The intersection of sex and gender in the treatment of influenza

Morgan, Rosemary; Klein, Sabra L.

doi:10.1016/j.coviro.2019.02.009

Cited by 69 publications

(62 citation statements)

References 64 publications

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“… 138 Epidemiological data reveal that severe seasonal influenza is more likely to affect young boys than young girls before puberty, and cause worse outcomes in adult women between puberty and menopause than in adult men. 139 During influenza outbreaks and pandemics, morbidity and mortality are higher for women than for men. 139 Following influenza A virus infection, the inflammatory responses to the virus produce immunopathogenic tissue damage and pulmonary disease.…”

Section: Sex and Gender Differences In Major Chronic Diseasesmentioning

confidence: 99%

Sex and gender: modifiers of health, disease, and medicine

et al. 2020

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Clinicians can encounter sex and gender disparities in diagnostic and therapeutic responses. These disparities are noted in epidemiology, pathophysiology, clinical manifestations, disease progression, and response to treatment. This Review discusses the fundamental influences of sex and gender as modifiers of the major causes of death and morbidity. We articulate how the genetic, epigenetic, and hormonal influences of biological sex influence physiology and disease, and how the social constructs of gender affect the behaviour of the community, clinicians, and patients in the health-care system and interact with pathobiology. We aim to guide clinicians and researchers to consider sex and gender in their approach to diagnosis, prevention, and treatment of diseases as a necessary and fundamental step towards precision medicine, which will benefit men's and women's health.

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Section: Sex and Gender Differences In Major Chronic Diseasesmentioning

confidence: 99%

Sex and gender: modifiers of health, disease, and medicine

et al. 2020

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“…The proteolytic enzyme activates S protein by splitting S1 from S2 of highly pathogenic human Coronaviruses (SARS-CoV, MERS-CoV, SARS-CoV-2) [ 29 ] but also HA1 and HA2 (Hemoagglutinin) from 2013 Asian H7N9 and H1N1 subtypes of influenza A viruses [ 58 ]. Of note, infection and death would preferentially target males in both these latter pandemics [ 59 ], although alternative data were reported from some Western Countries [ 60 ]. A genetic predisposition to a severe course from A(H1N1)pdm09 influenza infection was also found into the GG genotype rs2070788 variant carrying individuals from a Chinese cohort and a single-nucleotide polymorphism correlated with differential (and augmented) TMPRSS2 expression [ 61 ].…”

Section: Main Textmentioning

confidence: 99%

A gendered magnifying glass on COVID-19

2020

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COVID-19 pandemia is affecting Countries worldwide with a gendered death excess as being a male represents, especially in the 50–69 years age group, an unfavourable factor. Females are constitutionally prone to defend themselves against pathogens with a stronger efficiency than males. As a fact, several genes involved into the regulation of the innate and adaptive immune response are strategically placed on the X-chromosome and, among them, pathogen-related receptors (PRRs), such as Toll-like receptor 7, suitable to recognize ssRNAs and trigger a gendered successful anti-viral fight. On the other hand, a more regulated IL-6 production and a more contained inflammation after the encounter of a pathogen supply score points in favour of the female sex in the view that an abnormal and exaggerated cytokine release does represent the hallmark of the deathful SARS-CoV-2 infection. The sex-prevalent expression of the attachment and permissive molecules ACE2 and TMPRSS2 further supports the concept of a male-oriented vulnerability. In this review, the possible role of biological and immunological sex differences into the higher morbidity and mortality of SARS-CoV-2 between females and males are discussed.

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“…However, we also need to pay attention to racial and gender disparities in obesity and its role in the incidence, prevalence and severity of lung viral pathogenesis. 28 Furthermore, mapping genes to the patient profiles, and at the same time, associating pre-existing diseases to their respective clinical codes to efficiently link medical records with identified causative genes and variants will provide a cross cut analysis for more efficient identification of drugs and therapeutics for specific patients with COVID-19. Intelligently linking curated clinical data obtained from healthcare platforms with computationally processed genomics and metabolomics data is the key to identify common and rare functional variants, and examine relations between genomic variations and metabolite levels across multiple health disparities.…”

Section: Perspective: Mainstream Precision Medicinementioning

confidence: 99%

Integrative clinical, genomics and metabolomics data analysis for mainstream precision medicine to investigate COVID-19

et al. 2020

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Despite significant scientific and medical discoveries, the genetics of novel infectious diseases like COVID-19 remains far from understanding. SARS-CoV-2 is a single-stranded RNA respiratory virus that causes COVID-19 by binding to the ACE2 receptor in the lung and other organs. Understanding its clinical presentation and metabolomic and genetic profile will lead to the discovery of diagnostic, prognostic and predictive biomarkers, which may lead to more effective medical therapy. It is important to investigate correlations and overlap between reported diagnoses of a patient with COVID-19 in clinical data with identified germline and somatic mutations, and highly expressed genes from genomics data analysis. Timely model clinical, genomics and metabolomics data to find statistical patterns across millions of features to identify underlying biological pathways, modifiable risk factors and actionable information that supports early detection and prevention of COVID-19, and development of new therapies for better patient care. Next, ensuring security reconcile noise, need to build and train machine learning prognostic models to find actionable information that supports early detection and prevention of COVID-19. Based on the myriad data, applying appropriate machine learning algorithms to stratify patients, understand scenarios, optimise decision-making, identify high-risk rare variants (including ACE2, TMPRSS2) and making medically relevant predictions. Innovative and intelligent solutions are required to improve the traditional symptom-driven practice, and allow earlier interventions using predictive diagnostics and tailor better personalised treatments, when confronted with the challenges of pandemic situations.

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The intersection of sex and gender in the treatment of influenza

Cited by 69 publications

References 64 publications

Sex and gender: modifiers of health, disease, and medicine

Sex and gender: modifiers of health, disease, and medicine

A gendered magnifying glass on COVID-19

Integrative clinical, genomics and metabolomics data analysis for mainstream precision medicine to investigate COVID-19

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