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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“The differences seen between the sexesmay be related tomany factors, including genetic differences or differences in steroid hormone concentrations (reviewed in Oertelt-Prigione, 2012).”
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COVID-19 Incidence in Pakistan: Gender Disparity
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“Sex differences play a central role in determining how the male and female immune systems are regulated and respond to stimuli (15).”
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Endotoxin Neutralization as a Biomonitor for Inflammatory Bowel Disease
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“…in sepsis and bloodstream infections remain an area of ongoing research, prior studies have suggested that hormonal influences, immune response variability, and differences in healthcare-seeking behaviors may contribute to the observed disparity in outcomes between male and female patients (19).”
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Dedroogh, S., Schmiedl, S., Thürmann, P., Graf, K., Appelbaum, S., Koß, R., Theis, C., Zia, Z., Tebbenjohanns, J., Thal, S. C., et al. (2023) · Scientific Reports · doi:10.1038/s41598-023-34961-8 · Cited by 11
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“Many studies reported the effect of sex, gender and the extent of exposure to microorganisms on the immune response (Oertelt-Prigione, 2012 and Fink & Klein, 2015).”
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Dynamic of anti-spike receptor binding domain (RBD) levels and short-term adverse events following a heterologous booster dose of BNT162b2 after two doses of CoronaVac in Thai health care workers
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Alzheimer’s Disease and Other Dementias
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“Itislikely thattheseareimportantmoderatorsgiven that cytokine levels ﬂ uctuate according to weight 87 , menstrual cycle stage and sex 88,89 , and psychotropic medication usage 18 .”
HSD3B1 Expression Is Upregulated by Interleukin 4 in HT-29 Colon Cancer Cells via Multiple Signaling Pathways
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RANTES (CCL5) in Patients With Geographic Atrophy Age-Related Macular Degeneration
Fonteh, C. N., Palestine, A. G., Wagner, B. D., Patnaik, J. L., Mathias, M. T., Manoharan, N., Mandava, N., Baldermann, R., de Carlo, T. E., & Lynch, A. M. (2023) · Translational Vision Science & Technology · doi:10.1167/tvst.12.1.19 · Cited by 7
Myeloid cells do not contribute to gender-dependent differences in disease outcome in murine cutaneous leishmaniasis
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Myasthenia gravis and pregnancy
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Impacts of synthetic androgen and estrogenic antagonist administration on growth performance, sex steroids hormones, and immune markers of male and female broilers
Younis, M. E. M., Jaber, F. A., Majrashi, K. A., Ghoneim, H. A., Shukry, M., Shafi, M. E., Albaqami, N. M., El-Hack, M. E. A., & Ghanima, M. M. A. (2022) · Poultry Science · doi:10.1016/j.psj.2022.102244 · Cited by 8
“Receptors for nuclear and non-nuclear hormones are involved in their actions (Oertelt-Prigione, 2012).”
BackgroundInfluential
Association Between Sex and Efficacy of Immune Checkpoint Inhibitors: A Systematic Review and Meta Analysis
Lai, J., Kuang, X., Fu, Y., & Li, J. (2024) · Immunotherapy · doi:10.2217/imt-2023-0307 · Cited by 8
The Impact of Chemotherapy on Hepatitis B Antibody Titer in Patients with Hematological Malignancies
Yağcı, M., Suyanı, E., & Çakar, M. K. (2015) · Turkish Journal of Hematology · doi:10.4274/tjh.2013.0342 · Cited by 7
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tNGS-based detection of respiratory pathogens in a single center: associations with age, gender, season, and co-infections
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“Furthermore, it is crucial to examine gender-speci ﬁ c prevalence for individual pathogens, as hormonal, immunological, or behavioral differences may contribute to varying susceptibilities or exposure levels to speci ﬁ c agents (Oertelt-Prigione, 2012; Moulton, 2018; Sparks et al., 2023).”
