From the Respiratory Institute, Cleveland Clinic, 9500 Euclid Avenue, Cleveland, OH, 44106, USA.
Curr Allergy Asthma Rep. 2019 Sep 5;19(10):44. doi: 10.1007/s11882-019-0878-y.
Asthma, a common respiratory disease that affects about 10% of the US population, represents a significant public health issue. In the last decade, cumulative evidence has demonstrated sex disparities in asthma, including significant differences in epidemiology, clinical presentation, response to therapies, and health outcomes. Understanding sex-related differences in asthma enables clinicians to provide personalized asthma care and improve asthma outcome.
Recent studies on sex-related differences in asthma inform us on mechanism underlying asthma pathogenesis across all age groups. Sex hormones directly modulate immune pathways crucial in asthma pathogenesis and affect individual's response to environmental triggers and medications, such as leukokotriene inhibitors. Not surprisingly, the use of external sex hormone supplementations appears to modulate asthma risk. Identification of sex-specific asthma risk loci through genome-wide association studies also provides supporting evidence on sex-related differences in asthma. There is an interaction between sex and obesity, an interaction that could place females at higher risk for systemic inflammation and, consequently, asthma. In this article, we review epidemiological and clinical studies on sex-related differences in asthma, with a special focus on the role of sex hormones, including hormonal therapies and the asthma-obesity interaction.
哮喘是一种常见的呼吸道疾病,影响了美国约 10%的人口,是一个重大的公共卫生问题。在过去十年中,越来越多的证据表明哮喘存在性别差异,包括在流行病学、临床表现、对治疗的反应和健康结果方面存在显著差异。了解哮喘中的性别差异使临床医生能够提供个性化的哮喘护理并改善哮喘结果。
最近关于哮喘中性别差异的研究使我们了解了所有年龄段哮喘发病机制的潜在机制。性激素直接调节在哮喘发病机制中至关重要的免疫途径,并影响个体对环境触发因素和药物(如白三烯抑制剂)的反应。毫不奇怪,外源性性激素补充似乎会调节哮喘风险。通过全基因组关联研究确定的性别特异性哮喘风险基因座也为哮喘中的性别差异提供了支持性证据。性别与肥胖之间存在相互作用,这种相互作用可能使女性面临更高的全身炎症风险,进而导致哮喘。在本文中,我们综述了哮喘中性别差异的流行病学和临床研究,特别关注性激素的作用,包括激素治疗和哮喘-肥胖相互作用。