Division of Transplant Surgery and Transplant Surgery Research Laboratory, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA.
Division of Transplant Surgery and Transplant Surgery Research Laboratory, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA; Regenerative Medicine and Experimental Surgery, Department of General, Visceral and Transplant Surgery, Hannover Medical School, Hannover, Lower Saxony, Germany.
Am J Transplant. 2023 Nov;23(11):1661-1672. doi: 10.1016/j.ajt.2023.07.022. Epub 2023 Aug 4.
Biological sex affects immunity broadly, with recognized effects on the incidence and severity of autoimmune diseases, infections, and malignancies. Consequences of sex on alloimmunity and outcomes in solid organ transplantation are less well defined. Clinical studies have shown that donor and recipient sex independently impact transplant outcomes, which are further modified by aging. Potential mechanisms have thus far not been detailed and may include hormonal, genetic, and epigenetic components. Here, we summarize relevant findings in immunity in addition to studies in clinical and experimental organ transplantation detailing the effects of biological sex on alloimmunity. Understanding both clinical impact and mechanisms is expected to provide critical insights on the complexity of alloimmune responses, with the potential to fine-tune treatment and allocation while providing a rationale to include both sexes in transplant research.
生物学性别广泛影响免疫，其对自身免疫性疾病、感染和恶性肿瘤的发生率和严重程度有显著影响。性别对同种异体免疫和实体器官移植结局的影响则不太明确。临床研究表明，供体和受者的性别独立影响移植结局，且这一影响会随年龄的增长而进一步改变。潜在的机制尚未被详细阐明，可能包括激素、遗传和表观遗传因素。在此，我们总结了除临床和实验性器官移植研究外，免疫相关领域中有关生物学性别对同种异体免疫影响的研究结果。了解临床影响和机制有望深入了解同种免疫反应的复杂性，这可能有助于调整治疗和分配方案，同时为在移植研究中纳入两性提供依据。
