Sex Bias in Asthma Prevalence and Pathogenesis

Shah, Ruchi; Newcomb, Dawn C.

doi:10.3389/fimmu.2018.02997

Cited by 170 publications

(123 citation statements)

References 101 publications

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“…These observations have been frequently linked to the effect of female sex hormones in allergic asthma that have been well documented by us and other authors . In this regard, it has been shown that variations in female sex hormones during puberty, pregnancy or menopause can have a profound effect on asthma symptoms and severity …”

Section: Discussionsupporting

confidence: 53%

“…Sex differences in asthma have been well described in the literature. Several reports have shown that asthma is more prevalent in boys than in girls but this status is inverted during puberty, indicating an important role for sex hormones in the development of this disease . Similarly, the influence of obesity has also been documented with studies indicating that body weight is an important risk factor in asthma .…”

Section: Introductionmentioning

confidence: 99%

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Sex differences in the influence of obesity on a murine model of allergic lung inflammation

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Anhê

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et al. 2019

Clin Experimental Allergy

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Background: Despite the overwhelming evidence showing the influence of sex or obesity in the development of respiratory diseases in humans and animals, the mechanisms by which these combined two factors influence allergic asthma are not well understood. Objective:We have investigated the interaction between sex and weight gain in an experimental model of lung allergic inflammation induced by chicken egg ovalbumin (OVA) in mice. Methods:Animals were fed a high-fat diet for 8 weeks and then sensitized and challenged with OVA. Results:Our results demonstrate that in comparison with males, high-fat diet (HFD) allergic female mice exhibit a reduction in the number of leucocytes in the lung lumen when challenged with OVA and, in contrast, an accumulation of these cells in the lung tissue. In addition, we also observed that allergic HFD female mice presented a robust lung remodelling in comparison with HFD males, evidenced by higher deposition of collagen in the airways and TGF-β in lung fluid. Measuring epithelial adhesion molecule expression, we observed that female mice presented a significantly lower expression of CD103 than males in BAL cells, regardless of the diet. Similarly, HFD female mice express lower levels of EpCAM in lung tissue in comparison with males and lean females. Levels of A20/TNFAIP3 expression in lung tissue demonstrated that HFD female mice express lower levels of these regulatory factors than all the other groups. However, this reduction was not accompanied by an increase in activated NF-κB. Conclusions:Our results present evidence that the interaction between sex and weight gain alters the progression of allergic asthma in mice with females developing airway remodelling at a much earlier stage than males.Clinical Relevance: These data may contribute to a better understanding of the clinical differences in the development and severity of allergic asthma observed between men and women of reproductive age.

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Section: Discussionsupporting

confidence: 53%

Section: Introductionmentioning

confidence: 99%

Sex differences in the influence of obesity on a murine model of allergic lung inflammation

Lacerda

Anhê

Page

et al. 2019

Clin Experimental Allergy

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“…The clinical course of inflammatory lung diseases is influenced by several factors including sex, hormones, and poor air quality (Doherty et al 2009;Liptzin et al 2015;Silva et al 2017). Sex differences in lung disease incidence, prevalence, and severity have been noted for years, as well as increased prevalence rates for asthma, chronic obstructive pulmonary disease (COPD), and other inflammatory diseases in women versus men (Fuseini and Newcomb 2017;Tsiligianni et al 2017;Center for Disease Control and Prevention, 2018;Shah and Newcomb 2018). The number of women diagnosed with asthma, bronchitis, emphysema, COPD, pneumonia, and lung cancer has significantly increased in the past decade at higher rates than for men, and the mortality associated with many of these conditions is also now higher for women than men (Martinez et al 2007;Aryal et al 2014;Jenkins et al 2017).…”