Human Cytomegalovirus Seroprevalence Among Blood Donors in the Madinah Region, Saudi Arabia
Mahallawi, W. H., Khabour, O. F., Alsaedi, A. Q., Almuzaini, Z., & Ibrahim, N. A. (2022) · Cureus · doi:10.7759/cureus.21860 · Cited by 6
“The impact of sex on the relationship between BMI and HCMV IgG levels requires further investigation, as immune responses are well-known to vary between men and women [39-41].”
Background
Efficacy of Pd-1/Pd-L1 Inhibitors in Advanced Gastroesophageal Cancer Based on Characteristics: A Meta-Analysis
Liu, W., Huo, G., & Chen, P. (2023) · Immunotherapy · doi:10.2217/imt-2022-0305 · Cited by 7
Unmet Needs in Respiratory Diseases
Chang, C. C.-C. (2013) · Clinical Reviews in Allergy & Immunology · doi:10.1007/s12016-013-8399-2 · Cited by 6
“The respective contributory roles of genes, epigenetics, and the environment in the pathogenesis of lung diseases must be better elucidated [141] [142] [143] [144] [145] [146] [147] [148] .”
Age Differences by Sex in Antiretroviral-Naïve Participants: Pooled Analysis from Randomized Clinical Trials
Tracy, L. A., Struble, K. A., Firnhaber, C. S., Smeaton, L. M., Lake, J. E., Bell, T. K., Soon, G. G., Yan, J., Schnippel, K., & Cohn, S. E. (2018) · Journal of the Association of Nurses in AIDS Care · doi:10.1016/j.jana.2018.01.004 · Cited by 6
“Estrogen is a known humoral immune system enhancer, and premenopausal women uninfected with HIV usually have higher titers of antibody responses, higher CD41 T cell counts, and increases in proinflammatory markers such as interleukin-1 and -6, compared to postmenopausal uninfected women (Oertelt-Prigione, 2012; Patter…”
The effect of macrophage-targeted interventions on blood pressure – a systematic review and meta-analysis of preclinical studies
Wenstedt, E. F. E., van Croonenburg, T. J., van den Born, B. H., den Bossche, J. V., Hooijmans, C. R., & Vogt, L. (2020) · Translational research · doi:10.1016/j.trsl.2020.11.002 · Cited by 7
Ovarian hormones influence immune response to Staphylococcus aureus infection
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Gender issues during the times of COVID‐19 pandemic
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“In addition, the National Institutes of Health has adopted a code for the inclusion of both genders and ethnic minorities within clinical trials [27] A recent paper has investigated the inclusion of sex and/or gender data in currently registered COVID19 studies on ClinicalTrials.”
Method
Gender Susceptibility to COVID-19 Mortality: Androgens as the Usual Suspects?
Vahedian‐Azimi, A., Pourhoseingholi, M. A., Isfeedvajani, M. S., Behnam, B., & Sahebkar, A. (2021) · Advances in experimental medicine and biology · doi:10.1007/978-3-030-59261-5_23 · Cited by 6
Do sexual differences in life strategies make male lizards more susceptible to parasite infection?
Megía‐Palma, R., Cuervo, J. J., Fitze, P. S., Martı́nez, J., Jiménez‐Robles, O., la Riva, I. D., Reguera, S., Moreno‐Rueda, G., Blaimont, P., Kopena, R., et al. (2024) · Journal of Animal Ecology · doi:10.1111/1365-2656.14154 · Cited by 5
Effects of age and gender on immunogenicity and reactogenicity of SpikoGen recombinant spike protein vaccine: a post-hoc analysis
Anjidani, N., Shahpari, R., Kafi, H., Petrovsky, N., & Barati, S. (2024) · Scientific Reports · doi:10.1038/s41598-024-67945-3 · Cited by 5
“There is a growing body of evidence from literature showing that both innate and adaptive immune responses to viral infections differ between males and females 15 .”
Background
The aging immune system: Dysregulation, compensatory mechanisms, and prospects for intervention
Müller, L., & Pawelec, G. (2021) · Elsevier eBooks · doi:10.1016/b978-0-12-815962-0.00016-0 · Cited by 5

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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