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Reyes-García J, Montaño LM, Carbajal-García A, Wang YX. Sex Hormones and Lung Inflammation. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2021; 1304:259-321. [PMID: 34019274 DOI: 10.1007/978-3-030-68748-9_15] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Inflammation is a characteristic marker in numerous lung disorders. Several immune cells, such as macrophages, dendritic cells, eosinophils, as well as T and B lymphocytes, synthetize and release cytokines involved in the inflammatory process. Gender differences in the incidence and severity of inflammatory lung ailments including asthma, chronic obstructive pulmonary disease (COPD), pulmonary fibrosis (PF), lung cancer (LC), and infectious related illnesses have been reported. Moreover, the effects of sex hormones on both androgens and estrogens, such as testosterone (TES) and 17β-estradiol (E2), driving characteristic inflammatory patterns in those lung inflammatory diseases have been investigated. In general, androgens seem to display anti-inflammatory actions, whereas estrogens produce pro-inflammatory effects. For instance, androgens regulate negatively inflammation in asthma by targeting type 2 innate lymphoid cells (ILC2s) and T-helper (Th)-2 cells to attenuate interleukin (IL)-17A-mediated responses and leukotriene (LT) biosynthesis pathway. Estrogens may promote neutrophilic inflammation in subjects with asthma and COPD. Moreover, the activation of estrogen receptors might induce tumorigenesis. In this chapter, we summarize the most recent advances in the functional roles and associated signaling pathways of inflammatory cellular responses in asthma, COPD, PF, LC, and newly occurring COVID-19 disease. We also meticulously deliberate the influence of sex steroids on the development and progress of these common and severe lung diseases.
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Affiliation(s)
- Jorge Reyes-García
- Departamento de Farmacología, Facultad de Medicina, Universidad Nacional Autónoma de México, CDMX, Mexico City, Mexico.,Department of Molecular and Cellular Physiology, Albany Medical College, Albany, NY, USA
| | - Luis M Montaño
- Departamento de Farmacología, Facultad de Medicina, Universidad Nacional Autónoma de México, CDMX, Mexico City, Mexico
| | - Abril Carbajal-García
- Departamento de Farmacología, Facultad de Medicina, Universidad Nacional Autónoma de México, CDMX, Mexico City, Mexico
| | - Yong-Xiao Wang
- Department of Molecular and Cellular Physiology, Albany Medical College, Albany, NY, USA.
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2
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Becerra-Díaz M, Lerner AD, Yu DH, Thiboutot JP, Liu MC, Yarmus LB, Bose S, Heller NM. Sex differences in M2 polarization, chemokine and IL-4 receptors in monocytes and macrophages from asthmatics. Cell Immunol 2020; 360:104252. [PMID: 33450610 DOI: 10.1016/j.cellimm.2020.104252] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2020] [Revised: 11/08/2020] [Accepted: 11/10/2020] [Indexed: 12/27/2022]
Abstract
Allergic asthma affects more women than men. It is mediated partially by IL-4/IL-13-driven polarization of monocyte-derived macrophages in the lung. We tested whether sex differences in asthma are due to differential IL-4 responsiveness and/or chemokine receptor expression in monocytes and monocyte-derived macrophages from healthy and allergic asthmatic men and women. We found female cells expressed M2 genes more robustly following IL-4 stimulation than male cells, as did cells from asthmatics than those from healthy controls. This likely resulted from increased expression ofγC, part of the type I IL-4 receptor, and reduced IL-4-induced SOCS1, a negative regulator of IL-4 signaling, in asthmatic compared to healthy macrophages. Monocytes from asthmatic women expressed more CX3CR1, which enhances macrophage survival. Our findings highlight how sex differences in IL-4 responsiveness and chemokine receptor expression may affect monocyte recruitment and macrophage polarization in asthma, potentially leading to new sex-specific therapies to manage the disease.
