性激素对哮喘的影响:免疫和气道细胞的网络视角。
Sex Steroids Effects on Asthma: A Network Perspective of Immune and Airway Cells.
机构信息
Department of Pharmaceutical Sciences, School of Pharmacy, College of Health Professions, North Dakota State University, Fargo, ND 58102, USA.
Department of Biomedical Sciences, School of Medicine & Health Sciences, University of North Dakota, Grand Forks, ND 58202, USA.
出版信息
Cells. 2022 Jul 19;11(14):2238. doi: 10.3390/cells11142238.
A multitude of evidence has suggested the differential incidence, prevalence and severity of asthma between males and females. A compilation of recent literature recognized sex differences as a significant non-modifiable risk factor in asthma pathogenesis. Understanding the cellular and mechanistic basis of sex differences remains complex and the pivotal point of this ever elusive quest, which remains to be clarified in the current scenario. Sex steroids are an integral part of human development and evolution while also playing a critical role in the conditioning of the immune system and thereby influencing the function of peripheral organs. Classical perspectives suggest a pre-defined effect of sex steroids, generalizing estrogens popularly under the "estrogen paradox" due to conflicting reports associating estrogen with a pro- and anti-inflammatory role. On the other hand, androgens are classified as "anti-inflammatory," serving a protective role in mitigating inflammation. Although considered mainstream and simplistic, this observation remains valid for numerous reasons, as elaborated in the current review. Women appear immune-favored with stronger and more responsive immune elements than men. However, the remarkable female predominance of diverse autoimmune and allergic diseases contradicts this observation suggesting that hormonal differences between the sexes might modulate the normal and dysfunctional regulation of the immune system. This review illustrates the potential relationship between key elements of the immune cell system and their interplay with sex steroids, relevant to structural cells in the pathophysiology of asthma and many other lung diseases. Here, we discuss established and emerging paradigms in the clarification of observed sex differences in asthma in the context of the immune system, which will deepen our understanding of asthma etiopathology.
大量证据表明,男性和女性的哮喘发病率、患病率和严重程度存在差异。最近的文献综述认为,性别差异是哮喘发病机制中的一个重要不可改变的危险因素。理解性别差异的细胞和机制基础仍然很复杂,这也是目前尚未解决的问题的关键所在。性激素是人类发育和进化的重要组成部分,在调节免疫系统方面起着关键作用,从而影响外周器官的功能。传统观点认为性激素具有预先确定的作用,由于雌激素与促炎和抗炎作用相关的相互矛盾的报告,普遍将雌激素归为“雌激素悖论”。另一方面,雄激素被归类为“抗炎”,在减轻炎症方面发挥保护作用。尽管这种观察结果被认为是主流且简单的,但由于当前综述中阐述的诸多原因,这种观察结果仍然有效。女性的免疫元素比男性更强、更敏感,似乎更具优势。然而,多种自身免疫和过敏性疾病女性患病率显著高于男性,这与上述观察结果相矛盾,表明性激素的差异可能调节免疫系统的正常和功能障碍。本文通过讨论免疫系统中与哮喘和许多其他肺部疾病的病理生理学相关的关键免疫细胞系统元素及其与性激素的相互作用,说明了它们之间潜在的关系。这将加深我们对哮喘发病机制的理解。