Influence of biological sex in inflammatory bowel diseases

IF 45.9 1区医学 Q1 GASTROENTEROLOGY & HEPATOLOGY Nature Reviews Gastroenterology &Hepatology Pub Date : 2025-02-17 DOI:10.1038/s41575-025-01038-y

Diane M. Tshikudi, Charles N. Bernstein, Suresh Mishra, Jean-Eric Ghia, Heather K. Armstrong

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Abstract

The incidence of inflammatory bowel disease (IBD) has risen in the past decades and has emerged as a global health issue. IBD is characterized by chronic inflammation of the gastrointestinal tract. There is compelling evidence for the role of biological sex in IBD epidemiology, pathophysiology, disease progression, symptoms and extra-intestinal diseases. IBD disease course, management and therapies differ between men and women, yet there is a paucity of analysis of sex as a factor. This Review discusses the known influence of sex-linked genetic factors, hormones and hormone receptors in IBD incidence, prevalence, disease burden and clinical manifestation. Furthermore, we review the mechanisms underlying these sex-dependent effects on the dysregulation of gastrointestinal mucosal immunity (immune, epithelial barrier and microbiota) in IBD. To support the progressive inclusion of sex in the study of IBD, we summarize the current standard research methodology that should be implemented to investigate sex as a biological variable in IBD studies. Enhanced comprehension of the influence of sex in IBD pathophysiology will advance the development of targeted therapies and improve patient care.

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过去几十年来，炎症性肠病（IBD）的发病率不断上升，已成为一个全球性的健康问题。IBD 的特征是胃肠道慢性炎症。有令人信服的证据表明，生物性别在 IBD 的流行病学、病理生理学、疾病进展、症状和肠道外疾病中起着重要作用。男性和女性的 IBD 病程、管理和疗法各不相同，但对性别因素的分析却很少。本综述讨论了与性别相关的遗传因素、激素和激素受体对 IBD 发病率、流行率、疾病负担和临床表现的已知影响。此外，我们还回顾了这些性别依赖性影响 IBD 胃肠道粘膜免疫（免疫、上皮屏障和微生物群）失调的机制。为了支持在 IBD 研究中逐步纳入性别因素，我们总结了当前的标准研究方法，这些方法应在 IBD 研究中作为生物变量对性别进行调查。加强对性别在 IBD 病理生理学中的影响的理解将推动靶向疗法的开发并改善患者护理。

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来源期刊

Nature Reviews Gastroenterology &Hepatology 医学-胃肠肝病学

CiteScore

52.30

自引率

0.60%

发文量

147

审稿时长

6-12 weeks

期刊介绍： Nature Reviews Gastroenterology & Hepatology aims to serve as the leading resource for Reviews and commentaries within the scientific and medical communities it caters to. The journal strives to maintain authority, accessibility, and clarity in its published articles, which are complemented by easily understandable figures, tables, and other display items. Dedicated to providing exceptional service to authors, referees, and readers, the editorial team works diligently to maximize the usefulness and impact of each publication. The journal encompasses a wide range of content types, including Research Highlights, News & Views, Comments, Reviews, Perspectives, and Consensus Statements, all pertinent to gastroenterologists and hepatologists. With its broad scope, Nature Reviews Gastroenterology & Hepatology ensures that its articles reach a diverse audience, aiming for the widest possible dissemination of valuable information. Nature Reviews Gastroenterology & Hepatology is part of the Nature Reviews portfolio of journals.