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. 2012 Dec;34(12):1050-9.
doi: 10.1002/bies.201200099. Epub 2012 Sep 26.

Sex influences immune responses to viruses, and efficacy of prophylaxis and treatments for viral diseases

Sabra L Klein  1
Affiliations

Sex influences immune responses to viruses, and efficacy of prophylaxis and treatments for viral diseases

Sabra L Klein. Bioessays. 2012 Dec.

Abstract

The intensity and prevalence of viral infections are typically higher in males, whereas disease outcome can be worse for females. Females mount higher innate and adaptive immune responses than males, which can result in faster clearance of viruses, but also contributes to increased development of immunopathology. In response to viral vaccines, females mount higher antibody responses and experience more adverse reactions than males. The efficacy of antiviral drugs at reducing viral load differs between the sexes, and the adverse reactions to antiviral drugs are typically greater in females than males. Several variables should be considered when evaluating male/female differences in responses to viral infection and treatment: these include hormones, genes, and gender-specific factors related to access to, and compliance with, treatment. Knowledge that the sexes differ in their responses to viruses and to treatments for viral diseases should influence the recommended course of action differently for males and females. Editor's suggested further reading in BioEssays X-chromosome-located microRNAs in immunity: Might they explain male/female differences Abstract.

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Conflict of interest statement

No conflict of interest declared.

Figures

Figure 1
Figure 1. Sex-based differences in immune responses to viruses
Following exposure to a virus, antigen recognition by pattern recognition receptors (PRRs) and induction of innate immune responses, including the activity of antigen presenting cells (APCs) (e.g., dendritic cells and macrophages) and production of inflammatory cytokines (e.g., IFN-β, IFN-γ, and TNF-α) and chemokines (e.g., CCL2) are higher in females than males. Induction of the adaptive immune response, including the activation of lymphocytes, production of antibodies by B cells, and activity of CD4+ and CD8+ T cells also are higher in females than males. Following clearance of virus, the immune systems of both males and females return to homeostasis. During the return to homeostasis, females can maintain elevated immune responses resulting in a greater risk of developing immunopathology (i.e., tissue damage caused by excessively high or prolonged activation of immune responses) than males. In contrast, during the return to homeostasis in males, lower antiviral immune responses can result in an increased risk of virus persistence in males as compared with females.
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References

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