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Affiliation(s)
- Mireya Becerra-Díaz
- Department of Anesthesiology and Critical Care Medicine, Johns Hopkins University, School of Medicine, Baltimore, MD 21205, USA
| | - Andrew D Lerner
- Department of Anesthesiology and Critical Care Medicine, Johns Hopkins University, School of Medicine, Baltimore, MD 21205, USA; Department of Pulmonary and Critical Care Medicine, Johns Hopkins University, School of Medicine, Baltimore, MD 21205, USA
| | - Diana H Yu
- Department of Anesthesiology and Critical Care Medicine, Johns Hopkins University, School of Medicine, Baltimore, MD 21205, USA; Department of Pulmonary and Critical Care Medicine, Johns Hopkins University, School of Medicine, Baltimore, MD 21205, USA
| | - Jeffrey P Thiboutot
- Department of Anesthesiology and Critical Care Medicine, Johns Hopkins University, School of Medicine, Baltimore, MD 21205, USA; Department of Pulmonary and Critical Care Medicine, Johns Hopkins University, School of Medicine, Baltimore, MD 21205, USA
| | - Mark C Liu
- Department of Anesthesiology and Critical Care Medicine, Johns Hopkins University, School of Medicine, Baltimore, MD 21205, USA; Department of Pulmonary and Critical Care Medicine, Johns Hopkins University, School of Medicine, Baltimore, MD 21205, USA
| | - Lonny B Yarmus
- Department of Anesthesiology and Critical Care Medicine, Johns Hopkins University, School of Medicine, Baltimore, MD 21205, USA; Department of Pulmonary and Critical Care Medicine, Johns Hopkins University, School of Medicine, Baltimore, MD 21205, USA
| | - Sonali Bose
- Department of Anesthesiology and Critical Care Medicine, Johns Hopkins University, School of Medicine, Baltimore, MD 21205, USA; Department of Pulmonary and Critical Care Medicine, Johns Hopkins University, School of Medicine, Baltimore, MD 21205, USA
| | - Nicola M Heller
- Department of Anesthesiology and Critical Care Medicine, Johns Hopkins University, School of Medicine, Baltimore, MD 21205, USA; Allergy and Clinical Immunology, Johns Hopkins University, School of Medicine, Baltimore, MD 21205, USA.
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3
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Abstract
PURPOSE OF REVIEW The difference of food allergy prevalence between male and female individuals is well documented and should have more impact for personalized diagnosis and management. Although in younger age male sex dominates, in adults more women are affected by food allergies. This sex disparity diminishes again around menopause, underlining the influence of sex hormones, but in addition, also metabolic gender-specific factors and differences in microbiome composition might contribute to the different expression of food allergy in the two genders. The sex-dependent and gender-dependent influence on development of food allergy, disease severity, as well as on social, dietary and neuropsychological factors in studies mainly published within past 18 months are discussed in this review. RECENT FINDINGS Sex and gender differences likely play a role in food allergy development, for instance via influence on immune cells and mediators, or on the composition of the microbiome, but only few controlled studies on this specific topic are available. SUMMARY Future prospective studies need to clearly take into account the sex and gender difference in order to provide personalized diagnosis, management and treatment of food allergy.
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Affiliation(s)
- Isabella Pali-Schöll
- Comparative Medicine, Interuniversity Messerli Research Institute of the University of Veterinary Medicine, Medical University Vienna and University Vienna.,Institute of Pathophysiology and Allergy Research, Center of Pathophysiology, Infectiology and Immunology, Medical University of Vienna, Vienna, Austria
| | - Erika Jensen-Jarolim
- Comparative Medicine, Interuniversity Messerli Research Institute of the University of Veterinary Medicine, Medical University Vienna and University Vienna.,Institute of Pathophysiology and Allergy Research, Center of Pathophysiology, Infectiology and Immunology, Medical University of Vienna, Vienna, Austria
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Leffler J, Stumbles PA, Strickland DH. Immunological Processes Driving IgE Sensitisation and Disease Development in Males and Females. Int J Mol Sci 2018; 19:E1554. [PMID: 29882879 PMCID: PMC6032271 DOI: 10.3390/ijms19061554] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2018] [Revised: 05/21/2018] [Accepted: 05/21/2018] [Indexed: 01/15/2023] Open
Abstract
IgE sensitisation has increased significantly over the last decades and is a crucial factor in the development of allergic diseases. IgE antibodies are produced by B cells through the process of antigen presentation by dendritic cells, subsequent differentiation of CD4⁺ Th2 cells, and class switching in B cells. However, many of the factors regulating these processes remain unclear. These processes affect males and females differently, resulting in a significantly higher prevalence of IgE sensitisation in males compared to females from an early age. Before the onset of puberty, this increased prevalence of IgE sensitisation is also associated with a higher prevalence of clinical symptoms in males; however, after puberty, females experience a surge in the incidence of allergic symptoms. This is particularly apparent in allergic asthma, but also in other allergic diseases such as food and contact allergies. This has been partly attributed to the pro- versus anti-allergic effects of female versus male sex hormones; however, it remains unclear how the expression of sex hormones translates IgE sensitisation into clinical symptoms. In this review, we describe the recent epidemiological findings on IgE sensitisation in male and females and discuss recent mechanistic studies casting further light on how the expression of sex hormones may influence the innate and adaptive immune system at mucosal surfaces and how sex hormones may be involved in translating IgE sensitisation into clinical manifestations.
