Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2020 Apr 1:15:711-721.
doi: 10.2147/COPD.S237228. eCollection 2020.

Chronic Obstructive Pulmonary Disease in Women: A Biologically Focused Review with a Systematic Search Strategy

MeiLan K Han  1
Affiliations
Review

Chronic Obstructive Pulmonary Disease in Women: A Biologically Focused Review with a Systematic Search Strategy

MeiLan K Han. Int J Chron Obstruct Pulmon Dis. .

Erratum in

Abstract

Purpose: Evidence suggests that chronic obstructive pulmonary disease (COPD) symptoms and progression may differ between men and women. However, limited information is currently available on the pathophysiological and biological factors that may underlie these sex-related differences. The objective of this review is to systematically evaluate reports of potential sex-related differences, including genetic, pathophysiological, structural, and other biological factors, that may influence COPD development, manifestation, and progression in women.

Patients and methods: A PubMed literature search was conducted from inception until January 2020. Original reports of genetic, hormonal, and physiological differences, and biological influences that could contribute to COPD development, manifestation, and progression in women were included.

Results: Overall, 491 articles were screened; 29 articles met the inclusion criteria. Results from this analysis demonstrated between-sex differences in inflammatory, immune, genetic, structural, and physiological factors in patients with COPD.

Conclusion: Various biological differences are observed between men and women with COPD including differences in inflammatory and metabolic pathways related to obesity and fat distribution, immune cell function and autophagy, extent and distribution of emphysema and airway wall remodeling. An enhanced understanding of these differences has the potential to broaden our understanding of how COPD develops and progresses, thereby providing an opportunity to ultimately improve diagnosis, treatment, and monitoring of COPD in both men and women.

Keywords: COPD; biological; sex; systematic review; women.

PubMed Disclaimer

Conflict of interest statement

MeiLan K. Han reports consulting fees from Boehringer Ingelheim, GlaxoSmithKline, AstraZeneca, Merck, and Novartis. She also reports research support from Novartis and Sunovion. Boehringer Ingelheim also supported conduction of the systematic search.

Figures

Figure 1
Figure 1
Flowchart of the included studies. Notes: aArticles reporting adherence, asthma-COPD overlap, clinical characteristics, epidemiology, healthcare costs, hospitalizations, monitoring, risks associated with COPD, quality of life, animal models, and underdiagnoses. Abbreviation: COPD, chronic obstructive pulmonary disease.
Figure 2
Figure 2
Sex differences in COPD. Abbreviations: CCR, CC chemokine receptor; CD, cluster of differentiation; CELSR1, cadherin EGF LAG seven-pass G-type receptor 1; COPD, chronic obstructive pulmonary disease; CRP, C-reactive protein; FABP4, fatty acid‒binding protein 4; IL, interleukin; VEGF, vascular endothelial growth factor.
See this image and copyright information in PMC

References

    1. Boudewijns EA, Babu GR, Salvi S, Sheikh A, van Schayck OC. Chronic obstructive pulmonary disease: a disease of old age? J Glob Health. 2018;8(2):020306. doi: 10.7189/jogh.08.020306 - DOI - PMC - PubMed
    1. Aryal S, Diaz-Guzman E, Mannino DM. Influence of sex on chronic obstructive pulmonary disease risk and treatment outcomes. Int J Chron Obstruct Pulmon Dis. 2014;9:1145–1154. doi: 10.2147/COPD.S54476 - DOI - PMC - PubMed
    1. Bischoff EW, Schermer TR, Bor H, Brown P, van Weel C, van den Bosch WJ. Trends in COPD prevalence and exacerbation rates in Dutch primary care. Br J Gen Pract. 2009;59(569):927–933. doi: 10.3399/bjgp09X473079 - DOI - PMC - PubMed
    1. Buist AS, McBurnie MA, Vollmer WM, et al. International variation in the prevalence of COPD (the BOLD Study): a population-based prevalence study. Lancet. 2007;370(9589):741–750. doi: 10.1016/S0140-6736(07)61377-4 - DOI - PubMed
    1. Gershon AS, Wang C, Wilton AS, Raut R, To T. Trends in chronic obstructive pulmonary disease prevalence, incidence, and mortality in Ontario, Canada, 1996 to 2007: a population-based study. Arch Intern Med. 2010;170(6):560–565. doi: 10.1001/archinternmed.2010.17 - DOI - PubMed

MeSH terms