J Infect Dis. 2014 Jul 15;209 Suppl 3(Suppl 3):S120-6. doi: 10.1093/infdis/jiu232.
The success of the immune response is finely balanced between, on the one hand, the need to engage vigorously with, and clear, certain pathogens; and, on the other, the requirement to minimize immunopathology and autoimmunity. Distinct immune strategies to achieve this balance have evolved in females and males and also in infancy through to adulthood. Sex differences in outcome from a range of infectious diseases can be identified from as early as fetal life, such as in congenital cytomegalovirus infection. The impact of sex hormones on the T-helper 1/T-helper 2 cytokine balance has been proposed to explain the higher severity of most infectious diseases in males. In the minority where greater morbidity and mortality is observed in females, this is hypothesized to arise because of greater immunopathology and/or autoimmunity. However, a number of unexplained exceptions to this rule are described. Studies that have actually measured the sex differences in children in the immune responses to infectious diseases and that would further test these hypotheses, are relatively scarce.
免疫反应的成功取决于多种因素之间的微妙平衡，一方面需要积极应对并清除特定病原体；另一方面需要将免疫病理和自身免疫的风险降到最低。女性和男性以及婴儿期到成年期都进化出了不同的免疫策略来实现这种平衡。从胎儿期开始，就可以从一系列传染病的结果中发现性别差异，例如先天性巨细胞病毒感染。性激素对辅助性 T 细胞 1/辅助性 T 细胞 2 细胞因子平衡的影响被认为可以解释大多数传染病在男性中更为严重的原因。在少数情况下，女性的发病率和死亡率更高，这被假设是由于免疫病理和/或自身免疫的原因。然而，也有许多无法解释的例外情况。实际上，在儿童中测量了对传染病的免疫反应的性别差异，并进一步检验了这些假设的研究相对较少。
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