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Chronic inflammatory diseases in children are more severe in girls
Georges J A Casimir1, Sandra Mulier, Laurence Hanssens
1Department of Pulmonology and Allergology, University Children's Hospital Queen Fabiola, Free University of Brussels, Brussels, Belgium. gcasim@ulb.ac.be
Insights
In prepubescent children, girls show heightened inflammatory responses and more severe disease outcomes across asthma, cystic fibrosis, and sickle cell anemia. These sex-based differences suggest a genetic basis for immune reactivity.
Area of Science:
- Pediatric Immunology
- Inflammatory Diseases
- Sex-Based Biological Differences
Background:
- Females exhibit generally higher immune reactivity and more pronounced inflammatory responses compared to males.
- Understanding sex-based differences in pediatric inflammatory diseases is crucial for tailored clinical management.
Purpose of the Study:
- To investigate sex-based differences in inflammatory markers and clinical outcomes in children with chronic inflammatory conditions.
- To compare the expression of inflammatory markers and disease severity between girls and boys with asthma, cystic fibrosis, and sickle cell anemia.
Main Methods:
- Analysis of inflammatory markers including neutrophil count (NC) and C-reactive protein in 149 children (74 girls, 75 boys).
- Data collection across multiple time points for patients diagnosed with asthma, cystic fibrosis, or sickle cell anemia.
- Statistical comparison of clinical outcomes and treatment requirements between sexes.
Main Results:
- Girls with asthma had higher NC and required more cortisone and bronchodilators during recovery.
- Girls with cystic fibrosis showed higher NC from age 5 and more frequent infections/antibiotic use from age 2.
- Girls with sickle cell anemia experienced more crises and acute chest syndrome episodes.
Conclusions:
- Sex is associated with differential inflammatory marker expression and clinical outcomes in prepubescent children with chronic diseases.
- Findings suggest a potential genetic predisposition for sex-based immune differences rather than hormonal influences.
- These results highlight the importance of considering sex in the diagnosis and treatment of pediatric inflammatory conditions.
Abstract:
In humans and animal models, females express higher immune reactivity and more robust inflammatory responses. We analyzed the expression of current inflammatory markers in 149 children (74 girls and 75 boys) with three chronic inflammatory diseases: 50 with asthma, 47 with cystic fibrosis, and 52 with sickle cell anemia to evaluate the potential differences in clinical response according to sex. Data including temperature, neutrophil count (NC), and C-reactive protein were recorded for each patient at several time points according to his/her disease. In asthma, NC was higher in girls than in males (P < 0.02), as were doses of cortisone (P < 0.04) or inhaled bronchodilators (P < 0.01) received at recovery. In cystic fibrosis, NC became significantly higher in girls at age 5 years (P < 0.003), whereas episodes of infection and antibiotic administration were already significantly more frequent in girls at age 2 years (P < 0.02 and P < 0.05, respectively). In sickle cell anemia, the number of crises since diagnosis and number of acute chest syndrome episodes were significantly higher in girls (P < 0.01 and P < 0.05, respectively). Our study extends the documentation of a relationship between sex, inflammatory markers, and clinical outcome in prepubescent children, suggesting a genetic predetermination is more likely than hormonal influence.
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