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Geschlechtsspezifische Aspekte bei interstitiellen Lungenerkrankungen

Sex-specific aspects of interstitial lung diseases

  • Leitthema
  • Published:
Zeitschrift für Pneumologie Aims and scope

Zusammenfassung

Interstitielle Lungenerkrankungen (ILD) umfassen eine heterogene Gruppe von Erkrankungen des Interstitiums und der Alveolen mit sehr unterschiedlichem Krankheitsverhalten. Einige dieser Unterschiede können mithilfe des biologischen Geschlechtes („sex“) und des soziokulturellen bzw. geschlechtsspezifischen Verhaltens („gender“) erklärt werden. So unterscheidet sich die Epidemiologie vieler ILD abhängig vom Geschlecht. Dies ist sowohl auf genetische Faktoren als auch auf das Verhalten wie beispielsweise häusliche und berufliche Expositionen zurückzuführen. Auch bei der Diagnostik sowie der Inanspruchnahme des Gesundheitssystems kommen geschlechtsabhängige Aspekte zum Tragen. Dies zeigt sich z. B. durch eine höhere Rate an Hospitalisierungen bei Männern. Ebenfalls bei Männern wird tendenziell häufiger eine spezifische ILD-Therapie begonnen. Anhand verschiedener ILD wie der idiopathischen Lungenfibrose (IPF), exogen-allergischen Alveolitis (EAA), der Kollagenose-assoziierten ILD (CTD-ILD) und der Lymphangioleiomyomatose (LAM) lassen sich Gendereffekte auf Prävalenz und Prognose besonders gut verdeutlichen. Ein Bewusstsein für die vielfältigen geschlechtsspezifischen Aspekte in Diagnostik und Therapie sowie anderen Bereichen wie Ausbildung und klinischer Forschung ist essenziell.

Abstract

Interstitial lung diseases (ILD) comprise a heterogeneous group of diseases affecting the interstices and alveoli with various disease behaviors. Some of these differences can be explained by biological sex and sociocultural or gender-specific behavior The epidemiology of many ILD differs depending on the sex. This can be explained due to genetic factors as well as the behavior, such as domestic and occupational exposure. Sex-dependent aspects are also important in relation to the diagnostics and utilization of the healthcare system. This is reflected, for example, in the higher rate of hospitalization in men, who also tend to start a specific ILD treatment more frequently. Various ILD, such as idiopathic pulmonary fibrosis (IPF), hypersensitivity pneumonitis (HP), connective tissue disease-related ILD (CTD-ILD) and lymphangioleiomyomatosis (LAM), illustrate gender effects in the prevalence and outcome particularly well. Awareness of the diverse sex-specific aspects in the diagnostics and treatment as well as other areas, such as education and clinical research is essential.

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Literatur

  1. Valeyre D, Duchemann B, Annesi-Maesano I et al (2014) Interstitial lung diseases. In: Welte T, Annesi-Maesano I, Viegi G, Lundbäck B (Hrsg) Respiratory Epidemiology, Bd. 65. ERSMonograph,

    Google Scholar 

  2. American Thoracic Society and European Respiratory Society (2002) American Thoracic Society/European Respiratory Society international multidisciplinary consensus classification of the idiopathic interstitial pneumonias. Am J Respir Crit Care Med 165(2):277–304

    Article  Google Scholar 

  3. Travis WD, Costabel U, Hansell D (2013) An official American Thoracic Society/European Respiratory Society statement: update of the international multidisciplinary classification of the idiopathic interstitial pneumonias. Am J Respir Crit Care Med 188(6):733–748

    Article  PubMed  PubMed Central  Google Scholar 

  4. Kawano-Dourado L, Glassberg MK, Johannson KA et al (2021) Sex and gender in interstitial lung diseases. Eur Respir Rev 30(162):210105

    Article  PubMed  PubMed Central  Google Scholar 

  5. Karampitsakos T, Papaioannou O, Tzouvelekis A et al (2021) Interstitial Lung Diseases and the Impact of Gender. Clin Chest Med 42(3):531–541