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Affiliation(s)
- Jonatan Leffler
- Telethon Kids Institute, The University of Western Australia, 100 Roberts Rd, Subiaco, WA 6008, Australia.
| | - Philip A Stumbles
- Telethon Kids Institute, The University of Western Australia, 100 Roberts Rd, Subiaco, WA 6008, Australia.
- School of Paediatrics and Child Health, The University of Western Australia, Subiaco, WA 6008, Australia.
- School of Veterinary and Life Sciences, Murdoch University, Murdoch, WA 6150, Australia.
| | - Deborah H Strickland
- Telethon Kids Institute, The University of Western Australia, 100 Roberts Rd, Subiaco, WA 6008, Australia.
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Tarpataki N, Thuróczy J, Fischer N, Jacquenet S, Rostaher A, Richard C, Zwickl L, Olivry T, Favrot C. A pilot study of total and allergen-specific IgE serum levels during anestrous, estrous and pregnancy in healthy female dogs. Vet Dermatol 2018; 29:329. [PMID: 29687519 DOI: 10.1111/vde.12544] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/23/2018] [Indexed: 11/29/2022]
Abstract
BACKGROUND Allergen-specific IgE serology is used for the determination of sensitization status in dogs with atopic dermatitis; the influence of the female reproductive cycle on the results of such methods has not been studied in dogs. OBJECTIVES To compare the total and allergen-specific IgE of healthy bitches during anestrous, estrous and pregnancy. ANIMALS Eight privately owned, healthy bitches. METHODS Total and allergen-specific IgE levels were determined in eight bitches at three different time-points of their reproductive cycle: anestrous, estrous and pregnancy. RESULTS Total IgE was significantly decreased (median: 74%) in female dogs during pregnancy when compared to anestrous. In 14 of 216 (6%), allergen-specific IgE test results were variably positive and negative at different stages of the reproductive cycle. This variation, however, was not related to changes in total serum IgE levels. CONCLUSIONS Total IgE serum levels are reduced during pregnancy in female dogs. However, results of one allergen-specific IgE test did not appear to be markedly altered by the reproductive cycle in healthy bitches.
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Affiliation(s)
- Noémi Tarpataki
- Department and Clinic of Internal Medicine, University of Veterinary Medicine, István utca 2, Budapest, 1078, Hungary
| | - Julianna Thuróczy
- Department and Clinic of Reproduction, University of Veterinary Medicine, István utca 2, Budapest, 1078, Hungary
| | - Nina Fischer
- Dermatology Unit, Clinic for Small Animal Internal Medicine, Vetsuisse Faculty, University of Zurich, Winterthurerstrasse 260, 8057, Zurich, Switzerland
| | - Sandrine Jacquenet
- Genclis, 15 rue du bois de la Champelle, 54500, Vandoeuvre-les-Nancy, France
| | - Ana Rostaher
- Dermatology Unit, Clinic for Small Animal Internal Medicine, Vetsuisse Faculty, University of Zurich, Winterthurerstrasse 260, 8057, Zurich, Switzerland
| | - Christelle Richard
- Genclis, 15 rue du bois de la Champelle, 54500, Vandoeuvre-les-Nancy, France
| | - Lena Zwickl
- Dermatology Unit, Clinic for Small Animal Internal Medicine, Vetsuisse Faculty, University of Zurich, Winterthurerstrasse 260, 8057, Zurich, Switzerland
| | - Thierry Olivry
- Department of Clinical Sciences, College of Veterinary Medicine, NC State University, 1060 William Moore Drive, Raleigh, NC, 27607, USA
| | - Claude Favrot
- Dermatology Unit, Clinic for Small Animal Internal Medicine, Vetsuisse Faculty, University of Zurich, Winterthurerstrasse 260, 8057, Zurich, Switzerland
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6
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Sex steroid signaling: implications for lung diseases. Pharmacol Ther 2015; 150:94-108. [PMID: 25595323 DOI: 10.1016/j.pharmthera.2015.01.007] [Citation(s) in RCA: 108] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2014] [Accepted: 01/09/2015] [Indexed: 12/12/2022]
Abstract
There is increasing recognition that sex hormones (estrogen, progesterone, and testosterone) have biological and pathophysiological actions in peripheral, non-reproductive organs, including the lung. Clinically, sex differences in the incidence, morbidity and mortality of lung diseases such as asthma, chronic obstructive pulmonary disease (COPD), pulmonary fibrosis, lung cancer and pulmonary hypertension have been noted, although intrinsic sex differences vs. the roles of sex steroids are still not well-understood. Accordingly, it becomes important to ask the following questions: 1) Which sex steroids are involved? 2) How do they affect different components of the lung under normal circumstances? 