Review

. 2024 Jan 30;16(1):773-797.

doi: 10.21037/jtd-23-1069. Epub 2024 Jan 24.

Chinese expert consensus on the diagnosis, treatment, and management of asthma in women across life

Qiurong Hu¹, Xiaoyan Chen², Wanyi Fu¹, Yingyun Fu³, Ke He⁴, Huaqiong Huang⁵, Nan Jia¹, Meiling Jin⁶, Enmei Liu⁷, Xu Shi¹, Cui Song⁸, Nan Su⁹, Weiping Tan¹⁰, Wei Tang¹¹, Yanxin Wu⁴, Hua Xie¹², Min Zhang¹³, Mengchen Zou¹⁴, Kunling Shen¹⁵, Shaoxi Cai¹⁶, Jing Li¹

Affiliations

¹ Department of Allergy and Clinical Immunology, State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China.
² Department of Endocrinology and Metabolism, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China.
³ Department of Pulmonary and Critical Care Medicine, Shenzhen Institute of Respiratory Disease, The First Affiliated Hospital of Southern University of Science and Technology, The Second Clinical Medical College of Jinan University, Shenzhen People's Hospital, Shenzhen, China.
⁴ Department of Obstetric and Gynecology, The First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China.
⁵ Key Laboratory of Respiratory Disease of Zhejiang Province, Department of Respiratory and Critical Care Medicine, Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China.
⁶ Department of Allergy, Zhongshan Hospital, Fudan University, Shanghai, China.
⁷ Department of Respiratory Medicine Children's Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Pediatrics, Chongqing, China.
⁸ Department of Endocrinology and Genetic Metabolism disease, Children's Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Pediatrics, Chongqing, China.
⁹ Department of Pulmonary and Critical Care Medicine, China-Japan Friendship Hospital, National Clinical Research Center for Respiratory Diseases, Beijing, China.
¹⁰ Department of Pediatrics, Sun Yat-Sen Memorial Hospital Sun Yat-Sen University, Guangzhou, China.
¹¹ Department of Pulmonary and Critical Care Medicine, Shanghai Ruijin Hospital Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai, China.
¹² Department of Respiratory Medicine, General Hospital of Northern Theater Command, Shenyang, China.
¹³ Department of Pulmonary and Critical Care Medicine, Shanghai General Hospital Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai, China.
¹⁴ Department of Endocrinology and Metabolism, Nanfang Hospital, Southern Medical University, Guangzhou, China.
¹⁵ Respiratory Department, Beijing Children's Hospital, Capital Medical University, China National Clinical Research Center of Respiratory Diseases, National Center for Children's Health, Beijing, China.
¹⁶ Department of Respiratory and Critical Care Medicine, Chronic Airways Diseases Laboratory, Nanfang Hospital, Southern Medical University, Guangzhou, China.

PMID: 38410605
PMCID: PMC10894401
DOI: 10.21037/jtd-23-1069

Review

Chinese expert consensus on the diagnosis, treatment, and management of asthma in women across life

Qiurong Hu et al. J Thorac Dis. 2024.

. 2024 Jan 30;16(1):773-797.

doi: 10.21037/jtd-23-1069. Epub 2024 Jan 24.

