1
|
Chedraoui C, Fakhry B, Sleiman J, Hu B, Attaway A, Bazeley P, Kim HJ, Zhang P, Cleveland, Zein JG, Phoenix. Sex Differences in Lung Function in Asthma Across the Ages. CHEST PULMONARY 2024; 2:100047. [PMID: 39006171 PMCID: PMC11242929 DOI: 10.1016/j.chpulm.2024.100047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 07/16/2024]
Affiliation(s)
- Celine Chedraoui
- Lerner Research Institute (C. C., B. F., J. S., and B. H.), Quantitative Health Sciences (B. H. and P. B.), and the Respiratory Institute (A. A. and P. Z.), Cleveland Clinic; the Case Western Reserve University (H. J. K.); and the Department of Medicine (J. G. Z.), Division of Pulmonary Medicine, Mayo Clinic
| | - Battoul Fakhry
- Lerner Research Institute (C. C., B. F., J. S., and B. H.), Quantitative Health Sciences (B. H. and P. B.), and the Respiratory Institute (A. A. and P. Z.), Cleveland Clinic; the Case Western Reserve University (H. J. K.); and the Department of Medicine (J. G. Z.), Division of Pulmonary Medicine, Mayo Clinic
| | - Joelle Sleiman
- Lerner Research Institute (C. C., B. F., J. S., and B. H.), Quantitative Health Sciences (B. H. and P. B.), and the Respiratory Institute (A. A. and P. Z.), Cleveland Clinic; the Case Western Reserve University (H. J. K.); and the Department of Medicine (J. G. Z.), Division of Pulmonary Medicine, Mayo Clinic
| | - Bo Hu
- Lerner Research Institute (C. C., B. F., J. S., and B. H.), Quantitative Health Sciences (B. H. and P. B.), and the Respiratory Institute (A. A. and P. Z.), Cleveland Clinic; the Case Western Reserve University (H. J. K.); and the Department of Medicine (J. G. Z.), Division of Pulmonary Medicine, Mayo Clinic
| | - Amy Attaway
- Lerner Research Institute (C. C., B. F., J. S., and B. H.), Quantitative Health Sciences (B. H. and P. B.), and the Respiratory Institute (A. A. and P. Z.), Cleveland Clinic; the Case Western Reserve University (H. J. K.); and the Department of Medicine (J. G. Z.), Division of Pulmonary Medicine, Mayo Clinic
| | - Peter Bazeley
- Lerner Research Institute (C. C., B. F., J. S., and B. H.), Quantitative Health Sciences (B. H. and P. B.), and the Respiratory Institute (A. A. and P. Z.), Cleveland Clinic; the Case Western Reserve University (H. J. K.); and the Department of Medicine (J. G. Z.), Division of Pulmonary Medicine, Mayo Clinic
| | - Hyun Jo Kim
- Lerner Research Institute (C. C., B. F., J. S., and B. H.), Quantitative Health Sciences (B. H. and P. B.), and the Respiratory Institute (A. A. and P. Z.), Cleveland Clinic; the Case Western Reserve University (H. J. K.); and the Department of Medicine (J. G. Z.), Division of Pulmonary Medicine, Mayo Clinic
| | - Peng Zhang
- Lerner Research Institute (C. C., B. F., J. S., and B. H.), Quantitative Health Sciences (B. H. and P. B.), and the Respiratory Institute (A. A. and P. Z.), Cleveland Clinic; the Case Western Reserve University (H. J. K.); and the Department of Medicine (J. G. Z.), Division of Pulmonary Medicine, Mayo Clinic
| | - Cleveland
- Lerner Research Institute (C. C., B. F., J. S., and B. H.), Quantitative Health Sciences (B. H. and P. B.), and the Respiratory Institute (A. A. and P. Z.), Cleveland Clinic; the Case Western Reserve University (H. J. K.); and the Department of Medicine (J. G. Z.), Division of Pulmonary Medicine, Mayo Clinic
| | - Joe G Zein
- Lerner Research Institute (C. C., B. F., J. S., and B. H.), Quantitative Health Sciences (B. H. and P. B.), and the Respiratory Institute (A. A. and P. Z.), Cleveland Clinic; the Case Western Reserve University (H. J. K.); and the Department of Medicine (J. G. Z.), Division of Pulmonary Medicine, Mayo Clinic
| | - Phoenix
- Lerner Research Institute (C. C., B. F., J. S., and B. H.), Quantitative Health Sciences (B. H. and P. B.), and the Respiratory Institute (A. A. and P. Z.), Cleveland Clinic; the Case Western Reserve University (H. J. K.); and the Department of Medicine (J. G. Z.), Division of Pulmonary Medicine, Mayo Clinic
| |
Collapse
|
2
|
Dore MP, Meloni G, Bassu I, Pes GM. Helicobacter pylori Infection Does Not Protect Against Allergic Diseases: Evidence From a Pediatric Cohort From Northern Sardinia, Italy. Helicobacter 2024; 29:e13107. [PMID: 38943311 DOI: 10.1111/hel.13107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/11/2024] [Revised: 06/12/2024] [Accepted: 06/13/2024] [Indexed: 07/01/2024]
