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Open Access Highly Accessed Review

The role of female hormones on lung function in chronic lung diseases

Anthony Tam1, Don Morrish2, Samuel Wadsworth1, Delbert Dorscheid1, SF Paul Man1 and Don D Sin1*

Author Affiliations

1 The UBC James Hogg Research Centre, Providence Heart + Lung Centre & Department of Medicine, University of British Columbia (UBC), Vancouver, BC, Canada

2 Department of Medicine, The University of Alberta, Edmonton, AB, Canada

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BMC Women's Health 2011, 11:24  doi:10.1186/1472-6874-11-24

Published: 3 June 2011

Abstract

Background

The prevalence, morbidity, and mortality of inflammatory lung diseases such as asthma, chronic obstructive pulmonary disease (COPD) and cystic fibrosis (CF) are increasing in women. There is a dearth of data on the biological mechanisms to explain such observations. However, some large epidemiologic studies suggest that lung function fluctuates during the menstrual cycle in female patients with airways disease but not in women without disease, suggesting that circulating estradiol and progesterone may be involved in this process.

Discussion

In asthma, estradiol shuttles adaptive immunity towards the TH2 phenotype while in smokers estrogens may be involved in the generation of toxic intermediate metabolites in the airways of female smokers, which may be relevant in COPD pathogenesis. In CF, estradiol has been demonstrated to up-regulate MUC5B gene in human airway epithelial cells and inhibit chloride secretion in the airways. Progesterone may augment airway inflammation.

Summary

Taken together, clinical and in-vivo data have demonstrated a sex-related difference in that females may be more susceptible to the pathogenesis of lung diseases. In this paper, we review the effect of female sex hormones in the context of these inflammatory airway diseases.

Keywords:
lung function; menstrual cycle; sex hormones; asthma; cystic fibrosis; COPD