Geschlechtsunterschiede bei Infektionserkrankungen

Zusammenfassung

Geschlechtsunterschiede bei Empfänglichkeit, Krankheitsverlauf und Therapieansprechen bei Infektionserkrankungen entstehen aufgrund von unterschiedlichen biologische Faktoren, wie Einflüssen verschiedener X-chromosomal-kodierter Gene und hormonell bedingter Faktoren, sowie durch soziokulturelle Faktoren.

Frauen weisen sowohl eine stärkere angeborene als auch eine ausgeprägtere adaptive Immunantwort gegenüber verschiedenen Pathogenen und Impfstoffen auf, was einen Vorteil bei der Bekämpfung von akuten Infektionen darstellt. Aufgrund einer gesteigerten generalisierten Immunaktivierung in chronisch verlaufenden Infektionen, wie beispielsweise der HIV-1-Infektion ist dies jedoch mit einem schnelleren Krankheitsprogress assoziiert. Entscheidend werden Geschlechtsunterschiede von soziokulturellen Verhaltensmustern beeinflusst, welche Unterschiede in der Exposition gegenüber verschiedenen Krankheitserregern mit sich bringen und folglich zu unterschiedlichen Infektionsrisiken zwischen Frauen und Männern führen.

Es ist wichtig soziokulturelle Hintergründe sowie immunologische Mechanismen, welche den Geschlechtsunterschieden bei Infektionskrankheiten zugrunde liegen, besser zu verstehen und weiter zu erforschen. Das ist eine Voraussetzung, um individualisierte und geschlechtsspezifische Behandlungs- und Impfstrategien, welche zu effektiveren Therapien und einer Reduktion von Nebenwirkungen führen können, zu entwickeln. Dies erfordert auch ein ausgeglichenes Verhältnis weiblicher und männlicher Studienteilnehmer sowohl in grundlagenwissenschaftlichen als auch in klinischen Studien [10].

Abstract

Differences between women and men range from their anatomy, their natural social behavior to their susceptibility and response to different pathologies, including infectious diseases.

The underlying mechanisms of sex differences in infectious diseases are manifold, including differences in exposure to common pathogens, genetic factors that modulate immune responses against pathogens and hormonal factors that may alter susceptibility or disease progression, and responsiveness to treatment. On one hand, these mechanisms lead to higher innate and adaptive immune responses in females, which result in faster clearance of acute infections and higher antibody responses to several vaccines, on the other hand this contributes to an increased susceptibility to chronic inflammatory diseases.

In this review we summarize the underlying causes of sex differences in prevalence, clinical course of disease and treatment outcome of infectious diseases. In order to develop individualized treatment concepts, a fair balance between the sexes should be maintained in basic science, preclinical and clinical studies.

Schlüsselwörter

Geschlechtsunterschiede - Infektionskrankheiten - Virale Infektionen

Keywords

Sex differences - infectious diseases - viral infections

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