Could our gender impact how our immune system reacts?

A group of immunologists from the United States believes that gender, determined by biological traits such as sex chromosomes, sex hormones and reproductive tissues, affects a person's immune response. The article was published in Technology Review magazine.

“I naively thought: Everybody knows hormones can affect lots of physiological processes—our metabolism, our heart, our bone density. It must be affecting the immune system,” she says.," says Dr. Sabra Klein of Johns Hopkins University.

In immunology, it has long been believed that gender differences do not matter. Historically, clinical trials have focused on male participants, which has led to serious consequences for public health and medicine. For example, women were more often denied vital HIV treatment, and may have had serious side effects from drugs and vaccines if they received a "male" dose of the drug.

Different diseases affect us in different ways

Studies have shown that men and women suffer from infectious or autoimmune diseases in different ways. And this difference has a biological basis.

Women are nine times more likely to suffer from lupus and have severe asthma. They are also three times more likely than men to suffer from multiple sclerosis.

Meanwhile, men are twice as likely to suffer from tuberculosis than women, and are more likely to die from COVID-19. Experts attribute this to immune responses, as well as sociocultural gender differences: men are more likely to smoke, or work in industries such as mining or construction. This means that they are more likely to be exposed to toxic substances that can weaken the immune protection of the lungs.

Male and female immune systems also respond differently to HIV and some cancer treatments.

Why do women have a stronger immune response?

This phenomenon occurs in many mammals - and there is an evolutionary reason for that. One hypothesis suggests that a stronger immune response in women contributes to the transmission of a larger number of antibodies to children in the womb and through breast milk. However, increased immune reactions that help support infants' lives also increase the risk of autoimmune conditions when women get older.

Differences in the immune system also can manifest themselves on the X chromosome. The TLR7 gene plays an important role in the recognition of pathogens and activation of the immune system, but at the same time it is this gene that contributes to the higher prevalence of autoimmune conditions in women - especially lupus.

The TLR7 gene also contributes to a stronger immune response to HIV. Therefore, many women in the 1990s were left without therapy due to a lower viral load than in men. However, as experts note, it is the immune response, not the viral load, that "is the dominant predictor of the progression of HIV into AIDS."

What about transgender people?

Unfortunately, there are a number of groups of people whose immune system who have hardly been studied. Transgender people belong to this category, despite the fact that they have the highest risk of contracting HIV.

According to experts, hormonal therapy can change a person's immune response, but social factors can lead to increased stress and potentially adversely affect their immune system.

It is reported that immunologists are planning several studies in this area in the near future.

“We need to look at how men and women and gender minorities are impacted differentially so we can have better health care, better medicine, better vaccines,” says Morgan.