Abstract
BACKGROUND The "hygiene hypothesis" states that reduced exposure to microbial antigens due to an excessively hygienic environment can increase the risk of developing autoimmune diseases, including atopic disorders and asthma. In recent decades, there has been a progressive decline in the prevalence of numerous microorganisms following improved hygienic-sanitary conditions. More specifically, several studies reported an inverse association between the reduction in Helicobacter pylori infection and the rise of asthma and allergic disorders. AIM To evaluate the prevalence of atopic disorders in a pediatric population in relation to seropositivity against H. pylori. METHODS Children from Northern Sardinia, Italy, referred to the local Children's Hospital for any reason, were investigated to identify risk factors, especially H. pylori infection, associated with atopic disorders. A validated questionnaire, including demographics, house size, history of breastfeeding, residence, school or daycare center attendance, exposure to animals, and a defined diagnosis of atopy-including asthma-was filled out by a trained pediatrician according to parents' answers and child records. A blood sample was collected from each participant and immunoglobulin G against H. pylori was assessed by a locally validated ELISA test. RESULTS The seroprevalence of H. pylori infection was 11.7% among 492 children (240 females). Thirty-two children had a confirmed diagnosis of asthma and 12 of allergy. No one child showed both conditions. Statistically significant differences in H. pylori seropositivity were not detected between children with or without atopy (8.4% vs. 12.6; p = 0.233). Although atopic disorders were more frequent in children exposed to traditional atopic risk factors, none of them showed to be significant after adjusting for all covariates. CONCLUSIONS Serologically assessed H. pylori infection was not significantly associated with a reduced risk of atopic diseases in children.
Collapse
Affiliation(s)
- Maria Pina Dore
- Dipartimento di Medicina, Chirurgia e Farmacia, University of Sassari, Sassari, Italy
- Baylor College of Medicine, Houston, Texas, USA
| | - Gianfranco Meloni
- Dipartimento di Medicina, Chirurgia e Farmacia, University of Sassari, Sassari, Italy
| | - Ica Bassu
- Dipartimento di Medicina, Chirurgia e Farmacia, University of Sassari, Sassari, Italy
| | - Giovanni Mario Pes
- Dipartimento di Medicina, Chirurgia e Farmacia, University of Sassari, Sassari, Italy
- Blue Zone Longevity Observatory, Ogliastra, Italy
| |
Collapse
|
3
|
Jenkins CR, Singh D, Ducharme FM, Raherison C, Lavoie KL. Asthma and Rhinitis Through the Lifespan of Nonpregnant Women. THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY. IN PRACTICE 2023; 11:3578-3584. [PMID: 37802256 DOI: 10.1016/j.jaip.2023.09.040] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Revised: 09/22/2023] [Accepted: 09/28/2023] [Indexed: 10/08/2023]
Abstract
Increasingly, clinical practice guidelines advocate a precision medicine-based approach to care for asthma. This focus requires knowledge of not only different asthma phenotypes and their associated biomarkers but also sex and gender differences through the lifespan. Evidence continues to build in favor of different lifetime prevalence, clinical presentations, responses to management, and long-term prognosis of asthma. Women transition through many biological and psychosocial phases in their lives, all of which may interact with, and influence, their health and well-being. Historically, explanations have focused on hormonal effects on asthma in reproductive life, but a greater understanding of mechanisms starting before birth and changing over a lifetime is now possible, with immunologic, inflammatory, and hormonal factors playing a role. This article describes the evidence for the differences in asthma and rhinitis between men and women at different stages of life, the potential underlying mechanisms that contribute to this, and the implications for management and research. Future research studies should systematically report sex differences in asthma so that this knowledge can be used to develop a personalized approach to care, to achieve best possible outcomes for all.
