It's all about sex: gender, lung development and lung disease

Abstract

Accumulating evidence suggests that gender affects the incidence, susceptibility and severity of several lung diseases. Gender also influences lung development and physiology. Data from both human and animal studies indicate that sex hormones might contribute to disease pathogenesis or serve as protective factors, depending on the disease involved. In this review, the influence of gender and sex hormones on lung development and pathology will be discussed, with specific emphasis on pulmonary fibrosis, asthma and cancer.

Figure 1

A The interaction between sex and age in the prevalence of current asthma The smoothed curves suggest that the increased relative risk of asthma among females during the adult years is due to a loss of asthma among males and an increased incidence among females. Source: the third National Health and Nutrition Examination Survey (NHANES III) [28]. B Gender differences in mortality rates from pulmonary fibrosis in the US in 2003. Source [15]. C Gender differences in US Lung Cancer Diagnoses and Deaths in 2003. Source: U.S. Cancer Statistics Working Group. United States Cancer Statistics: 2003 Incidence and Mortality. Atlanta (GA): Department of Health and Human Services, Centers for Disease Control and Prevention, and National Cancer Institute; 2007.

Figure 2

Summary of the known effects of testosterone and estrogen in the lung. (+) indicates positive effect, (-) indicates negative effect, (+/-) indicates conflicting data, (?) indicates unknown effects.