    Article  PubMed  Google Scholar 

  6. Izbicki G, Segel MJ, Breuer R et al (2002) Time course of bleomycin-induced lung fibrosis. Int J Exp Pathol 83(3):111–119

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  7. Sclafani A, VanderLaan P (2018) Lymphangioleiomyomatosis. N Engl J Med 378(23):2224

    Article  PubMed  Google Scholar 

  8. Borie R, Crestani B, Bichat H (2009) Prevalence of telomere shortening in familial and sporadic pulmonary fibrosis is increased in men. Am J Respir Crit Care Med 179(11):1073

    Article  PubMed  Google Scholar 

  9. Wälscher J, Witt S, Kreuter M et al (2020) Hospitalisation patterns of patients with interstitial lung disease in the light of comorbidities and medical treatment—a German claims data analysis. Respir Res 21(1):73

    Article  PubMed  PubMed Central  Google Scholar 

  10. Dempsey TM, Payne S, Limper AH et al (2021) Adoption of the antifibrotic medications pirfenidone and nintedanib for patients with idiopathic pulmonary fibrosis. Ann Am Thorac Soc 18(7):1121–1128

    Article  PubMed  Google Scholar 

  11. Tannenbaum C, Ellis RP, Schiebinger L et al (2019) Sex and gender analysis improves science and engineering. Nature 575(7781):137–146

    Article  CAS  PubMed  Google Scholar 

  12. Fuentes N, Silveyra P (2018) Endocrine regulation of lung disease and inflammation. Exp Biol Med (Maywood) 243(17–18):1313–1322

    Article  CAS  PubMed  Google Scholar 

  13. Tzouvelekis A, Bouros D (2019) Estrogen Signaling and MicroRNAs in Lung Fibrosis. Sex, Hormones, and Rock Scars. Am J Respir Crit Care Med 200(10):1199–1200

    Article  PubMed  PubMed Central  Google Scholar 

  14. Newton CA, Batra K, Garcia CK et al (2016) Telomere-related lung fibrosis is diagnostically heterogeneous but uniformly progressive. Eur Respir J 48(6):1710–1720

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  15. Zhang D, Adegunsoye A, Newton CA et al (2023) Telomere length and immunosuppression in non-idiopathic pulmonary fibrosis interstitial lung disease. Eur Respir J 62(5):2300441

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  16. Knight SW, Heiss NS, Poustka A et al (1999) X‑linked dyskeratosis congenita is predominantly caused by missense mutations in the DKC1 gene. Am J Hum Genet 65(1):50–58

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  17. Cronkhite JT, Xing C, Garcia CK et al (2008) Telomere shortening in familial and sporadic pulmonary fibrosis. Am J Respir Crit Care Med 178(7):729–737

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  18. Townsley DM, Dumitriu B, Young NS et al (2016) Danazol treatment for telomere diseases. N Engl J Med 374(20):1922–1931

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  19. Hoffman TW, van Moorsel CHM, Grutters JC et al (2023) No effect of danazol treatment in patients with advanced idiopathic pulmonary fibrosis. ERJ Open Res 9(5):131–2023

    Article  PubMed  PubMed Central  Google Scholar 

  20. Frontbrune FS, Resche-Rigon M Assistance Publique – Hôpitaux de Paris. https://clinicaltrials.gov/ct2/show/NCT03710356/. Zugegriffen: 01.2024

  21. Reynolds C, Feary J, Cullinan P (2020) Occupational Contributions to Interstitial Lung Disease. Clin Chest Med 41(4):697–707

    Article  PubMed  Google Scholar 

  22. Kerget B, Araz O, Akgun M et al (2019) Female workers’ silicosis diagnosis delayed due to gender bias. Occup Med (lond) 69(3):219–222

    Article  CAS  PubMed  Google Scholar 

  23. Singh N, Singh S (2021) Interstitial Lung Diseases and Air Pollution: Narrative Review of Literature. Pulm Ther 7(1):89–100