Collapse
Affiliation(s)
| | - Dave Singh
- Medicines Evaluation Unit, Manchester University, Manchester, United Kingdom; NHS Foundation Trust, University of Manchester, Manchester, United Kingdom
| | - Francine M Ducharme
- Department of Pediatrics, University of Montréal, Montréal, QC, Canada; Department of Social and Preventive Medicine, School of Public Health, University of Montréal, Montréal, QC, Canada
| | - Chantal Raherison
- Department of Pulmonology, CHU Guadeloupe, French West Indies University, Guadeloupe, French West Indies
| | - Kim L Lavoie
- Department of Psychology, University of Quebec at Montréal (UQAM), Montréal, QC, Canada; Montréal Behavioural Medicine Centre (MBMC), CIUSSS-NIM, Hopital du Sacre-Coeur de Montreal, Montréal, QC, Canada
| |
Collapse
|
4
|
Reddy KD, Oliver BGG. Sexual dimorphism in chronic respiratory diseases. Cell Biosci 2023; 13:47. [PMID: 36882807 PMCID: PMC9993607 DOI: 10.1186/s13578-023-00998-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2023] [Accepted: 02/23/2023] [Indexed: 03/09/2023] Open
Abstract
Sex differences in susceptibility, severity, and progression are prevalent for various diseases in multiple organ systems. This phenomenon is particularly apparent in respiratory diseases. Asthma demonstrates an age-dependent pattern of sexual dimorphism. However, marked differences between males and females exist in other pervasive conditions such as chronic obstructive pulmonary disease (COPD) and lung cancer. The sex hormones estrogen and testosterone are commonly considered the primary factors causing sexual dimorphism in disease. However, how they contribute to differences in disease onset between males and females remains undefined. The sex chromosomes are an under-investigated fundamental form of sexual dimorphism. Recent studies highlight key X and Y-chromosome-linked genes that regulate vital cell processes and can contribute to disease-relevant mechanisms. This review summarises patterns of sex differences in asthma, COPD and lung cancer, highlighting physiological mechanisms causing the observed dimorphism. We also describe the role of the sex hormones and present candidate genes on the sex chromosomes as potential factors contributing to sexual dimorphism in disease.
Collapse
Affiliation(s)
- Karosham Diren Reddy
- Respiratory and Cellular Molecular Biology Group, Woolcock Institute of Medical Research, Glebe, NSW, 2037, Australia.
- School of Life Science, University of Technology Sydney, Ultimo, NSW, 2007, Australia.
