Sex Differences in Pediatric Infectious Diseases
Journal of Infectious Diseases July 15, 2014 V.209 SUPL.3 S120-S126
Maximilian Muenchhoff1 and Philip J. R. Goulder1,2
1Department of Paediatrics, University of Oxford, United Kingdom
2HIV Pathogenesis Programme, The Doris Duke Medical Research Institute, University of KwaZulu-Natal, Durban, South Africa
Correspondence: Prof Philip J. R. Goulder, Department of Paediatrics, University of Oxford, Peter Medawar Bldg for Pathogen Research, South Parks Road, Oxford OX1 3SY, UK v(firstname.lastname@example.org).
The success of the immune response is finely balanced between, on the one hand, the need to engage vigorously with, and clear, certain pathogens; and, on the other, the requirement to minimize immunopathology and autoimmunity.
Distinct immune strategies to achieve this balance have evolved in females and males and also in infancy through to adulthood. Sex differences in outcome from a range of infectious diseases can be identified from as early as fetal life, such as in congenital cytomegalovirus infection.
The impact of sex hormones on the T-helper 1/T-helper 2 cytokine balance has been proposed to explain the higher severity of most infectious diseases in males. In the minority where greater morbidity and mortality is observed in females, this is hypothesized to arise because of greater immunopathology and/or autoimmunity.
However, a number of unexplained exceptions to this rule are described. Studies that have actually measured the sex differences in children in the immune responses to infectious diseases and that would further test these hypotheses, are relatively scarce.
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