Curr Opin Allergy Clin Immunol. 2019 Oct;19(5):417-424. doi: 10.1097/ACI.0000000000000568.
Is sexual dimorphism also true in anaphylaxis as described in other allergic diseases? Possible gender differences in the epidemiology, triggers, severity, outcomes of anaphylaxis as well as in the pathogenesis of the disease are discussed.
Hormonal status and the X-chromosome-coded factors deeply involved in the regulation of T-cell and B-cell responses may influence the gender difference noticed in allergic diseases, such as asthma and rhinitis. Little is known if sex is also relevant for anaphylaxis, although the description of catamenial anaphylaxis is intriguing. However, epidemiologic bias, lack of reliable animal models for the human disease, differences into diagnostic codes and not harmonized clinical grading unfortunately represent hurdles to obtain meaningful information on this topic.
The female sex predisposes to a dysregulation of the immune response as suggested by the increased prevalence of autoimmunity and atopy. In anaphylaxis, pathomechanisms are not fully disclosed, triggers are numerous and IgE-dependent mast cell degranulation only represents a part of the story. Improvement into the definition of the disease including a more careful coding system and better investigations about triggers seem the only way to allow a more precise assessment of the possible different risk for women to develop anaphylaxis.
在其他过敏性疾病中所描述的过敏反应中是否也存在性别二态性？讨论了过敏反应的流行病学、诱因、严重程度、结局以及疾病发病机制方面可能存在的性别差异。
激素状态和 X 染色体编码的因子，这些因子在 T 细胞和 B 细胞反应的调节中起着重要作用，可能会影响到哮喘和鼻炎等过敏性疾病中的性别差异。虽然描述了月经性过敏反应，但对于过敏反应中性别是否也相关，目前知之甚少。然而，流行病学偏见、缺乏人类疾病的可靠动物模型、诊断代码的差异以及未统一的临床分级，不幸的是，这些都成为获得关于该主题的有意义信息的障碍。
女性更容易出现免疫反应失调，这正如自身免疫和过敏的发病率增加所表明的那样。在过敏反应中，发病机制尚未完全阐明，诱因众多，IgE 依赖性肥大细胞脱颗粒仅代表其中一部分。改善疾病的定义，包括更仔细的编码系统和更好地调查诱因，似乎是唯一的方法，可以更准确地评估女性发生过敏反应的风险是否不同。