    Article  PubMed  PubMed Central  Google Scholar 

  24. https://www.who.int/news-room/fact-sheets/detail/household-air-pollution-and-health#:~:text=Women%20and%20children%20disproportionately%20bear,from%20polluting%20stoves%20and%20fuels., letzter Abruf 5. Febr. 2024

  25. Gold JA, Jagirdar J, Rom WN et al (2000) Hut lung. A domestically acquired particulate lung disease. Medicine (Baltimore) 79(5):310–317

    Article  CAS  PubMed  Google Scholar 

  26. Hagmeyer L, Randerath W (2015) Smoking-related interstitial lung disease. Dtsch Ärztebl Int 112(4):43–50

    PubMed  PubMed Central  Google Scholar 

  27. Margaritopoulos GA, Vasarmidi E, Antoniou KM et al (2015) Smoking and interstitial lung diseases. Eur Respir Rev 24(137):428–435

    Article  PubMed  PubMed Central  Google Scholar 

  28. Davies G, Wells AU, du Bois RM (2004) Respiratory bronchiolitis associated with interstitial lung disease and desquamative interstitial pneumonia. Clin Chest Med 25(4):717–726

    Article  PubMed  Google Scholar 

  29. https://www.lung.org/quit-smoking/smoking-facts/impact-of-tobacco-use/women-and-tobacco-use, letzter Aufruf 6. Febr. 2024

  30. Salisbury ML, Xia M, Flaherty KR et al (2016) Idiopathic Pulmonary Fibrosis: Gender-Age-Physiology Index Stage for Predicting Future Lung Function Decline. Chest 149(2):491–498

    Article  PubMed  PubMed Central  Google Scholar 

  31. Hodgson U, Laitinen T, Tukiainen P (2002) Nationwide prevalence of sporadic and familial idiopathic pulmonary fibrosis: evidence of founder effect among multiplex families in Finland. Thorax 57(4):338–342

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  32. Zaman T, Moua T, Lee JS et al (2020) Differences in Clinical Characteristics and Outcomes Between Men and Women With Idiopathic Pulmonary Fibrosis: A Multicenter Retrospective Cohort Study. Chest 158(1):245–251

    Article  PubMed  PubMed Central  Google Scholar 

  33. Costabel U, Miyazaki Y, Selman M et al (2020) Hypersensitivity pneumonitis. Nat Rev Dis Primers 6(1):65

    Article  PubMed  Google Scholar 

  34. Raghu G, Remy-Jardin M, Wilson KC et al (2020) Diagnosis of hypersensitivity pneumonitis in adults. An Official ATS/JRS/ALAT Clinical Practice Guideline. Am J Respir Crit Care Med 202(3)::e36–e69

    Article  PubMed  Google Scholar 

  35. Rittig AH, Hilberg O, Løkke A et al (2019) Incidence, comorbidity and survival rate of hypersensitivity pneumonitis: a national population-based study. ERJ Open Res 5(4):259–2018

    Article  PubMed  PubMed Central  Google Scholar 

  36. Fernández Pérez ER, Kong AM, Cole AL et al (2018) Epidemiology of Hypersensitivity Pneumonitis among an insured population in the United States: A Claims-based Cohort Analysis. Ann Am Thorac Soc 15(4):460–469. https://doi.org/10.1513/AnnalsATS.201704-288OC

    Article  PubMed  Google Scholar 

  37. Blanc PD, Annesi-Maesano I, Redlich CA et al (2019) The occupational burden of nonmalignant respiratory diseases. An Official American Thoracic Society and European Respiratory Society Statement. Am J Respir Crit Care Med 199(11):1312–1334

    Article  PubMed  PubMed Central  Google Scholar 

  38. Tillie-Leblond I, Grenouillet F, Millon L et al (2011) Hypersensitivity pneumonitis and metalworking fluids contaminated by mycobacteria. Eur Respir J 37(3):640–647

    Article  CAS  PubMed  Google Scholar 

  39. Walters GI, Mokhlis JM, Burge PS et al (2019) Characteristics of hypersensitivity pneumonitis diagnosed by interstitial and occupational lung disease multi-disciplinary team consensus. Respir Med 155:19–25