| | - Brian Gregory George Oliver
- Respiratory and Cellular Molecular Biology Group, Woolcock Institute of Medical Research, Glebe, NSW, 2037, Australia
- School of Life Science, University of Technology Sydney, Ultimo, NSW, 2007, Australia
| |
Collapse
|
5
|
Zhang X, Xu Z, Lin J, Xie G, Lv C, Zhang M. Sex differences of small airway function and fractional exhaled nitric oxide in patients with mild asthma. Ann Allergy Asthma Immunol 2023; 130:187-198.e3. [PMID: 36400352 DOI: 10.1016/j.anai.2022.11.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2022] [Revised: 10/24/2022] [Accepted: 11/07/2022] [Indexed: 11/17/2022]
Abstract
BACKGROUND Sex differences of small airway function (SAF) and fractional exhaled nitric oxide (FeNO) in patients with mild asthma remain unclear. OBJECTIVE To evaluate sex differences of SAF and FeNO in patients with mild asthma confirmed by positive methacholine challenge test (MCT) result. METHODS This cross-sectional, double-centered, observational study enrolled 1609 adult patients with forced expiratory volume in 1 second greater than or equal to 80% and suspected asthma symptoms. Data of spirometry, FeNO, impulse oscillometry measurements, and peripheral blood test result were compared between males and females. The receiver-operating characteristic curves of SAF parameters and FeNO in predicting positive MCT result were also calculated. RESULTS In patients with mild asthma matched by age, males had better SAF but higher FeNO levels than females (60 [29.27%] vs 187 [46.75%] for small airway dysfunction, 78.6% vs 72.0% for forced expiratory flow [FEF]50%, 67.5% vs 60.1% for FEF75%, 73.7% vs 67.4% for FEF25%-75%, and 42.0 ppb vs 29.0 ppb for FeNO, respectively, all P ≤ .001). The FeNO levels in male current smokers were considerably lower than those of nonsmokers. SAF and FeNO values declined more rapidly with age among female than male patients with asthma. The optimal cutoff values of FEF25%-75%, FEF50%, and FeNO for predicting a positive MCT result were 81.5%, 86.4%, and 41.0 ppb in males vs 73.7%, 76.9%, and 35.0 ppb in females. CONCLUSION In patients with mild asthma, the female patients have worse SAF, lower FeNO levels, and a more prominent decline trend of those parameters with age than males. Sex-specific cutoff values should be considered when SAF parameters (FEF25%-75%, FEF50%), alone or combined with FeNO, are used to predict positive MCT result in asthma diagnosis.
Collapse
Affiliation(s)
- Xue Zhang
- Department of Respiratory and Critical Care Medicine, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, People's Republic of China
| | - Zichong Xu
- Department of Respiratory and Critical Care Medicine, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, People's Republic of China
| | - Jingwang Lin
- Department of Respiratory and Critical Care Medicine, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, People's Republic of China
| | - Guogang Xie
- Department of Respiratory and Critical Care Medicine, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, People's Republic of China
| | - Chengjian Lv
- Department of Respiratory and Critical Care Medicine, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, People's Republic of China
| | - Min Zhang
- Department of Respiratory and Critical Care Medicine, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, People's Republic of China.
| |
Collapse
|
6
|
Pelaia C, Casarella A, Pelaia G, Marcianò G, Rania V, Muraca L, Cione E, Bianco L, Palleria C, D'Agostino B, Mazzuca D, De Sarro G, Mizio GD, Gallelli L. What Is the Role of Sex-Related Differences in the Effectiveness and Safety of Biological Drugs Used in Patients With Severe Asthma? J Clin Pharmacol 2022; 63:544-550. [PMID: 36524322 DOI: 10.1002/jcph.2194] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2022] [Accepted: 12/09/2022] [Indexed: 12/23/2022]
Abstract
Biological drugs are used to treat severe asthma with an improvement of clinical symptoms. Data on sex difference of these drugs in patients with severe asthma are sparse. This study aimed to assess the effects of sex-related differences on biological drugs in patients with severe asthma. In this observational, open-label, prospective, noncontrolled, single-center cohort pilot study, we enrolled adult patients aged >18 years diagnosed with severe asthma and not previously treated with biological drugs. The first clinical end point was the statistical difference (P < .05) in the efficacy of biological drugs evaluated using the asthma control test and spirometry between sexes. The first safety end point was the statistical difference (P < .05) in developing adverse drug reactions between sexes. We enrolled 74 patients with severe asthma (48 women and 26 men) with a mean age of 59.4 (standard deviation, 11.8) years. The mean forced expiratory volume in 1 second was 6.9 (standard deviation, 13.9) for women and 9.4 (standard deviation, 10.7) for men and improved significantly after the treatment (P < .01), with no significant differences in sex (P = .8). Similarly, the asthma control test improved 12 months after the beginning of the treatment without significant differences between men and women (P = .5). The most common drug used was omalizumab (45.9% of the patients; P < .01) without significant differences between sex (P > .05). We did not observe the development of adverse drug reactions during the study. In conclusion, in asthmatic patients, sex does not have a role in either the effectiveness or safety of biological drugs.
