Hanamsagar Richa, Bilbo Staci D
Duke University, Department of Psychology & Neuroscience, Durham NC 27708, USA.
J Steroid Biochem Mol Biol. 2016 Jun;160:127-33. doi: 10.1016/j.jsbmb.2015.09.039. Epub 2015 Oct 23.
Several neurological conditions are associated with sex differences in prevalence or outcome. For example, autism predominantly affects boys, depression is more common in women, Parkinson's disease more common in men, and multiple sclerosis in women. In the case of stroke, women have a less favorable outcome and suffer from a more precipitous drop in health status compared to men. As a result, treatment of such diseases is difficult and yields variable results. Despite this, sex is rarely considered when making treatment decisions. The mechanisms underlying sex differences in disease progression are not well understood, however a strong link exists between different inflammation states of men and women and their propensity to develop certain diseases. As neuroinflammation is an important component of pathophysiology in many neurological conditions, it can be speculated that any changes in the state of inflammation in the brain during normal development can potentially lead to an increase in susceptibility to neurological and neurodegenerative diseases. Microglia play a crucial role in onset and modulation of inflammation and thus sex differences in microglial function could explain, at least in part, differences observed in susceptibilities and outcomes of neurological disorders in men and women. Understanding the mechanisms behind sex differences could help develop more targeted therapy with higher success rate, especially in diseases where sex differences are most prominent.
几种神经系统疾病在患病率或预后方面存在性别差异。例如,自闭症主要影响男孩,抑郁症在女性中更为常见,帕金森病在男性中更为常见,而多发性硬化症在女性中更为常见。就中风而言,与男性相比,女性的预后较差,健康状况下降更为急剧。因此,治疗这类疾病很困难,效果也各不相同。尽管如此,在做出治疗决策时,性别很少被考虑。疾病进展中性别差异的潜在机制尚不清楚,然而,男性和女性不同的炎症状态与其患某些疾病的倾向之间存在密切联系。由于神经炎症是许多神经系统疾病病理生理学的重要组成部分,可以推测,在正常发育过程中大脑炎症状态的任何变化都可能导致对神经系统疾病和神经退行性疾病易感性的增加。小胶质细胞在炎症的发生和调节中起关键作用,因此小胶质细胞功能的性别差异至少可以部分解释在男性和女性神经系统疾病易感性和预后中观察到的差异。了解性别差异背后的机制有助于开发更有针对性、成功率更高的治疗方法,尤其是在性别差异最为显著的疾病中。