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性别与健康和疾病:癌症相关生物学性别差异综述,重点关注神经胶质瘤。

Sex differences in health and disease: A review of biological sex differences relevant to cancer with a spotlight on glioma.

机构信息

Mathematical NeuroOncology Laboratory, Precision Neurotherapeutics Innovation Program, Mayo Clinic, Phoenix, AZ, USA.

College of Literature, Science, and the Arts, University of Michigan, Ann Arbor, MI, USA.

出版信息

Cancer Lett. 2021 Feb 1;498:178-187. doi: 10.1016/j.canlet.2020.07.030. Epub 2020 Oct 29.

Abstract

The influence of biological sex differences on human health and disease, while being increasingly recognized, has long been underappreciated and underexplored. While humans of all sexes are more alike than different, there is evidence for sex differences in the most basic aspects of human biology and these differences have consequences for the etiology and pathophysiology of many diseases. In a disease like cancer, these consequences manifest in the sex biases in incidence and outcome of many cancer types. The ability to deliver precise, targeted therapies to complex cancer cases is limited by our current understanding of the underlying sex differences. Gaining a better understanding of the implications and interplay of sex differences in diseases like cancer will thus be informative for clinical practice and biological research. Here we review the evidence for a broad array of biological sex differences in humans and discuss how these differences may relate to observed sex differences in various diseases, including many cancers and specifically glioblastoma. We focus on areas of human biology that play vital roles in healthy and disease states, including metabolism, development, hormones, and the immune system, and emphasize that the intersection of sex differences in these areas should not go overlooked. We further propose that mathematical approaches can be useful for exploring the extent to which sex differences affect disease outcomes and accounting for those in the development of therapeutic strategies.

摘要

生物性别差异对人类健康和疾病的影响虽然日益受到重视,但长期以来一直被低估和探索不足。虽然所有性别的人类在很多方面都比不同之处更相似,但人类生物学的最基本方面存在性别差异的证据,这些差异对许多疾病的病因学和病理生理学有影响。在癌症等疾病中,这些后果表现在许多癌症类型的发病率和预后的性别偏见中。由于我们目前对潜在性别差异的理解有限,因此能够为复杂的癌症病例提供精确、靶向治疗的能力受到限制。因此,更好地了解癌症等疾病中性别差异的影响和相互作用,将为临床实践和生物研究提供信息。在这里,我们回顾了人类中广泛存在的生物学性别差异的证据,并讨论了这些差异如何与各种疾病(包括许多癌症,特别是胶质母细胞瘤)中的观察到的性别差异相关。我们关注在健康和疾病状态中发挥重要作用的人类生物学领域,包括代谢、发育、激素和免疫系统,并强调不应忽视这些领域中性别差异的交叉点。我们进一步提出,数学方法可用于探索性别差异对疾病结果的影响程度,并在治疗策略的制定中考虑这些差异。

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