Collapse
Affiliation(s)
- Corrado Pelaia
- Department of Health Sciences, University "Magna Graecia" of Catanzaro, Catanzaro, Italy
| | - Alessandro Casarella
- Department of Health Sciences, University "Magna Graecia" of Catanzaro, Catanzaro, Italy
| | - Giulia Pelaia
- Department of Health Sciences, University "Magna Graecia" of Catanzaro, Catanzaro, Italy
| | - Gianmarco Marcianò
- Department of Health Sciences, University "Magna Graecia" of Catanzaro, Catanzaro, Italy
| | - Vincenzo Rania
- Department of Health Sciences, University "Magna Graecia" of Catanzaro, Catanzaro, Italy
| | - Lucia Muraca
- Department of Primary Care, ASP Catanzaro, Catanzaro, Italy
| | - Erika Cione
- Department of Pharmacy, Health and Nutritional Sciences, Department of Excellence 2018-2022, University of Calabria, Arcavacata di Rende, Rende, CS, Italy.,GalaScreenLaboratories, University of Calabria, Arcavacata di Rende, Rende, CS, Italy.,Medifarmagen SRL, University of Catanzaro and Mater Domini University Hospital, Catanzaro, Italy
| | - Luigi Bianco
- Operative Unit of Clinical Pharmacology, Mater Domini University Hospital, Catanzaro, Italy
| | - Caterina Palleria
- Operative Unit of Clinical Pharmacology, Mater Domini University Hospital, Catanzaro, Italy
| | - Bruno D'Agostino
- Department of Experimental Medicine, L. Donatelli, Section of Pharmacology, School of Medicine, University of Campania Luigi Vanvitelli, Naples, Italy
| | - Daniela Mazzuca
- Department of Health Sciences, University "Magna Graecia" of Catanzaro, Catanzaro, Italy
| | - Giovambattista De Sarro
- Department of Health Sciences, University "Magna Graecia" of Catanzaro, Catanzaro, Italy.,Medifarmagen SRL, University of Catanzaro and Mater Domini University Hospital, Catanzaro, Italy.,FAS@UMG Research Center, Department of Health Science, School of Medicine, University of Catanzaro, Catanzaro, Italy
| | - Giulio Di Mizio
- Department of Forensic Medicine, University of Catanzaro, Catanzaro, Italy
| | - Luca Gallelli
- Department of Health Sciences, University "Magna Graecia" of Catanzaro, Catanzaro, Italy.,GalaScreenLaboratories, University of Calabria, Arcavacata di Rende, Rende, CS, Italy.,Medifarmagen SRL, University of Catanzaro and Mater Domini University Hospital, Catanzaro, Italy.,Operative Unit of Clinical Pharmacology, Mater Domini University Hospital, Catanzaro, Italy.,FAS@UMG Research Center, Department of Health Science, School of Medicine, University of Catanzaro, Catanzaro, Italy
| |
Collapse
|
7
|
Hemshekhar M, Mostafa DHD, Spicer V, Piyadasa H, Maestre-Batlle D, Bolling AK, Halayko AJ, Carlsten C, Mookherjee N. Sex Dimorphism of Allergen-Induced Secreted Proteins in Murine and Human Lungs. Front Immunol 2022; 13:923986. [PMID: 35837410 PMCID: PMC9273854 DOI: 10.3389/fimmu.2022.923986] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2022] [Accepted: 06/03/2022] [Indexed: 11/15/2022] Open
Abstract
Biological sex influences disease severity, prevalence and response to therapy in allergic asthma. However, allergen-mediated sex-specific changes in lung protein biomarkers remain undefined. Here, we report sex-related differences in specific proteins secreted in the lungs of both mice and humans, in response to inhaled allergens. Female and male BALB/c mice (7-8 weeks) were intranasally challenged with the allergen house dust mite (HDM) for 2 weeks. Bronchoalveolar lavage fluid (BALF) was collected 24 hour after the last HDM challenge from allergen-naïve and HDM-challenged mice (N=10 per group, each sex). In a human study, adult participants were exposed to nebulized (2 min) allergens (based on individual sensitivity), BALF was obtained after 24 hour (N=5 each female and male). The BALF samples were examined in immunoblots for the abundance of 10 proteins shown to increase in response to allergen in both murine and human BALF, selected from proteomics studies. We showed significant sex-bias in allergen-driven increase in five out of the 10 selected proteins. Of these, increase in eosinophil peroxidase (EPX) was significantly higher in females compared to males, in both mice and human BALF. We also showed specific sex-related differences between murine and human samples. For example, allergen-driven increase in S100A8 and S100A9 was significantly higher in BALF of females compared to males in mice, but significantly higher in males compared to females in humans. Overall, this study provides sex-specific protein biomarkers that are enhanced in response to allergen in murine and human lungs, informing and motivating translational research in allergic asthma.