3) How does sex steroid signaling change in or contribute to lung disease, and in this regard, are sex steroids detrimental or beneficial? As our understanding of sex steroid signaling in the lung improves, it is important to consider whether such information can be used to develop new therapeutic strategies to target lung diseases, perhaps in both sexes or in a sex-specific manner. In this review, we focus on the basics of sex steroid signaling, and the current state of knowledge regarding how they influence structure and function of specific lung components across the life span and in the context of some important lung diseases. We then summarize the potential for sex steroids as useful biomarkers and therapeutic targets in these lung diseases as a basis for future translational research in the area of gender and individualized medicine.
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Farage MA, Berardesca E, Maibach H. The possible relevance of sex hormones on irritant and allergic responses: their importance for skin testing. Contact Dermatitis 2010; 62:67-74. [DOI: 10.1111/j.1600-0536.2009.01621.x] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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8
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Melgert BN, Ray A, Hylkema MN, Timens W, Postma DS. Are there reasons why adult asthma is more common in females? Curr Allergy Asthma Rep 2007; 7:143-50. [PMID: 17437685 DOI: 10.1007/s11882-007-0012-4] [Citation(s) in RCA: 105] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Many epidemiological studies suggest that women are at increased risk of developing adult-onset asthma and also suffer from more severe disease than men. These gender differences appear to be the product of biological sex differences as well as sociocultural and environmental differences. The biological sex differences include genetic, pulmonary, and immunological factors. There is compelling evidence that sex hormones are major determinants of at least these biological sex differences. This paper explores the current literature regarding effects of sex hormones on immune function, resident lung cells, and regulation of local processes in the lung to shed light on underlying mechanisms of gender differences in asthma. More research is needed to understand these mechanisms in order to improve treatment of women with asthma.
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Affiliation(s)
- Barbro N Melgert
- University of Pittsburgh Medical Center, Division of Pulmonary, Allergy, and Critical Care Medicine, NW 628 MUH, 3459 Fifth Avenue, Pittsburgh, PA 15213, USA.
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9
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Gender Differences in Asthma Development and Progression. ACTA ACUST UNITED AC 2007; 4 Suppl B:S133-46. [DOI: 10.1016/s1550-8579(07)80054-4] [Citation(s) in RCA: 203] [Impact Index Per Article: 11.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/17/2007] [Indexed: 11/19/2022]
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10
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Turner MC, Chen Y, Krewski D, Ghadirian P. An overview of the association between allergy and cancer. Int J Cancer 2006; 118:3124-32. [PMID: 16395696 DOI: 10.1002/ijc.21752] [Citation(s) in RCA: 101] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Numerous epidemiological studies have evaluated some aspect of the association between a history of allergy and cancer occurrence. In this article, an overview of the epidemiological evidence is presented with a discussion of a number of methodological issues important in this area of study. Literature searches were conducted using the MEDLINE database from 1966 through to August 2005 to identify articles that explored a personal history of allergic disorders as a risk factor for cancer. Although it is difficult to draw conclusions between allergy and cancer at many sites because of insufficient evidence or a lack of consistency both within and among studies completed to date, strong inverse associations have been reported for pancreatic cancer and glioma, whereas lung cancer was positively associated with asthma. Additional studies are needed to confirm these finding and to address the limitations of previous studies, including the validity and reliability of exposure measures and control for confounding. Further, large prospective studies using cancer incidence would be particularly useful, including studies using biological markers of allergic status to reduce potential misclassification and to confirm the results of previous studies based on self-report. There is also a need for further basic research to clarify a potential mechanism, should an association exist.
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Affiliation(s)
- Michelle C Turner
- R. Samuel McLaughlin Center for Population Health Risk Assessment, University of Ottawa, Canada.
