Cited by 459Sex and Gender in HealthcareEstrogen and related hormone effectsGenetic and Clinical Aspects of Sex Determination and Chromosomal Abnormalities

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The influence of sex and gender on the immune response

Oertelt-Prigione, Sabine·2012·Autoimmunity Reviews

DOI 10.1016/j.autrev.2011.11.022

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Abstract

The immune system and its orchestrated response are affected by a multitude of endogenous and exogenous factors, modulators and challenges. One of the most frequent differences described in the immune response is its vigor and activity in females compared to males, leading to the consequent increase in autoimmune conditions seen in the female population as well as differences in the immune response to pathogens and viruses. The following review summarizes our present knowledge on sex differences in the immune response, detailing the hormonal and genetic effects that have been proposed as explanatory mechanisms. Sexual hormones, mostly estrogen but also progesterone and testosterone, affect immune cells quantitatively and qualitatively. Relevant research has focused on the impact of hormones on cytokine production by the different effector cells, as well as impact on immunoglobulin production by B lymphocytes and activity of granulocytes and NK cells. The biological aspects are complemented by research data on the possible modulatory role of the X chromosome. In addition to biological differences, the frequently neglected role of gender as an immunomodulator is introduced and explored. Gender affects all areas of human life and consequently affects the different steps of an immune response. Exposure to various types of antigens, access to health promotion programs and health care, as well as prioritization of health needs and household resource allocation all affect the different response of females and males to immunologic challenges.

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Gender-Dependent Specificities in Cutaneous Melanoma Predisposition, Risk Factors, Somatic Mutations, Prognostic and Predictive Factors: A Systematic Review
D’Ecclesiis, O., Caini, S., Martinoli, C., Raimondi, S., Gaiaschi, C., Tosti, G., Queirolo, P., Veneri, C., Saieva, C., Gandini, S., et al. (2021) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph18157945 · Cited by 29
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“E-mail: yuzhengao@suda.edu.cn Macrophages play an important role in the immune-modulatory role of estrogen (Oertelt-Prigione, 2012).”
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Cutaneous Melanoma and Hormones: Focus on Sex Differences and the Testis
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Background
Androgens Regulate Bone Marrow B Lymphopoiesis in Male Mice by Targeting Osteoblast-Lineage Cells
Wilhelmson, A. S., Stubelius, A., Börjesson, A., Wu, J., Stern, A., Malin, S., Mårtensson, I., Ohlsson, C., Carlsten, H., & Tivesten, Å. (2015) · Endocrinology · doi:10.1210/en.2014-1822 · Cited by 26
“been focused on the actions of androgens, which also are powerful regulators in the immune system (3).”
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A gender-based approach to developing a healthy lifestyle and healthy weight intervention for diverse Utah women
Simonsen, S. E., Digre, K. B., Ralls, B., Mukundente, V., Davis, F. A., Rickard, S., Tavake-Pasi, F., Napia, E. E., Aiono, H., Chirpich, M., et al. (2014) · Evaluation and Program Planning · doi:10.1016/j.evalprogplan.2014.12.003 · Cited by 25
Gender-dependent changes in haematological parameters in patients with Cushing's disease before and after remission
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Advances and challenges in studying the tissue‐resident T cell compartment in the human female reproductive tract
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“Inflammatory responses are ste-reotypically greater in females, which may be dictated by greater cytokine release due to the location of cytokine and TLR genes on the X-chromosome (Oertelt-Prigione, 2012).”
Modification of the plasma complement protein profile by exogenous estrogens is indicative of a compromised immune competence in marine medaka (Oryzias melastigma)
Dong, M., Seemann, F., Humble, J. L., Liang, Y., Peterson, D. R., Ye, R., Ren, H., Kim, H.-S., Lee, J., Au, D. W. T., et al. (2017) · Fish & Shellfish Immunology · doi:10.1016/j.fsi.2017.09.020 · Cited by 24
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Immunity and the Endocrine System
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“Also gender-related lifestyle factors may contribute to differential immunity and disease susceptibility (Oertelt-Prigione, 2012).”
Comparison of subcutaneous versus intranasal immunization of male koalas (Phascolarctos cinereus) for induction of mucosal and systemic immunity against Chlamydia pecorum
Waugh, C. A., Timms, P., Andrew, D. W., Rawlinson, G., Brumm, J., Nilsson, K., & Beagley, K. W. (2015) · Vaccine · doi:10.1016/j.vaccine.2014.12.052 · Cited by 22
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Self-citation
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“One of the most frequent differences described in the immune response is the further activity of the immune system in females compared to males (Oertelt-Prigione, 2012).”
Background
Implications of Sex Difference in CT Scan Findings and Outcome of Patients with COVID-19 Pneumonia
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Background
Immunology and Reproduction
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“Furthermore, studies indicate that girls ’ immune systems develop earlier than boys ’ , leading females to produce stronger immune responses and antibodies to combat infectious pathogens (Oertelt-Prigione, 2012; Moulton, 2018; Sparks et al., 2023).”
Sexual dimorphism in aging hematopoiesis: an earlier decline of hematopoietic stem and progenitor cells in male than female mice
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Gene-expression Profiling in Non-small Cell Lung Cancer with Invasion of Mediastinal Lymph Nodes for Prognosis Evaluation.
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HSC extrinsic sex-related and intrinsic autoimmune disease–related human B-cell variation is recapitulated in humanized mice
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Background
The effect of patient sex on the efficacy and safety of anticancer immunotherapy
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Differences in Liver Graft Survival by Recipient Sex
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“The varied mechanisms at play in driving these associations are not yet fully described, but differences in endocrine-immune interactions between females and males are known to contribute to sex-based differences in immune responses (27, 28).”
Background
Sexual dimorphism in an animal model of Sjögren's syndrome: a potential role for Th17 cells
Voigt, A., Esfandiary, L., & Nguyen, C. Q. (2015) · Biology Open · doi:10.1242/bio.013771 · Cited by 19
Maternal metabolic adaptations are necessary for normal offspring growth and brain development
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“…in the literature in fact indicates a sexually dimorphic impact in the metabolism and immune system caused by dietary changes during pregnancy and lactation (Zambrano et al. 2006; Oertelt-Prigione 2012; Makarova et al. 2013; Sanchez-Garrido et al. 2013; Sardinha et al. 2013; Morselli et al. 2016).”
Background
Risk of Atopic Diseases among Siblings of Patients with Attention-Deficit Hyperactivity Disorder: A Nationwide Population-Based Cohort Study
Chang, T.-H., Tai, Y., Dai, Y., Chang, Y.-T., Chen, T., & Chen, M. (2019) · International Archives of Allergy and Immunology · doi:10.1159/000500831 · Cited by 18

