Guess Tiffany E, Rosen Joseph A, McClelland Erin E
Department of Biology, Middle Tennessee State University, Murfreesboro, TN 37132, USA.
J Fungi (Basel). 2018 Apr 18;4(2):49. doi: 10.3390/jof4020049.
Cryptococcosis, a fungal disease arising from the etiologic agent , sickens a quarter of a million people annually, resulting in over 180,000 deaths. Interestingly, males are affected by cryptococcosis more frequently than females, a phenomenon observed for more than a half century. This disparity is seen in both HIV (3M:1F) and HIV⁺ (8M:2F) populations of cryptococcal patients. In humans, male sex is considered a pre-disposing risk factor for cryptococcosis and males suffering from the disease have more severe symptoms and poorer outcomes. There are numerous observational, clinical and epidemiological studies documenting the male disadvantage in but with no further explanation of cause or mechanism. Despite being commonly acknowledged, little primary research has been conducted elucidating the reasons for these differences. The research that has been conducted, however, suggests sex hormones are a likely cause. Given that the sex difference is both prevalent and accepted by many researchers in the field, it is surprising that more is not known. This review highlights the data regarding differences in sexual dimorphism in infections and suggests future directions to close the research gap in this area.
隐球菌病是一种由病原体引起的真菌疾病，每年使25万人患病，导致超过18万人死亡。有趣的是，男性比女性更易感染隐球菌病，这一现象已被观察到半个多世纪。在隐球菌病患者的HIV（约300万男性:1万女性）和HIV⁺（约800万男性:200万女性）人群中均可见这种差异。在人类中，男性性别被认为是隐球菌病的一个易感风险因素，患该病的男性症状更严重，预后更差。有大量观察性、临床和流行病学研究记录了男性在隐球菌病方面的劣势，但没有对原因或机制进行进一步解释。尽管这一点已被普遍认可，但很少有初步研究阐明这些差异的原因。然而，已开展的研究表明性激素可能是一个原因。鉴于这种性别差异在该领域普遍存在且被许多研究人员所接受，令人惊讶的是我们对此了解得并不多。本综述强调了关于隐球菌感染中性别二态性差异的数据，并提出了缩小该领域研究差距的未来方向。