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Sunyer J, Antó JM, Plana E, Janson C, Jarvis D, Kony S, Omenaas ER, Svanes C, Wjst M, Leynaert B. Maternal atopy and changes in parity. Clin Exp Allergy 2006; 35:1028-32. [PMID: 16120084 DOI: 10.1111/j.1365-2222.2005.02300.x] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
BACKGROUND Atopic women tend to have fewer children, although atopy may favour conception. OBJECTIVE To assess whether atopy is associated with the number of new births and whether changes in parity are associated with a change in atopy in a cohort of young women. METHODS Women had atopy (defined as the presence of serum-specific IgE against common aeroallergens) measured in the European Community Respiratory Health Study during the years 1991--92 (n=4580). About 9 years later, 2844 (62.1%) were recontacted and 2414 (52.7%) had atopy measured again. RESULTS Atopic women had fewer children at baseline than non-atopic women but the association disappeared at the end of the follow-up. Atopy tended to increase parity during the follow-up, but in a non-statistically significant way (relative risk=1.08; 0.86-1.35, after adjusting for number of children at baseline, age, length of follow-up, education or social class). Prevalence of atopy during the follow-up changed by the same magnitude whatever the birth cohort and the change in the number of children (P for interaction >0.7). CONCLUSION Atopic women did not have a significantly higher fertility rate but they may postpone having their first child compared with non-atopic women. We are unable to confirm the hypothesis that atopy in women may decrease with successive pregnancies.
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Affiliation(s)
- J Sunyer
- Unitat de Recerca Respiratoria i Ambiental, Institut Municipal d'Investigació Mèdica, Barcelona, Spain
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Forastiere F, Sunyer J, Farchi S, Corbo G, Pistelli R, Baldacci S, Simoni M, Agabiti N, Perucci CA, Viegi G. Number of offspring and maternal allergy. Allergy 2005; 60:510-4. [PMID: 15727585 DOI: 10.1111/j.1398-9995.2005.00736.x] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
The consistent association seen between family size and childhood allergy has led to the 'hygiene hypothesis', namely that a lower frequency of infections in early childhood is associated with an increased risk of asthma and hay fever. Maternal atopy, however, is a strong predictor of childhood asthma and hay fever. If maternal atopy is inversely related to the number of siblings then the role of siblings in the development of childhood atopy, the basic tenet of the 'hygiene hypothesis', is challenged. We evaluated the association between number of pregnancies and number of live births with lifetime occurrence of maternal wheeze, asthma, allergic rhinitis, and allergic conjunctivitis in a cross-sectional study in four areas in Italy. A total of 1755 (35-74 year old) nonsmoking women filled a questionnaire on reproductive history as well as on lifetime occurrence of symptoms/diseases. The number of live births was inversely related to lifetime allergic rhinitis (P-value for trend=0.031) and allergic conjunctivitis (P-value for trend=0.011). The odds ratios for those with 4+ children (in comparison with those having 0-1) were: 0.53 (95% CI: 0.27-1.04) and 0.42 (95% CI: 0.22-0.81), respectively. A similar trend was seen for number of pregnancies, although not statistically significant. No association was found between number of pregnancies and number of live births with wheeze or asthma. The results may be interpreted as an indication that maternal atopy influences pregnancy outcomes or that pregnancy itself has an effect on maternal atopy.
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Affiliation(s)
- F Forastiere
- Dipartimento di Epidemiologia, ASL RME, Rome, Italy
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13
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Abstract
Assessing allergy by measurement of serum immunoglobulin (Ig) E antibodies is fast and safe to perform. Serum antibodies can preferably be assessed in patients with dermatitis and in those who regularly use antihistamines and other pharmacological agents that reduce skin sensitivity. Skin tests represent the easiest tool to obtain quick and reliable information for the diagnosis of respiratory allergic diseases. It is the technique more widely used, specific and reasonably sensitive for most applications as a marker of atopy. Measurement of serum IgE antibodies and skin-prick testing may give complimentary information and can be applied in clinical and epidemiological settings. Peripheral blood eosinophilia is less used, but is important in clinical practice to demonstrate the allergic aetiology of disease, to monitor its clinical course and to address the choice of therapy. In epidemiology, hypereosinophilia seems to reflect an inflammatory reaction in the airways, which may be linked to obstructive airflow limitation.
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Affiliation(s)
- S Baldacci
- Institute of Clinical Physiology, Pisa, Italy
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