Gender differences in asthma development and progression
Gender differences in asthma development and progression
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DOI：
10.1016/s1550-8579(07)80054-4
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发表时间：
2007-01-01
期刊：
影响因子：
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通讯作者：
Postma, Dirkje S.
中科院分区：
文献类型：
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作者：
Postma, Dirkje S.
背景资料：哮喘是一种慢性炎症性气道疾病，青春期前男孩的患病率高于女孩，成年后女性的患病率高于男性。由于疾病的复杂性，没有一个简单的机制可以解释在哮喘中发现的性别差异。目的：这篇文章回顾了性别对特应性和哮喘的发展和结果的影响。方法：通过PubMed数据库检索1980年至2007年的英语文章，使用术语哮喘，性别，性别，激素和肺发育。结果：很可能是荷尔蒙的变化和遗传易感性都有助于发生在青春期的患病率的变化。严重哮喘在女性中也更常见。在成年后，妇女更容易受到吸烟的影响，更容易患上asthma.Conclusions：重要的是要确定哮喘是否是一个社会，文化，激素和/或遗传问题。关于哮喘发生和进展中的性别差异的许多主题需要额外的研究。例如，需要研究胎儿肺发育和激素因素的相互作用，因为它对整个生命都有影响。哮喘的遗传学研究应按性别分层，因为某些多态性与女性哮喘特别相关。进一步的研究应在哮喘和特应性相关的染色体-基因相互作用（如X染色体基因）上进行。此外，还需要研究细胞激素对哮喘和特应性疾病的影响与两性先天和后天免疫的关系。这将不仅使哮喘患者受益，而且使许多其他疾病的患者受益，这些疾病在患病率，严重程度和治疗反应方面存在性别差异。研究观察到的人类性别差异的动物模型应侧重于与肺和免疫发育有关的环境和激素因素的易感性。哮喘治疗反应的差异也需要检查。双盲研究需要按性别分层，应分别研究女性和男性的治疗反应。此外，性别和行为变化之间的相互作用与哮喘的发展和管理应加以研究。(Gend 2007;4[Suppl B]：S133-S146）版权所有（c）2007 Excerpta Medica，Inc.
Background: Asthma is a chronic inflammatory airway disease that has a higher prevalence in boys than in girls before puberty and a higher prevalence in women than in men in adulthood. Because of the complexity of the disease, no single straightforward mechanism can explain the gender differences found in asthma.Objective: This article reviews the effects of sex on the development and outcome of atopy and asthma.Methods: English-language articles were identified by a PubMed database search from 1980 to 2007 using the terms asthma, gender, sex, hormones, and lung development.Results: It is likely that hormonal changes and genetic susceptibility both contribute to the change in prevalence that occurs about the time of puberty. Severe asthma is also more predominant in females. In adulthood, women are more susceptible to the effects of smoking and more likely to develop asthma.Conclusions: It is important to determine whether asthma is a social, cultural, hormonal, and/or genetic issue. A number of topics on gender differences in asthma development and progression require additional research. For example, the interaction of fetal lung development and hormonal factors needs to be studied because it has consequences throughout life. Genetic studies of asthma should be stratified by sex, because some polymorphisms are particularly related to asthma in females. Further studies should be conducted on hormone-gene interactions (eg, X-chromosome genes) in relation to asthma and atopy. In addition, cellular hormonal influences in asthma and atopy in relation to innate and acquired immunity in both sexes need to be examined. This would benefit patients not only with asthma but also with many other diseases that show gender differences in prevalence, severity, and treatment response. Animal models investigating observed gender differences in humans should focus on susceptibility to environmental and hormonal factors in relation to lung and immune development. Differences in treatment response in asthma need to be examined as well. Double-blind studies need to be stratified by sex, and treatment responses in females and males should be investigated separately. Furthermore, interaction between gender and behavioral change in relation to asthma development and management should be studied. (Gend Med. 2007;4[Suppl B]:S133-S146) Copyright (c) 2007 Excerpta Medica, Inc.