Rio Pierluigi, Caldarelli Mario, Miccoli Edoardo, Guazzarotti Giulia, Gasbarrini Antonio, Gambassi Giovanni, Cianci Rossella
Department of Medical and Surgical Sciences, Catholic University of Sacred Heart, 00168 Rome, Italy.
Fondazione Policlinico Universitario A. Gemelli, Istituto di Ricerca e Cura a Carattere Scientifico (IRCCS), 00168 Rome, Italy.
Diseases. 2025 Jun 7;13(6):179. doi: 10.3390/diseases13060179.
In recent years, gender medicine has emerged as a field of research analyzing sex-related differences in health and disease. Biological sex, depending on sex chromosome complement, sex steroid hormones, and reproductive organs, has been demonstrated to influence human susceptibility to infections, immune responses against pathogens, the clinical severity of infectious diseases, and responses to the available treatments. Men and women differ in their chromosome set, with men having one X chromosome (XY) and women two (XX). This different genetic composition results in a sex-dimorphic expression of genes and pathways involved in immune regulation, as well as in shaping immune responses to infectious agents. Moreover, estrogen, progesterone, and testosterone, impacting cells and pathways involved in both innate and adaptive immunity, have been shown to drive sex dimorphism in infectious diseases. This narrative review aims to explore the sex-related differences in responses to infections, specifically focusing on the underlying genetic and hormonal mechanisms. Hence, aging-related changes in the immune system and their potential impact on immune responses against pathogens will be discussed. Understanding sex differences and stratifying the population according to them will open the door to precision medicine and personalized patient care.
近年来，性别医学已成为一个研究领域，分析健康和疾病中与性别相关的差异。生物性别取决于性染色体组成、性类固醇激素和生殖器官，已被证明会影响人类对感染的易感性、针对病原体的免疫反应、传染病的临床严重程度以及对现有治疗的反应。男性和女性的染色体组不同，男性有一条X染色体（XY），女性有两条（XX）。这种不同的基因组成导致参与免疫调节的基因和途径出现性别二态性表达，以及塑造对传染原的免疫反应。此外，雌激素、孕激素和睾酮会影响先天免疫和适应性免疫中涉及的细胞和途径，已被证明会导致传染病中的性别二态性。这篇叙述性综述旨在探讨感染反应中的性别相关差异，特别关注潜在的遗传和激素机制。因此，将讨论免疫系统与衰老相关的变化及其对针对病原体的免疫反应的潜在影响。了解性别差异并据此对人群进行分层将为精准医学和个性化患者护理打开大门。
