TY - JOUR
T1 - Sex and Gender in Lung Diseases and Sleep Disorders
T2 - A State-of-the-Art Review: Part 2
AU - Sodhi, Amik
AU - Cox-Flaherty, Katherine
AU - Greer, Meredith Kendall
AU - Lat, Tasnim I.
AU - Gao, Yuqing
AU - Polineni, Deepika
AU - Pisani, Margaret A.
AU - Bourjeily, Ghada
AU - Glassberg, Marilyn K.
AU - D'Ambrosio, Carolyn
N1 - Publisher Copyright:
© 2022 American College of Chest Physicians
PY - 2023/2
Y1 - 2023/2
N2 - There is now ample evidence that differences in sex and gender contribute to the incidence, susceptibility, presentation, diagnosis, and clinical course of many lung diseases. Some conditions are more prevalent in women, such as pulmonary arterial hypertension and sarcoidosis. Some life stages—such as pregnancy—are unique to women and can affect the onset and course of lung disease. Clinical presentation may differ as well, such as the higher number of exacerbations experienced by women with cystic fibrosis (CF), more fatigue in women with sarcoidosis, and more difficulty in achieving smoking cessation. Outcomes such as mortality may be different as well, as indicated by the higher mortality in women with CF. In addition, response to therapy and medication safety may also differ by sex, and yet, pharmacogenomic factors are often not adequately addressed in clinical trials. Various aspects of lung/sleep biology and pathobiology are impacted by female sex and female reproductive transitions. Differential gene expression or organ development can be impacted by these biological differences. Understanding these differences is the first step in moving toward precision medicine for all patients. This article is the second part of a state-of-the-art review of specific effects of sex and gender focused on epidemiology, disease presentation, risk factors, and management of selected lung diseases. We review the more recent literature and focus on guidelines incorporating sex and gender differences in pulmonary hypertension, CF and non-CF bronchiectasis, sarcoidosis, restless legs syndrome and insomnia, and critical illness. We also provide a summary of the effects of pregnancy on lung diseases and discuss the impact of sex and gender on tobacco use and treatment of nicotine use disorder.
AB - There is now ample evidence that differences in sex and gender contribute to the incidence, susceptibility, presentation, diagnosis, and clinical course of many lung diseases. Some conditions are more prevalent in women, such as pulmonary arterial hypertension and sarcoidosis. Some life stages—such as pregnancy—are unique to women and can affect the onset and course of lung disease. Clinical presentation may differ as well, such as the higher number of exacerbations experienced by women with cystic fibrosis (CF), more fatigue in women with sarcoidosis, and more difficulty in achieving smoking cessation. Outcomes such as mortality may be different as well, as indicated by the higher mortality in women with CF. In addition, response to therapy and medication safety may also differ by sex, and yet, pharmacogenomic factors are often not adequately addressed in clinical trials. Various aspects of lung/sleep biology and pathobiology are impacted by female sex and female reproductive transitions. Differential gene expression or organ development can be impacted by these biological differences. Understanding these differences is the first step in moving toward precision medicine for all patients. This article is the second part of a state-of-the-art review of specific effects of sex and gender focused on epidemiology, disease presentation, risk factors, and management of selected lung diseases. We review the more recent literature and focus on guidelines incorporating sex and gender differences in pulmonary hypertension, CF and non-CF bronchiectasis, sarcoidosis, restless legs syndrome and insomnia, and critical illness. We also provide a summary of the effects of pregnancy on lung diseases and discuss the impact of sex and gender on tobacco use and treatment of nicotine use disorder.
KW - cystic fibrosis
KW - gender
KW - nonbreathing sleep disorders
KW - pregnancy
KW - pulmonary hypertension
KW - sarcoidosis
KW - sex
KW - smoking cessation
UR - http://www.scopus.com/inward/record.url?scp=85146134580&partnerID=8YFLogxK
U2 - 10.1016/j.chest.2022.08.2240
DO - 10.1016/j.chest.2022.08.2240
M3 - Review article
C2 - 36183784
AN - SCOPUS:85146134580
SN - 0012-3692
VL - 163
SP - 366
EP - 382
JO - CHEST
JF - CHEST
IS - 2
ER -