Are there reasons why adult asthma is more common in females?

Melgert, Barbro N.; Ray, Anuradha; Hylkema, Machteld N.; Timens, Wim; Postma, Dirkje S.

doi:10.1007/s11882-007-0012-4

Cited by 159 publications

(138 citation statements)

References 70 publications

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“…Although many reasons have been hypothesized, it is believed that reproductive hormones may partly explain these sex differences (30). Our study shows that ever having smoked is a risk factor for adult-onset asthma, but only for women.…”

Section: Original Researchmentioning

confidence: 51%

Adult-Onset Asthma Becomes the Dominant Phenotype among Women by Age 40 Years. The Longitudinal CARDIA Study

Sood¹,

Qualls

Schuyler³

et al. 2013

Annals ATS

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Rationale: Although asthma is usually considered to originate in childhood, adult-onset disease is being increasingly reported.Objectives: To contrast the proportion and natural history of adultonset versus pediatric-onset asthma in a community-based cohort. We hypothesized that asthma in women is predominantly of adult onset rather than of pediatric onset.Methods: This study used data from the Coronary Artery Risk Development in Young Adults (CARDIA) cohort in the United States over a 25-year period. Adult-and pediatric-onset asthma phenotypes were studied, as defined by age at onset of 18 years or older. Subjects with asthma were categorized by sex, obesity, atopy, smoking, and race by mean age/examination year, using a three-way analysis of covariance model. Natural history of disease was examined using probabilities derived from a Markov chain model. Measurements and Main Results:Asthma of adult onset became the dominant (i.e., exceeded 50%) phenotype in women by age 40 years. The age by which adult-onset asthma became the dominant phenotype was further lowered for obese, nonatopic, eversmoking, or white women. The prevalence trend with increasing time for adult-onset disease was greater among subjects with nonatopic than atopic asthma among both sexes. Furthermore, adult-onset asthma had remarkable sex-related differences in risk factors. In both sexes, the quiescent state for adult-onset asthma was less frequent and also "less stable" over time than for pediatric-onset asthma.Conclusions: Using a large national cohort, this study challenges the dictum that most asthma in adults originates in childhood. Studies of the differences between pediatric-and adult-onset asthma may provide greater insight into the phenotypic heterogeneity of asthma.

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Section: Original Researchmentioning

confidence: 51%

Adult-Onset Asthma Becomes the Dominant Phenotype among Women by Age 40 Years. The Longitudinal CARDIA Study

Sood¹,

Qualls

Schuyler³

et al. 2013

Annals ATS

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“…5 Among adults, epidemiological studies have demonstrated that the prevalence of asthma is higher among females than among males. [6][7][8] The relationship between sex hormones and asthma has been evaluated in several studies. 9,10 Sex-related differences in the risk, incidence and pathogenesis of a variety of lung diseases exist in humans.…”

Section: Introductionmentioning

confidence: 99%

Association between asthma and female sex hormones

Baldaçara

Silva

2017

Sao Paulo Med. J.

