Division of Pulmonary and Critical Care Medicine, University of Michigan, Ann Arbor, MI, USA.
Int J Chron Obstruct Pulmon Dis. 2020 Apr 1;15:711-721. doi: 10.2147/COPD.S237228. eCollection 2020.
Evidence suggests that chronic obstructive pulmonary disease (COPD) symptoms and progression may differ between men and women. However, limited information is currently available on the pathophysiological and biological factors that may underlie these sex-related differences. The objective of this review is to systematically evaluate reports of potential sex-related differences, including genetic, pathophysiological, structural, and other biological factors, that may influence COPD development, manifestation, and progression in women.
A PubMed literature search was conducted from inception until January 2020. Original reports of genetic, hormonal, and physiological differences, and biological influences that could contribute to COPD development, manifestation, and progression in women were included.
Overall, 491 articles were screened; 29 articles met the inclusion criteria. Results from this analysis demonstrated between-sex differences in inflammatory, immune, genetic, structural, and physiological factors in patients with COPD.
Various biological differences are observed between men and women with COPD including differences in inflammatory and metabolic pathways related to obesity and fat distribution, immune cell function and autophagy, extent and distribution of emphysema and airway wall remodeling. An enhanced understanding of these differences has the potential to broaden our understanding of how COPD develops and progresses, thereby providing an opportunity to ultimately improve diagnosis, treatment, and monitoring of COPD in both men and women.
有证据表明，慢性阻塞性肺疾病（COPD）的症状和进展在男性和女性之间可能存在差异。然而，目前关于可能导致这些性别差异的病理生理和生物学因素的信息有限。本综述的目的是系统评估与 COPD 女性患者的发病、表现和进展相关的潜在性别差异的报告，包括遗传、病理生理、结构和其他生物学因素。
对PubMed 文献进行了从创建到 2020 年 1 月的检索。纳入了关于遗传、激素和生理差异以及可能导致女性 COPD 发展、表现和进展的生物学影响的原始报告。
总共筛选出 491 篇文章，其中 29 篇符合纳入标准。这项分析的结果表明，COPD 患者存在性别间炎症、免疫、遗传、结构和生理因素的差异。
在患有 COPD 的男性和女性之间观察到各种生物学差异，包括与肥胖和脂肪分布、免疫细胞功能和自噬、肺气肿的程度和分布以及气道壁重塑相关的炎症和代谢途径的差异。更好地理解这些差异有可能拓宽我们对 COPD 如何发展和进展的认识，从而有机会最终改善 COPD 在男性和女性中的诊断、治疗和监测。