Collapse
Affiliation(s)
- Mahadevappa Hemshekhar
- Manitoba Centre for Proteomics and Systems Biology, Department of Internal Medicine, University of Manitoba, Winnipeg, MB, Canada
| | - Dina H. D. Mostafa
- Manitoba Centre for Proteomics and Systems Biology, Department of Internal Medicine, University of Manitoba, Winnipeg, MB, Canada
- Department of Immunology, University of Manitoba, Winnipeg, MB, Canada
| | - Victor Spicer
- Manitoba Centre for Proteomics and Systems Biology, Department of Internal Medicine, University of Manitoba, Winnipeg, MB, Canada
| | - Hadeesha Piyadasa
- Manitoba Centre for Proteomics and Systems Biology, Department of Internal Medicine, University of Manitoba, Winnipeg, MB, Canada
- Department of Immunology, University of Manitoba, Winnipeg, MB, Canada
- Department of Pathology, School of Medicine, Stanford University, Palo Alto, CA, United States
| | - Danay Maestre-Batlle
- Air Pollution Exposure Laboratory, Division of Respiratory Medicine, Department of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Anette K. Bolling
- Air Pollution Exposure Laboratory, Division of Respiratory Medicine, Department of Medicine, University of British Columbia, Vancouver, BC, Canada
- Department of Air Quality and Noise, Norwegian Institute of Public Health, Oslo, Norway
| | - Andrew J. Halayko
- Department of Physiology and Pathophysiology, University of Manitoba, Winnipeg, MB, Canada
- Biology of Breathing Group, The Children’s Hospital Research Institute of Manitoba, Winnipeg, MB, Canada
| | - Christopher Carlsten
- Air Pollution Exposure Laboratory, Division of Respiratory Medicine, Department of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Neeloffer Mookherjee
- Manitoba Centre for Proteomics and Systems Biology, Department of Internal Medicine, University of Manitoba, Winnipeg, MB, Canada
- Department of Immunology, University of Manitoba, Winnipeg, MB, Canada
- Biology of Breathing Group, The Children’s Hospital Research Institute of Manitoba, Winnipeg, MB, Canada
- *Correspondence: Neeloffer Mookherjee,
| |
Collapse
|
8
|
Jenkins CR, Boulet LP, Lavoie KL, Raherison-Semjen C, Singh D. Personalized Treatment of Asthma: The Importance of Sex and Gender Differences. THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY. IN PRACTICE 2022; 10:963-971.e3. [PMID: 35150902 DOI: 10.1016/j.jaip.2022.02.002] [Citation(s) in RCA: 24] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/15/2021] [Revised: 01/18/2022] [Accepted: 02/03/2022] [Indexed: 12/19/2022]
Abstract
An individual's sex (nominally male or female, based on biological attributes) and gender (a complex term referring to socially constructed roles, behaviors, and expressions of identity) influence the clinical course of asthma in several ways. The physiologic development of the lungs and effects of sex hormones may explain why more boys than girls have asthma, and after puberty, more women than men have asthma. Female sex hormones have an impact throughout the life span and are associated with poor asthma control. Gender may influence exposure to asthma triggers, and sex and gender can influence the prevalence of comorbidities and interactions with health care professionals. Despite widely reported sex- and gender-based differences in asthma and asthma management, these issues frequently are not considered by health care professionals. There is also inconsistency regarding the use of "sex" and "gender" in scientific discourse; research is needed to define sex- and gender-based differences better and how they might interact to influence asthma outcomes. This review outlines the impact an individual's sex and gender can have on the pathogenesis, clinical course, diagnosis, treatment, and management of asthma.
