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Geschlechtsspezifische Unterschiede in gastroenterologischen Erkrankungen

Sex-specific differences in gastroenterological diseases

  • Schwerpunkt: Genderspezifische Diagnostik und Therapie in der Inneren Medizin
  • Published:
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Zusammenfassung

Zahlreiche gastroenterologische Erkrankungen weisen hinsichtlich Inzidenz, Prognose und Therapieansprechen deutliche Unterschiede zwischen den Geschlechtern auf. Diese werden nur zum Teil in der Grundlagen- und klinischen Forschung oder auch im klinischen Alltag berücksichtigt. Beispielsweise werden in der Grundlagenforschung viele Tierexperimente nur mit männlichen Tieren durchgeführt. Bei malignen Erkrankungen des Gastrointestinaltrakts ist die Inzidenz bei Männern häufig höher als bei Frauen. Dies kann nicht allein durch ein unterschiedliches Risikoverhalten erklärt werden. Mittlerweile konnten unter anderem geschlechtsspezifische Unterschiede in der Immunantwort und eine Beeinflussung des Tumorsuppressors p53 durch X‑Chromosom-Inaktivierung nachgewiesen werden. Trotz dieser neuen Erkenntnisse muss das Verständnis der zugrunde liegenden Mechanismen zwingend verbessert werden, da sich hieraus weitreichende Konsequenzen ergeben können. Ziel dieser Übersichtsarbeit ist es, diese geschlechtsspezifischen Unterschiede darzustellen und somit das Bewusstsein dafür zu schärfen. Die Berücksichtigung von geschlechtsspezifischen Aspekten stellt einen entscheidenden Faktor für die individualisierte Therapie dar.

Abstract

Diseases of the gastrointestinal tract present with substantial sex differences that have a potential impact on patient outcome. This fact is not sufficiently addressed either in basic research or in clinical studies. For example, most animal studies utilize male animals. Despite differences in incidence, sex may affect complication rates, prognosis, or therapeutic response. The incidence of gastrointestinal cancers is frequently higher in males, but this observation cannot solely rely on a distinct risk behaviour. Here, differences in immune response and p53 signalling may be factors responsible for this finding. Nevertheless, taking sex differences into account and improving our understanding of relevant mechanisms is crucial and will most likely have a substantial impact on disease outcome. This overview aims to highlight sex differences in the context of various gastroenterological diseases, primarily to enhance awareness. Attention to sex-specific differences is essential to improve individualized treatment.

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Authors and Affiliations

  1. Universitätsklinik und Poliklinik für Innere Medizin I, Martin-Luther-Universität Halle-Wittenberg, Ernst-Grube-Str. 40, 06120, Halle (Saale), Deutschland

    Laura Roth, Patrick Michl & Jonas Rosendahl

  2. Department of Cancer Biology, Dana Farber Cancer Institute, Boston, MA, USA

    Laura Roth

  3. Department of Cell Biology, Harvard Medical School, Boston, MA, USA

    Laura Roth

  4. Klinik für Innere Medizin IV, Universitätsklinikum Heidelberg, Heidelberg, Deutschland

    Patrick Michl

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  1. Laura Roth
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L. Roth, P. Michl und J. Rosendahl geben an, dass kein Interessenkonflikt besteht.

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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Roth, L., Michl, P. & Rosendahl, J. Geschlechtsspezifische Unterschiede in gastroenterologischen Erkrankungen. Innere Medizin 64, 736–743 (2023). https://doi.org/10.1007/s00108-023-01491-4

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