Personalized Treatment of Asthma: The Importance of Sex and Gender Differences

Jenkins, Christine; Boulet, Louis‐Philippe; Lavoie, Kim L.; Raherison‐Semjen, Chantal; Singh, Dave

doi:10.1016/j.jaip.2022.02.002

Cited by 31 publications

(20 citation statements)

References 132 publications

(200 reference statements)

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“…In adults, asthma tends to be more severe in women than in men in terms of prevalence, severity, and duration [26]. Different physiology and behaviors such as smoking, occupation, lifestyle, and diet may result in these differences [26]. Female sex hormones linked to poor asthma control [26].…”

Section: Discussionmentioning

confidence: 99%

“…Different physiology and behaviors such as smoking, occupation, lifestyle, and diet may result in these differences [26]. Female sex hormones linked to poor asthma control [26]. Estrogen and progesterone promote asthma pathogenesis and worsen asthmatic symptoms, while testosterone prevents the inflammatory process of asthma [26].…”

Section: Discussionmentioning

confidence: 99%

“…Female sex hormones linked to poor asthma control [26]. Estrogen and progesterone promote asthma pathogenesis and worsen asthmatic symptoms, while testosterone prevents the inflammatory process of asthma [26]. Different gene expression may be another factor in different manifestations of asthma.…”

Section: Discussionmentioning

confidence: 99%

“…However, house dust mites are considered to be one of the main allergens of active cysteine proteases [19]. Women spend more time than men doing housework and are therefore more exposed to household allergens such as house dust [26]. The role of apolipoprotein expression in different gender of asthmatic patients is unknown.…”

Section: Discussionmentioning

confidence: 99%

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Transcriptome analysis in patients with asthma after inhaled combination therapy with long-acting β2-agonists and corticosteroids

Liang¹,

Tzeng²,

Hsieh³

et al. 2022

Int. J. Med. Sci.

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Introduction: Asthma is one of the major public health problems that imposes a great burden on societal, financial, and healthcare around the world. Asthma poorly affects the health-related quality of life and daily activities of patients. Treatment of asthma, including inhaled corticosteroids (ICS) and long-acting beta-agonists (LABAs), mainly aims to improve the lung function and reduce symptoms and exacerbations. Current treatment regimens are symptom-based strategies, and the status of airway inflammation after treatment is yet unknown. We conducted this study to understand the comprehensive inflammation or airway remodeling status of patients after ICS-LABA treatment through RNA transcriptome analysis. Materials and methods: Eight newly diagnosed asthmatic patients and two healthy subjects were recruited in this study. Asthmatic patients underwent blood tests, lung function test, and RNA transcriptome analysis before and after ICS-LABA treatment. Results: In comparison with healthy subjects, pretreatment asthmatic patients had higher expression of protein tyrosine kinase and related signaling pathways. After ICS-LABA treatment, the expression of nuclear receptor transcription coactivator, N-acetyltransferase, protein tyrosine kinase, nuclear receptor, and RNA polymerase II-activating transcription factor were downregulated. However, the post-treatment asthmatic patients still had higher expression of cysteine-type endopeptidase, endodeoxyribonuclease, apolipoprotein, and unfolded protein was still upregulated than healthy subjects. Conclusions: The combination of ICS/LABAs decreased airway inflammatory and remodeling pathways. However, allergen stimulation-related pathways were still upregulated in patients after ICS/LABA treatment. The combination of medication and allergen removal is a complete strategy for asthma.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Transcriptome analysis in patients with asthma after inhaled combination therapy with long-acting β2-agonists and corticosteroids

Liang¹,

Tzeng²,

Hsieh³

et al. 2022

Int. J. Med. Sci.

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“…Certainly, it may be also assumed that the lack of sex-specific recommendations for the treatment of asthma and COPD could be because no real difference in effectiveness exists but, unfortunately, to date it is not known whether this hypothesis is true [ 9 ]. In any case, it seems that both sex, assessed as male or female according to biological attributes, and gender, referred to social roles, behaviours, and expressions of identity, may significantly modulate the pharmacological response to asthma and COPD treatments [ 7 , 10 ].…”

Section: Introductionmentioning

confidence: 99%

Sex differences in adult asthma and COPD therapy: a systematic review

et al. 2022

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Background Although asthma is more prevalent in women and the prevalence of COPD is increasing in women, the current international recommendations for the management and prevention of asthma and COPD provide no sex-related indication for the treatment of these diseases. Therefore, we systematically reviewed the evidence across literature on the sex-related effectiveness of asthma and COPD therapy. Methods This systematic review has been registered in PROSPERO and performed according to PRISMA-P. The PICO framework was applied for the literature search strategy: "patient problem” included adult patients suffering from asthma or COPD, “Intervention” regarded the pharmacological treatments for asthma or COPD, “Comparison” was vs. baseline, active controls, or placebo, “Outcome” was any difference sex-related in the effectiveness of interventions. Results In asthma 44% of the evidence reported that men responded better than women to the therapy, whereas this percentage was 28% in COPD. ICS was generally less effective in women than in men to treat asthma, and consistent evidence suggests that in asthmatic patients ICS/LABA/LAMA combination may be equally effective in both men and women. Due to the inconsistent available evidence, it is not possible to identify specific treatments whose effectiveness is related to sex difference in COPD patients. Conclusions There is a strong need of investigating the sex-related impact of asthma and COPD treatments. Pre-specified analyses in men and women should be planned in future trial protocols, a necessary condition that should be requested also by the regulatory agencies to overcome the anachronistic “one-size-fits-all” approach to therapeutics associated with suboptimal outcomes for patients.

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