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Impact of gender on asthma in childhood and adolescence: A GA 2LEN review

Department of Woman and Child Health, Karolinska Institutet, Stockholm, Sweden.
Allergy (Impact Factor: 6). 02/2008; 63(1):47-57. DOI: 10.1111/j.1398-9995.2007.01524.x
Source: PubMed

ABSTRACT A number of studies have shown gender differences in the prevalence of wheeze and asthma. The aim of this review was to examine published results on gender differences in childhood and adolescent asthma incidence and prevalence, define current concepts and to identify new research needs. A Medline search was performed with the search words (gender OR sex) AND (child OR childhood OR adolescence) AND (asthma). Articles that reported on absence or presence of gender differences in asthma were included and reviewed, and cross-references were checked. Boys are consistently reported to have more prevalent wheeze and asthma than girls. In adolescence, the pattern changes and onset of wheeze is more prevalent in females than males. Asthma, after childhood, is more severe in females than in males, and is underdiagnosed and undertreated in female adolescents. Possible explanations for this switch around puberty in the gender susceptibility to develop asthma include hormonal changes and gender-specific differences in environmental exposures. This aspect needs consideration of the doctors and allergists who diagnose and treat asthmatic individuals. In conclusion, sex hormones are likely to play an important role in the development and outcome of the allergic immune response and asthma in particular. By obtaining functional data from appropriate models, the exact underlying mechanisms can be unravelled. To examine the effect of gender-specific differences in environmental exposures and changes of asthma prevalence and severity in puberty, larger populations may need to be investigated.

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    • "It has been well studied that asthma is linked to gender and it is more frequent in females than in males [7] [8] [9] [10]. Furthermore, asthma exacerbations in women are related to life period and its severity to their hormonal status, i.e., puberty, menstrual cycle, pregnancy and menopause [11] [12] [13] [14] [15]. "
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    ABSTRACT: Therapy with estrogens is frequently used in menopausal women and as hormonal contraception. Because of its thrombotic effects, long term estrogen administration used in hormonal replacement therapy (HRT) and contraception could represent a health hazard. In this regard, 17β-aminoestrogens such as aminoestrol, butolame and pentolame have shown promising HRT potential, because they have a weak agonist estrogenic action and antithrombotic activity. Additionally, estrogens play a protective role in airway smooth muscle, but the effect of 17β-aminoestrogens on the airway smooth muscle has not been tested yet. In guinea pig tracheal smooth muscle pentolame and butolame induced hyperresponsiveness to histamine (His), carbachol (Cch) and KCl. Interestingly, aminoestrol did not show this effect at the highest concentration studied, it even lowered the contraction induced by Cch. The hyperresponsiveness induced by pentolame to His was abolished by nifedipine. In single tracheal myocytes, KCl induced an increment in the intracellular Ca(2+) concentration [Ca(2+)]i, pentolame also showed an increase in [Ca(2+)]i and the addition of KCl in the plateau of this rise further significantly augmented the [Ca(2+)]i response. Additionally, in patch clamp experiments pentolame increased the L-type Ca(2+) currents. Thus, 17β-aminoestrogens such as pentolame and butolame, but not aminoestrol, activate L-type Ca(2+) channel to induced hyperresponsiveness to Cch, His and KCl in guinea pig tracheal smooth muscle. Due to its lack of effect on airways and to its anticoagulant characteristics, aminoestrol seems to be the best alternative in the HRT among the 17β-aminoestrogens studied. Copyright © 2015. Published by Elsevier Inc.
    Steroids 06/2015; 101. DOI:10.1016/j.steroids.2015.06.001 · 2.72 Impact Factor
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    • "Both androgens and estrogens exert a role in immune diseases. Although the precise mechanisms by which these steroid hormones affect the immune system are not completely elucidated, their effects may be responsible for the gender differences in the onset and course of immune diseases, including allergic conditions [8] [17] [19] [20] "
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    ABSTRACT: Purpose. Vernal keratoconjunctivitis (VKC) is a chronic allergic disease mainly affecting boys in prepubertal age and usually recovering after puberty. To evaluate a possible role of sex hormones in VKC, serum levels of sex hormones in children and adolescents with VKC were assessed. Methods. 12 prepubertal and 7 early pubertal boys with active VKC and 6 male patients with VKC in remission phase at late pubertal age and 48 healthy age and sex-matched subjects were included. Serum concentration of estrone, 17 beta-estradiol, dehydroepiandrosterone-sulfate, total testosterone and free testosterone, dihydrotestosterone (DHT), cortisol, delta-4-androstenedione, follicle-stimulating hormone, luteinizing hormone, and sex-hormones binding globuline (SHBG) were evaluated. Results. Serum levels of Estrone were significantly increased in all groups of patients with VKC when compared to healthy controls (í µí±ƒ < 0.001). Prepubertal and early pubertal VKC showed a significant decrease in DHT (í µí±ƒ = 0.007 and í µí±ƒ = 0.028, resp.) and SHBG (í µí±ƒ = 0.01 and í µí±ƒ = 0.002, resp.) when compared to controls and serum levels of SHBG were increased in late pubertal VKC in remission phase (í µí±ƒ = 0.007). Conclusions and Relevance. VKC patients have different circulating sex hormone levels in different phases of the disease and when compared to nonallergic subjects. These findings suggest a role played by sex hormones in the pathogenesis and/or activity of VKC.
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    • "les - cence noted that although boys report more wheezing and asthma than girls , the pattern reverses during adolescence , with girls experiencing more severe asthma ( Almqvist et al . , 2008 ) . Potential reasons for the increased severity among adolescent girls include hormonal changes or a greater susceptibility to environmental ex - posures ( Almqvist et al . , 2008 ) . To the extent that environmental exposures are more prevalent in poor quality housing , if girls in the MTO treatment group experienced better housing quality , this could explain why housing quality masks more harmful treatment effects . Household smoke exposure also has been linked with asthma attack among girls but not boys ( Str"
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