Authors

Affiliations

¹ Department of Allergy and Clinical Immunology, State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China.
² Department of Endocrinology and Metabolism, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China.
³ Department of Pulmonary and Critical Care Medicine, Shenzhen Institute of Respiratory Disease, The First Affiliated Hospital of Southern University of Science and Technology, The Second Clinical Medical College of Jinan University, Shenzhen People's Hospital, Shenzhen, China.
⁴ Department of Obstetric and Gynecology, The First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China.
⁵ Key Laboratory of Respiratory Disease of Zhejiang Province, Department of Respiratory and Critical Care Medicine, Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China.
⁶ Department of Allergy, Zhongshan Hospital, Fudan University, Shanghai, China.
⁷ Department of Respiratory Medicine Children's Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Pediatrics, Chongqing, China.
⁸ Department of Endocrinology and Genetic Metabolism disease, Children's Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Pediatrics, Chongqing, China.
⁹ Department of Pulmonary and Critical Care Medicine, China-Japan Friendship Hospital, National Clinical Research Center for Respiratory Diseases, Beijing, China.
¹⁰ Department of Pediatrics, Sun Yat-Sen Memorial Hospital Sun Yat-Sen University, Guangzhou, China.
¹¹ Department of Pulmonary and Critical Care Medicine, Shanghai Ruijin Hospital Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai, China.
¹² Department of Respiratory Medicine, General Hospital of Northern Theater Command, Shenyang, China.
¹³ Department of Pulmonary and Critical Care Medicine, Shanghai General Hospital Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai, China.
¹⁴ Department of Endocrinology and Metabolism, Nanfang Hospital, Southern Medical University, Guangzhou, China.
¹⁵ Respiratory Department, Beijing Children's Hospital, Capital Medical University, China National Clinical Research Center of Respiratory Diseases, National Center for Children's Health, Beijing, China.
¹⁶ Department of Respiratory and Critical Care Medicine, Chronic Airways Diseases Laboratory, Nanfang Hospital, Southern Medical University, Guangzhou, China.

PMID: 38410605
PMCID: PMC10894401
DOI: 10.21037/jtd-23-1069

Abstract

Background: The epidemiology and severity of asthma vary by sex and age. The diagnosis, treatment, and management of asthma in female patients are quite challenging. However, there is hitherto no comprehensive and standardized guidance for female patients with asthma.

Methods: Corresponding search strategies were determined based on clinical concerns regarding female asthma. Search terms included "sex hormones and lung development", "sex hormone changes and asthma", "hormones and asthma immune response", "women, asthma", "children, asthma", "puberty, asthma", "menstruation, asthma", "pregnancy, asthma", "lactation, asthma", "menopause, asthma", "obesity, asthma", and "women, refractory, severe asthma". Literature was retrieved from PubMed/Medline, Embase, Cochrane Library, China Biology Medicine disc, China National Knowledge Infrastructure, Wanfang Data with the search date of July 30, 2022 as the last day. This consensus used the Grading of Recommendations Assessment, Development, and Evaluation to evaluate the strength of recommendation and quality of evidence.

Results: We collected basic research results and clinical evidence-based medical data and reviewed the effects of sex hormones, classical genetics, and epigenetics on the clinical presentation and treatment response of female patients with asthma under different environmental effects. Based on that, we formulated this expert consensus on the management of female asthma throughout the life cycle.

Conclusions: This expert consensus on the management of asthma in women throughout the life cycle provides diagnosis, treatment, and research reference for clinical and basic medical practitioners.

Keywords: Sex hormone; asthma; female.

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Conflict of interest statement

Conflicts of Interest: All authors have completed the ICMJE uniform disclosure form (available at https://jtd.amegroups.com/article/view/10.21037/jtd-23-1069/coif). The authors have no conflicts of interest to declare.

Figures

**Figure 1**
Global prevalence of asthma among males and female. Source: Institute for Health Metrics and Evaluation (https://www.healthdata.org/). Used with permission. All rights reserved.

**Figure 2**
Periodic changes of sex hormones in women of childbearing age. LH, luteinizing hormone; FSH, follicle-stimulating hormone.

**Figure 3**
Effect of sex hormones on immune system response in asthma. IL, interleukin; NO, nitric oxide; AHR, airway hyperresponsiveness; DC, dendritic cell; ILC, innate lymphoid cell; Th, T helper cell.

See this image and copyright information in PMC

References

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Chinese expert consensus on the diagnosis, treatment, and management of asthma in women across life

Affiliations

Chinese expert consensus on the diagnosis, treatment, and management of asthma in women across life

Authors

Affiliations

Abstract

Conflict of interest statement

Figures

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References

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Abstract

Conflict of interest statement

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