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Can testosterone protect men from asthma?

Women are twice as likely to develop asthma after puberty than are men, and they are also more likely to suffer from more severe forms of the disorder. More girls develop asthma than boys during childhood as well. However, doctors and researchers have not had a good idea as to why this difference in susceptibility to asthma exists. However, an international team of scientists recently published an article in the Journal of Experimental Medicine that helps to answer this question.

Given that a major distinguishing factor between men and women is the distribution of hormones in their bodies, the researchers had speculated that hormones may play a role in the different levels of resistance to asthma seen in men versus women. It turns out that they were right. 

Recently identified cells, called innate lymphoid cells, which are a specific type of cell in the immune system, contribute to the onset of asthma. What the scientists showed is that testosterone, a hormone that is present in significantly higher quantities in men than in women, inhibits the activity of these lymphoid cells. Specifically, testosterone prevents these innate lymphoid cells from proliferating. Through this action, testosterone helps to prevent the onset of asthma.

In addition to helping us understand why we observe sex differences in the vulnerability to asthma, this recent study may also help us figure out how better to treat people – and perhaps women specifically – who suffer from asthma. Mimicking the action that testosterone has on the immune system, for example, may be one way to help treat women with asthma. This type of hormonal mimicry has been used in the past to treat other diseases. Breast cancer is one example where this strategy has proven successful.

Steroids have been a common approach to treating severe asthma, but steroids are not very specific in what they target, so they tend to have a number of side effects. These side effects can be severe and unpleasant. A treatment that could more specifically target the innate lymphoid cells could potentially help asthma patients without adverse side effects.

More research is needed to determine how this latest discovery can be used to help asthma sufferers. Nonetheless, these results help physicians and scientists better understand sex differences in the incidence of asthma and how future therapies may be developed to combat the disease. 

Dr. Summit Shah

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