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Minerva Respiratory Medicine 2022 September;61(3):120-37

DOI: 10.23736/S2784-8477.22.02013-7

Copyright © 2022 EDIZIONI MINERVA MEDICA

language: English

The impact of gender differences on pulmonary diseases and their clinical implications

Chiara MARTELLI, Roberto RANA, Franco ALFANO, Chiara ARENA, Federico BARALDI, Tommaso BIGONI, Serena CASANOVA, Marianna COMETA, Martina POMPIGNOLI, Federica SANTOLI, Enea TAZZARI, Francesca URBANI, Antonio URSITTI, Marco CONTOLI, Alberto PAPI

Unit of Respiratory Medicine, Department of Translational Medicine, University of Ferrara, Ferrara, Italy



Male and female patients are usually considered clinically equivalent from a diagnostic and treatment point of view, and no relevance is given to the differences in morphometry and physiology of the respiratory system between the two sexes. This is a major limitation in the understanding of the pathology and effective management of multiple respiratory ailments. The present review analyses the available literature on the major respiratory diseases from a gender-difference perspective. We performed our research using the PubMed Advanced Browser. The research for each clinical condition was conducted by using the key words “gender” OR “sex.” For example, considering asthma, the search criteria were “asthma” AND “gender” OR “sex.” All the respiratory diseases considered in this review are deeply influenced by the sex of the patient in diverse ways. For example, in women, estrogens could play a protective role in some conditions, like IPF, while in others they are associated with increased risk of disease development, as in some types of severe asthma. Psychological symptoms are more frequent in women with obstructive conditions such as OSAS, COPD, and asthma. Despite the available evidence, current therapeutic strategies largely ignore these differences, and data on gender-weighted interventions are still scarce. Sex differences are common in respiratory diseases. They have largely been ignored in clinical approaches towards these diseases. Evidence has been generated in the last few decades in favor of gender-based diagnostic and therapeutic strategies.


KEY WORDS: Sex; Hormones; Asthma; Pulmonary disease, chronic obstructive; Infections; Pneumonia; Tuberculosis; COVID-19; Lung neoplasms

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