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Sex Differences in Paediatric and Adult Asthma
Anika Naeem1, Patricia Silveyra1
1Pulmonary, Immunology and Physiology Laboratory, Department of Pediatrics, Pennsylvania State University College of Medicine, Hershey, Pennsylvania, USA.
Insights
Asthma affects millions globally, with sex hormones potentially influencing disease development, especially in females post-puberty. Further research is needed to understand these sex-specific factors for personalized asthma treatments.
Area of Science:
- Pulmonology
- Immunology
- Endocrinology
Background:
- Asthma is a prevalent chronic respiratory condition affecting both children and adults.
- Disease prevalence and presentation differ between sexes across the lifespan, suggesting hormonal influences.
- Current diagnostic approaches and understanding of asthma pathogenesis require refinement, particularly regarding sex-specific factors.
Purpose of the Study:
- To review recent advancements in asthma diagnostics for pediatric and adult populations.
- To explore the impact of Body Mass Index (BMI), environmental exposures, socioeconomic status, and sex hormones on asthma.
- To elucidate the role of sex hormones in asthma pathogenesis and identify potential targets for personalized medicine.
Main Methods:
- Review of current literature on asthma diagnostics and pathogenesis.
- Analysis of epidemiological and experimental data on asthma risk factors.
- Synthesis of evidence regarding the influence of sex hormones on airway inflammation and hyper-reactivity.
Main Results:
- Evidence suggests circulating sex hormone levels contribute to asthma symptoms in post-pubertal females.
- The role of sex hormones in asthma pathogenesis in males and children remains largely unestablished.
- Mechanisms linking hormonal influences to airway inflammation and hyper-reactivity require further investigation.
Conclusions:
- Asthma development and severity are influenced by diverse factors, varying with age and sex.
- Further research is crucial to identify specific sex hormone contributions to asthma.
- Understanding these sex-specific mechanisms will enable the development of personalized asthma treatment strategies.
Abstract:
Asthma is the most common chronic condition in Western countries. Affecting 1 in 7 children and 1 in 12 adults, asthma is responsible for >350,000 avoidable deaths every year. While most children who develop symptoms of asthma are <5 years of age, the disease is frequently misdiagnosed or not suspected in infants and toddlers. In addition, the prevalence of asthma is different in males and females throughout their lifespan. While boys are more likely to develop asthma than girls, this pattern is reversed after puberty. This indicates that sex-specific factors, such as fluctuations in hormone levels, play a role in the disease's pathogenesis. In this review, the authors discuss recent advances in diagnostic tools for asthma in both adults and children, as well as the influences of BMI, environmental exposures, socioeconomic factors, and sex hormones in the disease's pathogenesis. The review will show that both experimental and epidemiological evidence suggest that circulating sex hormone levels are important contributors to asthma symptoms in post-pubertal females, while their role in males and children has not been yet established. In addition, the mechanisms associated with these hormonal influences on airway inflammation and hyper-reactivity have not been yet elucidated. The authors conclude that different factors affect asthma rates and severity in children and adults, and that more research needs to be conducted to identify the specific contributions of sex hormones. These will allow the development of more personalised asthma treatment strategies for men and women at different stages of life.
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