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Am J Respir Crit Care Med. 2018 Oct 1;198(7):850-858. doi: 10.1164/rccm.201801-0168WS.

Female Sex and Gender in Lung/Sleep Health and Disease. Increased Understanding of Basic Biological, Pathophysiological, and Behavioral Mechanisms Leading to Better Health for Female Patients with Lung Disease.

Author information

1
1 Division of Pulmonary and Critical Care, University of Michigan, Ann Arbor, Michigan.
2
2 Division of Pediatric Pulmonology, Columbia University Medical Center, New York, New York.
3
3 Pharmacology Ph.D. Program, Sandra and Edward Meyer Cancer Center, New York, New York.
4
4 Department of Medicine, Brown University, Providence, Rhode Island.
5
5 Department of Medicine, University of California Los Angeles, Los Angeles, California.
6
6 Department of Medicine, Harvard Medical School, Boston, Massachusetts.
7
7 Department of Medicine and.
8
8 Department of Neurology, Brigham and Women's Hospital, Boston, Massachusetts.
9
9 Pediatric Pulmonology, Case Western Reserve University, Cleveland, Ohio.
10
10 Department of Anesthesiology and Critical Care Medicine, Johns Hopkins University, Baltimore, Maryland.
11
11 Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee.
12
12 Division of Pulmonary and Critical Care, Brigham and Women's Hospital, Boston, Massachusetts.
13
13 Division of Pulmonary and Critical Care, University of Texas Southwestern Medical Center, Dallas, Texas.
14
14 Division of Pulmonary, Critical Care, Sleep, and Occupational Medicine, Indiana University School of Medicine, Indianapolis, Indiana.
15
15 Division of Allergy, Pulmonary, and Critical Care Medicine, Vanderbilt University Medical Center, Nashville, Tennessee.
16
16 Division of Pulmonary Sciences and Critical Care Medicine, University of Colorado, Denver, Colorado.
17
17 Department of Medicine, Columbia University, New York, New York.
18
18 Department of Psychiatry, Yale School of Medicine, New Haven, Connecticut.
19
19 Neurologic Institute, Cleveland Clinic, Cleveland, Ohio.
20
20 Department of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania.
21
21 Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, Minnesota.
22
22 Department of Pathology and Molecular Medicine, McMaster University, Hamilton, Ontario, Canada.
23
23 Office of Rare Diseases Research, National Center for Advancing Translational Sciences, National Institutes of Health, Bethesda, Maryland.
24
24 Division of Lung Diseases, NHLBI/NIH, Bethesda, Maryland; and.
25
25 Office of Research on Women's Health, NIH-Office of the Director, Bethesda, Maryland.

Abstract

Female sex/gender is an undercharacterized variable in studies related to lung development and disease. Notwithstanding, many aspects of lung and sleep biology and pathobiology are impacted by female sex and female reproductive transitions. These may manifest as differential gene expression or peculiar organ development. Some conditions are more prevalent in women, such as asthma and insomnia, or, in the case of lymphangioleiomyomatosis, are seen almost exclusively in women. In other diseases, presentation differs, such as the higher frequency of exacerbations experienced by women with chronic obstructive pulmonary disease or greater cardiac morbidity among women with sleep-disordered breathing. Recent advances in -omics and behavioral science provide an opportunity to specifically address sex-based differences and explore research needs and opportunities that will elucidate biochemical pathways, thus enabling more targeted/personalized therapies. To explore the status of and opportunities for research in this area, the NHLBI, in partnership with the NIH Office of Research on Women's Health and the Office of Rare Diseases Research, convened a workshop of investigators in Bethesda, Maryland on September 18 and 19, 2017. At the workshop, the participants reviewed the current understanding of the biological, behavioral, and clinical implications of female sex and gender on lung and sleep health and disease, and formulated recommendations that address research gaps, with a view to achieving better health outcomes through more precise management of female patients with nonneoplastic lung disease. This report summarizes those discussions.

KEYWORDS:

lung disorders; sex/gender; sleep disorders

PMID:
29746147
PMCID:
PMC6173069
[Available on 2019-10-01]
DOI:
10.1164/rccm.201801-0168WS

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