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Biological differences between the sexes and susceptibility to tuberculosis
Shepherd Nhamoyebonde1, Alasdair Leslie1
1KwaZulu-Natal Research Institute for Tuberculosis and HIV, Nelson R. Mandela School of Medicine, University of KwaZulu-Natal, Durban, South Africa.
Sex differences in tuberculosis (TB) susceptibility may be driven by biology, not just epidemiology. Sex hormones significantly impact immune responses, offering new insights into effective TB resistance strategies.
Area of Science:
- Immunology
- Sex-based Biology
- Infectious Diseases
Background:
- Tuberculosis (TB) disproportionately affects men globally.
- Epidemiological factors have been traditionally cited as the primary cause of this sex bias.
- Emerging evidence suggests biological sex differences play a crucial role in TB susceptibility.
Purpose of the Study:
- To explore the potential impact of biological sex differences on susceptibility to mycobacterial infections.
- To investigate the underlying mechanisms, particularly the role of sex hormones in modulating immune responses against tuberculosis.
- To identify key components of an effective immune response to tuberculosis by studying sex-based variations.
Main Methods:
- Review of epidemiological data on tuberculosis sex disparities.
- Analysis of immunological studies investigating sex-based differences in response to mycobacteria.
- Exploration of the influence of sex hormones on immune cell function and cytokine production relevant to tuberculosis.
Main Results:
- Biological sex differences, beyond epidemiological factors, are likely contributors to tuberculosis incidence.
- Sex hormones, such as estrogen and testosterone, demonstrably modulate immune responses crucial for controlling mycobacterial infections.
- Specific immune pathways and cellular responses exhibit distinct patterns between sexes in the context of tuberculosis.
Conclusions:
- Biological sex is a significant factor influencing tuberculosis susceptibility and disease progression.
- Understanding the immunomodulatory effects of sex hormones is critical for developing targeted tuberculosis prevention and treatment strategies.
- Further research into sex-specific immune responses will enhance our comprehension of effective tuberculosis immunity.
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