Sex Differences in the Anatomy of the Airways and the Lungs: Impact on Dysanapsis across the Lifespan

LoMauro, Antonella; Aliboni, Lorenzo; Aliverti, Andréa

doi:10.1007/978-3-030-63549-7_2

Cited by 4 publications

(5 citation statements)

References 67 publications

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“…In contrast to Gu et al 23 , no systematic increment of θ R and decrement of θ L was observed in the LUL post-operative cases, possibly because of the limited size of our population. Although the characterization and the role of structural modifications on post-operative pulmonary function is still an open field of research 36 , the pre and post-operative values measured angles in our study are in line with the expected intersubject variability, also accounting for the sex-related differences between women and men 37 .…”

Section: Discussionsupporting

confidence: 85%

Functional analysis of the airways after pulmonary lobectomy through computational fluid dynamics

Aliboni

Tullio

Pennati

et al. 2022

Sci Rep

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Pulmonary lobectomy, which consists of the partial or complete resection of a lung lobe, is the gold standard intervention for lung cancer removal. The removal of functional tissue during the surgery and the re-adaptation of the remaining thoracic structures decrease the patient's post-operative pulmonary function. Residual functionality is evaluated through pulmonary function tests, which account for the number of resected segments without considering local structural alterations and provide an average at-the-mouth estimation. Computational Fluid Dynamics (CFD) has been demonstrated to provide patient-specific, quantitative, and local information about airways airflow dynamics. A CFD investigation was performed on image-based airway trees reconstructed before and after the surgery for twelve patients who underwent lobectomy at different lobes. The geometrical alterations and the variations in fluid dynamics parameters and in lobar ventilation between the pre and post-operative conditions were evaluated. The post-operative function was estimated and compared with current clinical algorithms and with actual clinical data. The post-operative configuration revealed a high intersubject variability: regardless of the lobectomy site, an increment of global velocity, wall pressure, and wall shear stress was observed. Local flow disturbances also emerged at, and downstream of, the resection site. The analysis of lobar ventilation showed severe variations in the volume flow rate distribution, highlighting the compensatory effects in the contralateral lung with an increment of inflow. The estimation of post-operative function through CFD was comparable with the current clinical algorithm and the actual spirometric measurements. The results confirmed that CFD could provide additional information to support the current clinical approaches both in the operability assessment and in the prescription of personalized respiratory rehabilitation.

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Section: Discussionsupporting

confidence: 85%

Functional analysis of the airways after pulmonary lobectomy through computational fluid dynamics

Aliboni

Tullio

Pennati

et al. 2022

Sci Rep

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“…3,23 An explanation for the greater predominance of boys with asthma in the prepubertal years could be dysanaptic lung growth. 24 In girls, bronchial airways and lung parenchyma grow proportionally, but in boys, bronchial airway growth lags behind parenchymal growth, resulting in disproportionately fewer alveoli for the number of airways. 25 Upon maturation, males develop larger diameter airways, lung volumes, maximum expiratory flow, and diffusion surface than do females.…”

Section: Anatomic Differencesmentioning

confidence: 99%

Personalized Treatment of Asthma: The Importance of Sex and Gender Differences

Jenkins

Boulet

Lavoie

et al. 2022

The Journal of Allergy and Clinical Immunology: In Practice

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“…During adolescence, higher respiratory pressures generated by males are attributed to the influence of testosterone and to the changing shape of the thorax and respiratory muscles during puberty [62]. Because sex-induced dysanaptic growth of airways versus lungs is maintained in adulthood, women should be placed at an advantage in terms of respiratory mechanics and airflow [7,10]. Indeed, females have a higher ratio of forced expiratory volume in one second (FEV 1 ) and FVC [62].…”

Section: Sex Hormones and Lung Immune Cellsmentioning

confidence: 99%

“…Although men are more prone to develop obstructive sleep apnoea because of their anatomical facial features (i.e. longer upper airway and larger soft palate, figure 2) [10,142], it is extremely unlikely that women assigned female gender at birth exposed to transgender hormone therapy with androgens develop an anatomically male upper airway [143]. The role of cross-sex hormone therapy needs to be investigated.…”

Section: Pregnancymentioning

confidence: 99%

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Sex and gender in respiratory physiology

LoMauro

Aliverti

2021

Eur Respir Rev

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Sex is a biological concept determined at conception. Gender is a social concept. Medicine recognises sex as a biological variable and recommends including sex as a factor in clinical practice norms and as a topic of bench and clinical research. Sex plays a role in respiratory physiology according to two pathways: hormones and anatomy, with females characterised by smaller dimensions at every level of the respiratory system. Sex hormones also play specific roles in lung inflammatory processes, breathing control and in response to diseases. The literature is extremely controversial because many factors need to be considered to avoid erroneous comparisons. The main difficulty lies in creating homogeneous groups of subjects according to age, body weight, lung/airway size, fluctuations in circulating hormone levels, and exercise protocol. Because almost all of the knowledge available in physiology is based on research in males, medicine for women is therefore less evidence-based than that being applied to men. Finally, the number of transsexual people is increasing and they represent new challenges for clinicians, due to the anatomical and physiological changes that they undergo.

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Sex Differences in the Anatomy of the Airways and the Lungs: Impact on Dysanapsis across the Lifespan

Cited by 4 publications

References 67 publications

Functional analysis of the airways after pulmonary lobectomy through computational fluid dynamics

Functional analysis of the airways after pulmonary lobectomy through computational fluid dynamics

Personalized Treatment of Asthma: The Importance of Sex and Gender Differences

Sex and gender in respiratory physiology

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