4.5 Editorial Material

Sex and gender in lung health and disease: more than just Xs and Ys

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Sex, gender and the pulmonary physiology of exercise

Paolo B. Dominelli et al.

Summary: In this review, we discuss the influence of both sex and gender on the pulmonary system's response to exercise in healthy humans. We explore the rationale for considering sex and gender differences and highlight anatomical differences, with females typically having smaller lungs and airways than males. We describe how these anatomical differences impact functional aspects of the pulmonary system and how gender can further influence the response to exercise.

EUROPEAN RESPIRATORY REVIEW (2022)

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Just breathe: a review of sex and gender in chronic lung disease

Ranjani Somayaji et al.

Summary: Chronic lung diseases, such as chronic obstructive pulmonary disease, asthma, and bronchiectasis, show significant sex- and gender-based differences in terms of disease risk, severity, and treatment approach. This review highlights the importance of considering these differences in clinical and research settings and emphasizes the opportunities for therapeutic development and greater education and understanding among patients and healthcare providers.

EUROPEAN RESPIRATORY REVIEW (2022)

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The evolving landscape of sex-based differences in lung cancer: a distinct disease in women

Meera Ragavan et al.

Summary: In contrast to a few decades ago, the incidence rates of lung cancer in women are now comparable to or higher than those in men and are rising rapidly in many parts of the world. Women face unique risk factors for lung cancer, including both exogenous and endogenous exposures. The current screening guidelines may not accurately assess the lung cancer risk in women. Women diagnosed with lung cancer have a clear mortality benefit compared to men, but there may be sex-based differences in treatment outcomes and side effects.

EUROPEAN RESPIRATORY REVIEW (2022)

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Sex and gender in interstitial lung diseases

Leticia Kawano-Dourado et al.

Summary: Sex and gender differences play a significant role in the research, lung health, healthcare access, and healthcare delivery for lung diseases. The interplay between biological sex and sociocultural gender influences genetics, epigenomic modifiers, hormones, immune function, response to treatment, and interaction with healthcare systems in complex ways. It is crucial to systematically integrate sex and gender analysis into relevant domains for individualized, patient-centered medicine in lung diseases.

EUROPEAN RESPIRATORY REVIEW (2021)

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Sex and gender in asthma

Nowrin U. Chowdhury et al.

Summary: Asthma is a heterogeneous disease with significant differences in prevalence and severity between males and females. Factors such as sex hormones, genetics, and environmental factors play important roles in the differences observed in asthma incidence and severity. Fluctuations in sex hormone levels, gene expression, epigenetic modifications, and responses to environmental factors all contribute to the varying manifestations of asthma between genders.

EUROPEAN RESPIRATORY REVIEW (2021)

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Sex and gender in respiratory physiology

Antonella LoMauro et al.

Summary: Sex is a biological concept determined at conception, while gender is a social concept. Sex plays a significant role in respiratory physiology, with females having smaller dimensions in the respiratory system and sex hormones playing specific roles in lung inflammatory processes, breathing control, and disease response. Due to research predominantly focusing on males, evidence-based medicine for women is relatively lacking. The increasing number of transgender individuals presents new challenges for clinicians due to anatomical and physiological changes they undergo.

EUROPEAN RESPIRATORY REVIEW (2021)

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Sex and gender in pulmonary arterial hypertension

Celine Cheron et al.

Summary: Pulmonary arterial hypertension is a rare disease characterized by pulmonary vascular remodeling and elevated pulmonary pressure, with a female predominance. Several mechanisms, including estrogen signaling pathways and BMPR2 mutation, contribute to the pathogenesis of PAH, specifically in women. Women generally have better prognosis and right ventricular function in PAH, and may respond differently to treatment, necessitating particular attention to contraception and pregnancy management.

EUROPEAN RESPIRATORY REVIEW (2021)