Female Sex and Gender in Lung/Sleep Health and Disease. Increased Understanding of Basic Biological, Pathophysiological, and Behavioral Mechanisms Leading to Better Health for Female Patients with Lung Disease

Abstract

Female sex/gender is an under-characterized variable in studies related to lung development and disease. Notwithstanding, many aspects of lung and sleep biology and pathobiology are impacted by female sex and female reproductive transitions. These may manifest as differential gene expression or peculiar organ development. Some conditions are more prevalent in women, such as asthma and insomnia, or in the case of LAM, are seen almost exclusively in women. In other diseases, presentation differs such as the higher frequency of exacerbations experienced by women with COPD or greater cardiac morbidity among women with sleep disordered breathing. Recent advances in –omics and behavioral science provide an opportunity to specifically address sex-based differences and explore research needs and opportunities that will elucidate biochemical pathways, thus enabling more targeted/personalized therapies. To explore the status of and opportunities for research in this area, the National Heart, Lung, and Blood Institute (NHLBI), in partnership with the National Institutes of Health (NIH) Office of Research on Women’s Health (ORWH) and the Office of Rare Diseases Research (ORDR), convened a workshop of investigators in Bethesda, (MD) on September 18-19, 2017. At the workshop the participants reviewed the current understanding of the biological, behavioral, and clinical implications of female sex and gender on lung and sleep health and disease, and formulated recommendations that address research gaps, with a view of achieving better health outcomes through more precise management of female patients with non-neoplastic lung disease were proposed. This report summarizes those discussions.