    Article  PubMed  Google Scholar 

  40. Wijsenbeek M, Cottin V (2020) Spectrum of fibrotic lung diseases. N Engl J Med 383:958–968

    Article  CAS  PubMed  Google Scholar 

  41. Stevenson BR, Thompson GA, McLean-Tooke AP et al (2019) Autoantibodies in interstitial lung diseases. Pathology 51(5):518–523

    Article  CAS  PubMed  Google Scholar 

  42. Kono M, Nakamura Y, Chida K et al (2014) Usual interstitial pneumonia preceding collagen vascular disease: a retrospective case control study of patients initially diagnosed with idiopathic pulmonary fibrosis. PLoS ONE 9(4):e94775

    Article  PubMed  PubMed Central  Google Scholar 

  43. Fairweather D, Frisancho-Kiss S, Rose NR (2008) Sex differences in autoimmune disease from a pathological perspective. Am J Pathol 173:600–609

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  44. Shao T, Shi X, Shuai Z et al (2021) Interstitial lung disease in connective tissue disease: A common lesion with Heterogeneous Mechanisms and Treatment Considerations. Front Immunol 7;12:684699 (Jun)

    Article  Google Scholar 

  45. Huang S, Doyle TJ, Sparks JA et al (2020) Rheumatoid arthritis-related lung disease detected on clinical chest computed tomography imaging: Prevalence, risk factors, and impact on mortality. Semin Arthritis Rheum 50(6):1216–1225

    Article  PubMed  PubMed Central  Google Scholar 

  46. Kondoh Y, Makino S, Kuwana M et al (2021) 2020 guide for the diagnosis and treatment of interstitial lung disease associated with connective tissue disease. Respir Investig 59(6):709–740

    Article  CAS  PubMed  Google Scholar 

  47. O’Mahony AM, Lynn E, Murphy DJ, Fabre A, Lymphangioleiomyomatosis MC (2020) a clinical review. Breathe (sheff) 16(2):200007

    PubMed  Google Scholar 

  48. Aubry MC, Myers JL, Tazelaar HD et al (2000) Pulmonary lymphangioleiomyomatosis in a man. Am J Respir Crit Care Med 162(2 Pt 1):749–752

    Article  CAS  PubMed  Google Scholar 

  49. Schiavina M, Di Scioscio V, D’Errico-Grigioni A et al (2007) Pulmonary lymphangioleiomyomatosis in a karyotypically normal man without tuberous sclerosis complex. Am J Respir Crit Care Med 1;176(1):96–98

    Article  PubMed  Google Scholar 

  50. Gupta N, Lee HS, Ryu JH et al (2019) The NHLBI LAM registry: prognostic physiologic and radiologic biomarkers emerge from a 15-year prospective longitudinal analysis. Chest 155:288–296

    Article  PubMed  Google Scholar 

  51. Gupta N, Lee HS, Young LR et al (2019) Analysis of the MILES cohort reveals determinants of disease progression and treatment response in lymphangioleiomyomatosis. Eur Respir J 53:1802066

    Article  CAS  PubMed  PubMed Central  Google Scholar 

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  1. Zentrum für interstitielle und seltene Lungenerkrankungen, Thoraxklinik, Universitätsklinikum Heidelberg, Heidelberg, Deutschland

    Katharina Buschulte & Markus Polke

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  1. Katharina Buschulte
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  2. Markus Polke
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Correspondence to Katharina Buschulte.

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K. Buschulte erhielt Vortragshonorare von Boehringer Ingelheim und eine Forschungsförderung vom Sarkoidose-Netzwerk e. V. M. Polke erhielt Vortragshonorare von AstraZeneca und Boehringer Ingelheim.

Für diesen Beitrag wurden von den Autor/-innen keine Studien an Menschen oder Tieren durchgeführt. Für die aufgeführten Studien gelten die jeweils dort angegebenen ethischen Richtlinien.

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Buschulte, K., Polke, M. Geschlechtsspezifische Aspekte bei interstitiellen Lungenerkrankungen. Z Pneumologie (2024). https://doi.org/10.1007/s10405-024-00551-2

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