Division of Infectious Diseases, Medical University of Graz, Graz, Austria.
Division of Infectious Diseases and Global Public Health, Department of Medicine, University of California San Diego, La Jolla, California, USA.
Mycoses. 2022 Jun;65(6):599-612. doi: 10.1111/myc.13449. Epub 2022 May 25.
Biological sex, which comprises differences in host sex hormone homeostasis and immune responses, can have a substantial impact on the epidemiology of infectious diseases. Comprehensive data on sex distributions in invasive fungal diseases (IFDs) are lacking. In this review, we performed a literature search of in vitro/animal studies, clinical studies, systematic reviews and meta-analyses of invasive fungal infections. Females represented 51.2% of invasive candidiasis cases, mostly matching the proportions of females among the general population in the United States and Europe (>51%). In contrast, other IFDs were overrepresented in males, including invasive aspergillosis (51% males), mucormycosis (60%), cryptococcosis (74%), coccidioidomycosis (70%), histoplasmosis (61%) and blastomycosis (66%). Behavioural variations, as well as differences related to biological sex, may only in part explain these findings. Further investigations concerning the association between biological sex/gender and the pathogenesis of IFDs are warranted.
生物学性别,包括宿主性激素稳态和免疫反应的差异,对传染病的流行病学有重大影响。侵袭性真菌病(IFD)的性别分布综合数据尚缺乏。在本综述中,我们对侵袭性真菌感染的体外/动物研究、临床研究、系统评价和荟萃分析进行了文献检索。侵袭性念珠菌病病例中女性占 51.2%,与美国和欧洲女性在总人口中的比例(>51%)基本一致。相比之下,其他 IFD 在男性中更为多见,包括侵袭性曲霉病(51%为男性)、毛霉病(60%)、隐球菌病(74%)、球孢子菌病(70%)、组织胞浆菌病(61%)和芽生菌病(66%)。行为差异以及与生物学性别相关的差异可能仅部分解释了这些发现。需要进一步研究生物学性别与 IFD 发病机制之间的关系。