Novel Insights on Sex-Related Differences in Asthma

  • Peng Zhang
  • Joe ZeinEmail author
Asthma (V Ortega, Section Editor)
Part of the following topical collections:
  1. Topical Collection on Asthma


Purpose of Review

Asthma, a common respiratory disease that affects about 10% of the US population, represents a significant public health issue. In the last decade, cumulative evidence has demonstrated sex disparities in asthma, including significant differences in epidemiology, clinical presentation, response to therapies, and health outcomes. Understanding sex-related differences in asthma enables clinicians to provide personalized asthma care and improve asthma outcome.

Recent Findings

Recent studies on sex-related differences in asthma inform us on mechanism underlying asthma pathogenesis across all age groups. Sex hormones directly modulate immune pathways crucial in asthma pathogenesis and affect individual’s response to environmental triggers and medications, such as leukokotriene inhibitors. Not surprisingly, the use of external sex hormone supplementations appears to modulate asthma risk. Identification of sex-specific asthma risk loci through genome-wide association studies also provides supporting evidence on sex-related differences in asthma. There is an interaction between sex and obesity, an interaction that could place females at higher risk for systemic inflammation and, consequently, asthma.


In this article, we review epidemiological and clinical studies on sex-related differences in asthma, with a special focus on the role of sex hormones, including hormonal therapies and the asthma-obesity interaction.


Asthma Sex-related difference Menopause Oral contraception pills Menopausal hormone replacement therapy Obesity 



We thank Kimberly Yeager, Ph.D. for her valuable input on the review.

Funding Information

Joe G. Zein: NIH-NHLBI K08HL133381.

Compliance with Ethical Standards

Conflict of Interest

Peng Zhang and Joe Zein declare no conflicts of interest relevant to this manuscript.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.


Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

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Authors and Affiliations

  1. 1.From the Respiratory InstituteCleveland ClinicClevelandUSA

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