Potential immunological effects of gender-affirming hormone therapy in transgender people - an unexplored area of research.

IF 4.3 3区 材料科学 Q1 ENGINEERING, ELECTRICAL & ELECTRONIC
ACS Applied Electronic Materials Pub Date : 2022-12-10 eCollection Date: 2022-01-01 DOI:10.1177/20420188221139612
Alice A White, Ashleigh Lin, Xander Bickendorf, Blake S Cavve, Julia K Moore, Aris Siafarikas, Deborah H Strickland, Jonatan Leffler
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引用次数: 0

Abstract

There are well-described sex-based differences in how the immune system operates. In particular, cisgender (cis) females have a more easily activated immune system; associated with an increased prevalence of autoimmune diseases and adverse events following vaccinations. Conversely, cis males have a higher threshold for immune activation, and are more prone to certain infectious diseases, such as coronavirus disease (COVID-19). Oestrogen and testosterone have immune-modulatory properties, and it is likely that these contribute to the sexual dimorphism of the immune system. There are also important immune-related genes located on the X chromosome, such as toll-like receptor (TLR) 7/8; and the mosaic bi-allelic expression of such genes may contribute to the state of immune hyperactivation in cis females. The scientific literature strongly suggests that sex-based differences in the functioning of the immune system are related to both X-linked genes and immune modulation by sex hormones. However, it is currently not clear how this impacts transgender (trans) people receiving gender-affirming hormonal therapy. Moreover, it is estimated that in Australia, at least 2.3% of adolescents identify as trans and/or gender diverse, and referrals to specialist gender-affirming care are increasing each year. Despite the improving social awareness of trans people, they remain chronically underrepresented in the scientific literature. In addition, a small number of case studies describe new onset autoimmune disorders in adult trans females following oestrogen use. However, there is currently minimal long-term research with an immunological focus on trans people. Therefore, to ensure the positive health outcomes of trans people, it is crucial that the role of sex hormones in immune modulation is investigated further.

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变性人接受性别确认激素疗法的潜在免疫学影响--一个尚未探索的研究领域。
在免疫系统的运作方式上存在着明显的性别差异。特别是,顺性别(cis)女性的免疫系统更容易被激活;这与自身免疫性疾病和接种疫苗后不良反应的发生率增加有关。相反,顺性男性的免疫激活阈值较高,更容易罹患某些传染病,如冠状病毒病(COVID-19)。雌激素和睾酮具有免疫调节特性,很可能是它们导致了免疫系统的性双态性。X 染色体上还有一些重要的免疫相关基因,如收费样受体(TLR)7/8;这些基因的镶嵌式双等位基因表达可能会导致顺式雌性的免疫亢进状态。科学文献强烈表明,免疫系统功能的性别差异与 X 连锁基因和性激素的免疫调节作用有关。然而,目前还不清楚这对接受性别确认荷尔蒙疗法的变性人(跨性别)有什么影响。此外,据估计,在澳大利亚,至少有 2.3% 的青少年被认定为变性人和/或性别多元化者,而转诊到性别确认专科治疗的人数也在逐年增加。尽管社会对变性人的认识不断提高,但他们在科学文献中的代表性仍然长期不足。此外,少数病例研究描述了成年变性女性在使用雌激素后新出现的自身免疫性疾病。然而,目前针对变性人的免疫学长期研究极少。因此,为了确保变性人获得积极的健康结果,进一步研究性荷尔蒙在免疫调节中的作用至关重要。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
7.20
自引率
4.30%
发文量
567
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