Authors: Oertelt-Prigione, S.
Venue: Autoimmunity Reviews
Publisher: Elsevier BV
Published: 2012-05
Volume: 11
Issue: 6-7
Pages: A479-A485
ISSN: 1568-9972 (ISSN-L)
DOI: 10.1016/j.autrev.2011.11.022
OpenAlex: W2045019335
Cited by: 459
References: 102
Citations by year: 2026: 21 · 2025: 31 · 2024: 38 · 2023: 28 · 2022: 32 · 2021: 43 · 2020: 45 · 2019: 23 · 2018: 28 · 2017: 35 · 2016: 32 · 2015: 36 · 2014: 37 · 2013: 22 · 2012: 7
FWCI: 3.21
Type: journal article
Language: en
Open access: closed
Licence: www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations: Autoimmunity Reviews (publishedVersion)
PubMed (publishedVersion)
Publikationen an der Universität Bielefeld (Universität Bielefeld) (submittedVersion)
Topics: Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Sex and Gender in Healthcare
Life Sciences › Biochemistry, Genetics and Molecular Biology › Endocrinology › Estrogen and related hormone effects
Life Sciences › Biochemistry, Genetics and Molecular Biology › Genetics › Genetic and Clinical Aspects of Sex Determination and Chromosomal Abnormalities
Keywords: sex differences in immune response, gender differences, autoimmune disease, sex hormones, estrogen, progesterone, testosterone, cytokine production, antibody production, B cells, granulocytes, natural killer cells, X chromosome, social determinants of health, health care access
MeSH terms: B-Lymphocytes, Bone Marrow Cells, Dendritic Cells, Female, Humans, Immunity, Active, Immunologic Factors, Killer Cells, Natural, Male, Sex Factors, Gonadal Steroid Hormones, T-Lymphocytes

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The influence of sex and gender on the immune response

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