Sex and gender in bronchiectasis: an analysis of two Italian centres and a review of literature

Le résumé fourni par la source

Non-cystic fibrosis bronchiectasis presents a higher prevalence among females in most countries and women affected by bronchiectasis have a more severe disease course and a worse outcome. Some mechanisms suggested to be implied in this gender disparity are anatomical predisposition and differences in the respiratory microbiome. Moreover, some of the conditions that cause bronchiectasis are more common in females. There is increasing evidence regarding the role of sex specific hormones: in vitro studies have shown how progesterone reduces mucociliary clearance, whereas oestradiol was seen to be associated with mucoid conversion and increased exacerbations in patients colonised with Pseudomonas aeruginosa. Our analysis considered 201 patients diagnosed with non-cystic fibrosis bronchiectasis, of which 170 referred to the Respiratory Unit of San Matteo Hospital of Pavia and 31 to the Respiratory Unit of Ospedali Riuniti of Foggia. According to literature, the majority of these patients were females (78.6%). We found that a greater percentage of females had at least one colonization (whether bacterial, fungal or mycobacterial) compared to males (p=0.028), women had lower BMI (p=0.005) and higher frequency of pneumonia (p<0.001). On the other hand, despite the fact that most patients were females we didn’t observe a statistically significant difference regarding age, number of exacerbations, number of bacterial, fungal, viral or NTM isolates, symptoms and disease severity, assessed by the BSI (Bronchiectasis Severity Index), between males and females. This might find explanation in the small number of patients taken into consideration, thus requiring further analysis and data collection.

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