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CONTEXT AND OBJECTIVE: The relationship between sex hormones and asthma has been evaluated in several studies. The aim of this review article was to investigate the association between asthma and female sex hormones, under different conditions (premenstrual asthma, use of oral contraceptives, menopause, hormone replacement therapy and pregnancy). DESIGN AND SETTING: Narrative review of the medical literature, Universidade Federal do Tocantins (UFT) and Universidade Federal de São Paulo (Unifesp). METHODS:We searched the CAPES journal portal, a Brazilian platform that provides access to articles in the MEDLINE, PubMed, SciELO, and LILACS databases. The following keywords were used based on Medical Subject Headings: asthma, sex hormones, women and use of oral contraceptives. RESULTS:The associations between sex hormones and asthma remain obscure. In adults, asthma is more common in women than in men. In addition, mortality due to asthma is significantly higher among females. The immune system is influenced by sex hormones: either because progesterone stimulates progesterone-induced blocking factor and Th2 cytokines or because contraceptives derived from progesterone and estrogen stimulate the transcription factor GATA-3. CONCLUSIONS:The associations between asthma and female sex hormones remain obscure. We speculate that estrogen fluctuations are responsible for asthma exacerbations that occur in women. Because of the anti-inflammatory action of estrogen, it decreases TNF-α production, interferon-γ expression and NK cell activity. We suggest that further studies that highlight the underlying physiopathological mechanisms contributing towards these interactions should be conducted. RESUMO CONTEXTO E OBJETIVO:A relação entre os hormônios sexuais e a asma tem sido investigada em diversos estudos. Esta revisão tem como objetivo descrever a relação entre hormônios sexuais (endógenos e exó-genos) e a inflamação nas vias aéreas, especialmente na asma, em eventos diferentes (na asma pré-menstrual, durante o uso de anticoncepcionais, na menopausa, no uso de terapia hormonal e na gestação). TIPO DE ESTUDO E LOCAL:Revisão narrativa da literatura médica, Universidade Federal do Tocantins (UFT) e Universidade Federal de São Paulo (Unifesp). MÉTODO: Pesquisamos o Portal de Periódicos Capes, uma plataforma brasileira que fornece acesso a artigos nas bases de dados MEDLINE, PubMed, SciELO e LILACS. Os descritores utilizados foram asma, hormônios sexuais, mulheres e uso de anticoncepcionais, com base no "Medical Subject Headings". RESULTADOS: As associações entre hormônios sexuais e asma ainda permanecem obscuras. Em adultos, a asma é mais frequente em mulheres do que em homens. Além disso, a mortalidade por asma é significativamente maior no sexo feminino, destacando-se que o sistema imunológico sofre influência de hormônios sexuais, seja porque a progesterona estimula o fator bloqueador induzido pela progesterona e citocinas Th2 ou porque contraceptivos derivados de progesterona e estrógeno estimulam o fator de transcriç...

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“…With respect to tobacco consumption, it has been suggested that women may be at greater risk than men of developing respiratory health problems and susceptibility to lung cancer later in life, as a result of the fact that smoking affects airway development during childhood [3][4][5][6]. In addition, studies have found that sex-specific factors may be important etiologic factors in the development of asthma [7,8], pulmonary diseases [9] and lung cancer [10].…”

Section: Introductionmentioning

confidence: 99%

Sex and gender differences in tobacco smoking among adolescents in French secondary schools

Kalaboka

Piau

King

et al. 2016

Monaldi Arch Chest Dis

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Aim. We investigated the relationship between sex (genetic/biological) and gender (environmental/ cultural) factors in relation to adolescent tobacco smoking. Methods. A representative sample of 11,582 students from French secondary public schools participated in the study by completing a self-administered, standardised questionnaire. Results. Using the WHO classification for smoking in the youth, 15.6% of the adolescents were regular smokers, 7.7% occasional smokers, 17.9% experimental smokers and 4.8% ex-smokers, with no statistically significant gender difference. Taking non-smoking as a reference, puberty had a much greater effect on the likelihood of being a regular smoker [OR=18.0 (95% Confidence Interval: 9.6- 32)] than of being an experimental/occasional smoker [OR=3.7 (2.9-4.6)] among girls. For boys, the effect of puberty was not as great [OR=4.7 (3.5-6.5)] for regular vs. [OR=2.1 (1.8-2.5)] for experimental/occasional smokers). Similarly, illicit drug use had a larger effect on the likelihood of being regular smoker vs. non-smoker [OR=15.0 (12.0-20.0) in boys and 12 (8.8-16.0) in girls] than of being experimental/occasional smoker vs. a non-smoker [OR=4.8 (3.7-6.1) and 2.9 (2.1-3.9) respectively]. Other factors related to regular smoking were exposure to passive smoking and regular alcohol consumption. Living with both parents was a protective factor for life and regular smoking in both genders. Conclusions. Our results show that influential factors of sex-related (puberty), gender-specific (environmental tobacco smoking, alcohol consumption, drug abuse) or sex/gender (regular sexual intercourse) are related to the smoking behaviour in French adolescents.

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Are there reasons why adult asthma is more common in females?

Cited by 159 publications

References 70 publications

Adult-Onset Asthma Becomes the Dominant Phenotype among Women by Age 40 Years. The Longitudinal CARDIA Study

Adult-Onset Asthma Becomes the Dominant Phenotype among Women by Age 40 Years. The Longitudinal CARDIA Study

Association between asthma and female sex hormones

Sex and gender differences in tobacco smoking among adolescents in French secondary schools

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