Abstract
Allergies are rapidly worsening in recent decades, representing the most common immunological diseases. The mechanism of disorders such as asthma, rhinocongiuntivitis, urticaria, atopic dermatitis, food and drug allergies, and anaphylaxis still remain unclear and consequently treatments is mostly still symptomatic and aspecific while developments of new therapies are limited. A growing amount of data in the literature shows us how the prevalence of allergic diseases is different in both sexes and its changes over the course of life. Genes, hormones, environmental and immunological factors affect sex disparities associated with the development and control of allergic diseases, while they more rarely are considered and reported regarding their differences related to social, psychological, cultural, economic, and employment aspects. This review describes the available knowledge on the role of sex and gender in allergies in an attempt to improve the indispensable gender perspective whose potential is still underestimated while it represents a significant turning point in research and the clinic. It will offer insights to stimulate exploration of the many aspects still unknown in this relationship that could ameliorate the preventive, diagnostic, and therapeutic strategies in allergic diseases.
Highlights
The differences in biological sex, gender identity, relations, role, and their impact on health and diseases may have significative implications for prevention, screening, diagnosis and treatment
Gender medicine focuses on sex differences and on their impact in the development, diagnosis, and treatment of diseases, and considers gender differences as social and cultural determinants that can have a decisive impact on health
Immune cell populations vary between the sexes: females from birth have a higher proportion of CD4+ T lymphocytes than male, CD4+ and CD8+ T cells decline with age in both sexes though compared to men, and aged women show lower memory Tregs and NK cells
Summary
The differences in biological sex, gender identity, relations, role, and their impact on health and diseases may have significative implications for prevention, screening, diagnosis and treatment. Immune cell populations vary between the sexes: females from birth have a higher proportion of CD4+ T lymphocytes than male, CD4+ and CD8+ T cells decline with age in both sexes though compared to men, and aged women show lower memory Tregs and NK cells These observations may at least in part justify the sex biased immune response and cytokine production. Eicosanoids the potent bioactive lipid mediators mostly produced by immune cells through the pathways of the cyclooxygenase, lipoxygenase and cytochrome p450 regulate acute and chronic inflammation and play a crucial role in normal and aberrant immune responses Belonging to this family of molecules are prostaglandins, leukotrienes, hydroxyeicosatetraenoic acids, and dihydroxyeicosanotreic acids, which spread the inflammation and anti-inflammatory lipoxins, epoxyeicosatrienoic acids, and E-series information on the mechanism by which sex hormones derived by microbiome impact on the host immune response [19,20]. With reference to B cells, the mTORc pathway is certainly essential for many aspects of the B lymphocyte development and function, but much of details of these regulatory circuitry are still to be clarified [46]
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