Collapse
Affiliation(s)
| | | | - Kim L Lavoie
- Department of Psychology, University of Québec at Montreal and Montreal Behavioural Medicine Centre, CIUSSS-NIM, Hôpital du Sacré-Cœur de Montréal, Montreal, Canada
| | - Chantal Raherison-Semjen
- Centre Hospitalier Universitaire de Guadeloupe, Guadeloupe, France; INSERM U1219, EpiCene Team, University of Bordeaux, Bordeaux, France
| | - Dave Singh
- University of Manchester, Manchester University NHS Foundation Trust, Manchester, United Kingdom
| |
Collapse
|
9
|
Sex, Allergic Diseases and Omalizumab. Biomedicines 2022; 10:biomedicines10020328. [PMID: 35203537 PMCID: PMC8869622 DOI: 10.3390/biomedicines10020328] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2021] [Revised: 01/25/2022] [Accepted: 01/26/2022] [Indexed: 11/17/2022] Open
Abstract
Gender differences are increasingly emerging in every area of medicine including drug therapy; however, specific gender-targeted studies are infrequent. Sex is a fundamental variable, which cannot be neglected. When optimizing therapies, gender pharmacology must always be considered in order to improve the effectiveness and safety of the use of drugs. Knowledge of gender differences promotes appropriate use of therapies and greater health protection for both genders. Further development of gender research would make it possible to report on differences in the assimilation and response of the female organism as compared to the male, in order to identify potential risks and benefits that can be found between genders. Furthermore, a better understanding of sex/gender-related influences, with regard to pharmacological activity, would allow the development of personalized “tailor-made” medicines. Here, we summarize the state of knowledge on the role of sex in several allergic diseases and their treatment with omalizumab, the first biologic drug authorized for use in the field of allergology.
Collapse
|
10
|
Zhang Y, Huang L. Characteristics of older adult hospitalized patients with bronchial asthma: a retrospective study. Allergy Asthma Clin Immunol 2021; 17:122. [PMID: 34861886 PMCID: PMC8641253 DOI: 10.1186/s13223-021-00628-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2021] [Accepted: 11/18/2021] [Indexed: 11/10/2022] Open
Abstract
Background Bronchial asthma is a chronic inflammation of the airways. Older adult patients with bronchial asthma are defined as patients older than 65 and with a previous or current clear diagnosis of asthma. The purpose of this study was to determine the characteristics of older adult hospitalized patients with bronchial asthma. Methods We retrospectively analyzed the data from patients with bronchial asthma admitted to the General Hospital of the Northern Theater Command from September 2018 to January 2020. We divided them into the older adult (≥ 65 years) and the younger (< 65 years) groups. We compared the clinical and epidemiological characteristics of the two groups. Results There were 181 inpatients with bronchial asthma, including 41 older adult patients, accounting for 22.7%. There were significant differences in age, sex, smoking, duration of disease, age at diagnosis of asthma, hospital stays, hospitalization costs, number of acute attacks 1 year before admission, number of hospitalizations in our hospital one year before admission, asthma control test score, forced expiratory volume in 1 s (FEV1), FEV1/FVC, the severity of acute attacks, comorbidities, and inhaled corticosteroid dose between the two groups. There were many older adult patients with asthma (mostly late-onset asthma). The hospitalization costs were high. Most patients had many comorbidities, poor asthma control, severe attack, and heavy economic burdens. Conclusion Attention should be focused on achieving asthma control in older adult patients to improve their quality of life and reduce their economic burdens.
Collapse
|