Section: Introductionmentioning

confidence: 99%

Modulation of the lung inflammatory response to ozone by the estrous cycle

et al. 2019

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Emerging evidence suggests that sex differences exist in the control of lung innate immunity; however, the specific roles of sex hormones in the inflammatory response, and the mechanisms involved are unclear. Here, we investigated whether fluctuations in circulating hormone levels occurring in the mouse estrous cycle could affect the inflammatory response to air pollution exposure. For this, we exposed female mice (C57 BL /6J, 8 weeks old) at different phases of the estrous cycle to 2 ppm of ozone or filtered air ( FA ) for 3 h. Following exposure, we collected lung tissue and bronchoalveolar lavage fluid ( BAL ), and performed lung function measurements to evaluate inflammatory responses and respiratory mechanics. We found a differential inflammatory response to ozone in females exposed in the luteal phase (metestrus, diestrus) versus the follicular phase (proestrus, estrus). Females exposed to ozone in the follicular phase had significantly higher expression of inflammatory genes, including Ccl2, Cxcl2, Ccl20, and Il6, compared to females exposed in the luteal phase ( P < 0.05), and displayed differential activation of regulatory pathways. Exposure to ozone in the follicular phase also resulted in higher BAL neutrophilia, lipocalin levels, and airway resistance than exposure in the luteal phase ( P < 0.05). Together, these results show that the effects of ozone exposure in the female lung are affected by the estrous cycle phase, and potentially hormonal status. Future studies investigating air pollution effects and inflammation in women should consider the menstrual cycle phase and/or circulating hormone levels.

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“…12 Ruchi Shah et al, proposed that in childhood asthma is more prevalent among males and in adulthood more prevalent in women and hormone fluctuations alter the symptoms of asthma among women. 13 Iris Koper et al, also agreed on gender differences of asthma. 14 Be´ne´dicte Leynaert et al, proposed that non allergic asthma is more frequent in women than men and female sex is an independent risk factor for nonallergic asthma.…”

Section: Discussionmentioning

confidence: 94%

Clinical and Demographic Profile of Patients Diagnosed as Bronchial Asthma in a Tertiary Care Centre

Ramakrishna¹,

Haribabu²,

Priya³

et al. 2019

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BACKGROUNDBronchial asthma is a chronic inflammatory disease of the air ways and is of heterogenous aetiology characterized by episodes of wheeze, chest tightness, cough and shortness of breath. It is one of the most common diseases worldwide and nearly 300 million suffer from attacks of bronchial asthma every year. 1 METHODSWe have taken a total of one hundred patients diagnosed as bronchial asthma, aged above 18 years and analysed their age, gender, duration of illness, frequency of symptoms, diurnal variation, time of attack of bronchial asthma and season of attack. We analysed the severity with peak flow meter and spirometry and analysed the reversibility of airway obstruction at the time of diagnosis 15 minutes after salbutamol dry powder inhalation. RESULTSAge of the patients ranged from 21 to 60 years. In our study of hundred patients, 55% are females and rest are males. Peak prevalence is seen among both males and females in the 41-60 years age group. 52% patients had 2 to 5 years of history. 31% had less than 2 years of history and 17% showed more than 5 years of history. 33% of the patients had daily attacks with nocturnal symptoms and 19% had attacks more than twice weekly requiring rescue medication. Diurnal variation was seen in 66% of the patients. 59% of the patients had attacks predominantly seen in winter and 14% had attacks throughout the year. 9% of patients showed summer-time attacks of bronchial asthma. 18% had attacks in rainy season. Only 13% patients showed >12% reversibility in FEV1 at the time of enrolment. At the time of enrolment mild obstruction was seen in 21%, moderate obstruction in 33%, and severe obstruction in 44%. Symptoms improved every week. Good response with 80% of patients showing more than 60% FEV1 was seen after 4 weeks of treatment. 20% patients continued to have less than 60% FEV1 and 12% of them have less than 40% FEV1 after 4 weeks of treatment. CONCLUSIONSAsthma occurred predominantly in 40-60 years of age. Females outnumbered males in our study. More than half the patients gave a history of 2-5 years. Half the patients had more than twice weekly attacks. Diurnal variation was seen in two thirds. Winter attacks were predominant in 59% and 14% of patients showed no seasonal variation. More than 12% reversibility was seen in only 13% at the time of admission into the study. 80% of patients improved symptomatically at the end of four weeks. HOW TO CITE THIS ARTICLE:Ramakrishna R, Haribabu R, Hari Priya S, et al. Clinical and demographic profile of patients diagnosed as bronchial asthma in a tertiary care centre.

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Sex Bias in Asthma Prevalence and Pathogenesis

Cited by 170 publications

References 101 publications

Sex differences in the influence of obesity on a murine model of allergic lung inflammation

Sex differences in the influence of obesity on a murine model of allergic lung inflammation

Modulation of the lung inflammatory response to ozone by the estrous cycle

Clinical and Demographic Profile of Patients Diagnosed as Bronchial Asthma in a Tertiary Care Centre

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