Sexual Dimorphism and Gender in Infectious Diseases

Epidemiological studies and clinical observations show evidence of sexual dimorphism in infectious diseases. Women are at less risk than men when it comes to developing most infectious diseases. However, understanding these observations requires a gender approach that takes into account an analysis of both biological and social factors. The host’s response to infection differs in males and females because sex differences have an impact on hormonal and chromosomal control of immunity. Estradiol appears to confer protective immunity, while progesterone and testosterone suppress anti-infectious responses. In addition, genetic factors, including those associated with sex chromosomes, also affect susceptibility to infections. Finally, differences in occupational activities, lifestyle, and comorbidities play major roles in exposure to pathogens and management of diseases. Hence, considering sexual dimorphism as a critical variable for infectious diseases should be one of the steps taken toward developing personalized therapeutic approaches.

[1]  M. Mahmoudi,et al.  Escape from X chromosome inactivation and female bias of autoimmune diseases , 2020, Molecular Medicine.

[2]  M. Altfeld,et al.  Heterogeneous Escape from X Chromosome Inactivation Results in Sex Differences in Type I IFN Responses at the Single Human pDC Level , 2020, Cell Reports.

[3]  S. Einav,et al.  COVID-19 gender susceptibility and outcomes: A systematic review , 2020, PloS one.

[4]  Steven M. Holland,et al.  Autoantibodies against type I IFNs in patients with life-threatening COVID-19 , 2020, Science.

[5]  D. DeMeo,et al.  Sex and gender: modifiers of health, disease, and medicine , 2020, The Lancet.

[6]  Arthur S Slutsky,et al.  Molecular mechanisms of sex bias differences in COVID-19 mortality , 2020, Critical Care.

[7]  Haibin Zhu,et al.  Effect of Chlamydia trachomatis on adverse pregnancy outcomes: a meta-analysis , 2020, Archives of Gynecology and Obstetrics.

[8]  V. Regitz-Zagrosek,et al.  Impact of sex and gender on COVID-19 outcomes in Europe , 2020, Biology of Sex Differences.

[9]  M. Emdin,et al.  Cardiovascular disease and COVID-19: les liaisons dangereuses , 2020, European journal of preventive cardiology.

[10]  G. Kroemer,et al.  Bacterial infection and non-Hodgkin’s lymphoma , 2020, Critical reviews in microbiology.

[11]  R. Verma,et al.  Prevalence of Dengue Fever in Western Uttar Pradesh, India: A Gender-Based Study , 2020, International journal of applied & basic medical research.

[12]  D. Raoult,et al.  The sexual dimorphism of anticardiolipin autoantibodies in acute Q fever patients. , 2019, Clinical microbiology and infection : the official publication of the European Society of Clinical Microbiology and Infectious Diseases.

[13]  D. Nand,et al.  Dengue in Fiji: epidemiology of the 2014 DENV-3 outbreak , 2019, Western Pacific surveillance and response journal : WPSAR.

[14]  M. Sammel,et al.  Glucocorticoid–immune response to acute stress in women and men living with HIV , 2019, Journal of Behavioral Medicine.

[15]  Francesca N. Delling,et al.  Heart Disease and Stroke Statistics—2019 Update: A Report From the American Heart Association , 2019, Circulation.

[16]  D. Raoult,et al.  Whipple's disease and Tropheryma whipplei infections: when to suspect them and how to diagnose and treat them , 2018, Current opinion in infectious diseases.

[17]  D. Raoult,et al.  Clinical Features and Complications of Coxiella burnetii Infections From the French National Reference Center for Q Fever , 2018, JAMA network open.

[18]  J. Mege,et al.  Sex and bacterial infectious diseases , 2018, New microbes and new infections.

[19]  M. Bonten,et al.  Exposure to Coxiella burnetii and risk of non-Hodgkin lymphoma: a retrospective population-based analysis in the Netherlands. , 2018, The Lancet. Haematology.

[20]  Dennis Görlich,et al.  Sex bias in MHC I-associated shaping of the adaptive immune system , 2018, Proceedings of the National Academy of Sciences.

[21]  A. Canivet,et al.  TLR7 escapes X chromosome inactivation in immune cells , 2018, Science Immunology.

[22]  A. Katsnelson Beyond the breath: Exploring sex differences in tuberculosis outside the lungs , 2017, Nature Medicine.

[23]  J. Bunn,et al.  Genetic variation in chromosome Y regulates susceptibility to influenza A virus infection , 2017, Proceedings of the National Academy of Sciences.

[24]  Kuan Rong Chan,et al.  The mechanistic role of antibodies to dengue virus in protection and disease pathogenesis , 2017, Expert review of anti-infective therapy.

[25]  S. Klein,et al.  Sex Steroids Mediate Bidirectional Interactions Between Hosts and Microbes , 2017, Hormones and Behavior.

[26]  A. Stapleton The Vaginal Microbiota and Urinary Tract Infection , 2016, Microbiology spectrum.

[27]  M. Plummer,et al.  Global burden of cancers attributable to infections in 2012: a synthetic analysis. , 2016, The Lancet. Global health.

[28]  Richard G. White,et al.  Sex Differences in Tuberculosis Burden and Notifications in Low- and Middle-Income Countries: A Systematic Review and Meta-analysis , 2016, PLoS medicine.

[29]  S. Klein,et al.  Sex differences in immune responses , 2016, Nature Reviews Immunology.

[30]  S. Hantz,et al.  Q fever and pregnancy: experience from the Limoges Regional University Hospital , 2016, Archives of Gynecology and Obstetrics.

[31]  M. Atchison,et al.  Unusual maintenance of X chromosome inactivation predisposes female lymphocytes for increased expression from the inactive X , 2016, Proceedings of the National Academy of Sciences.

[32]  G. Saade,et al.  Zika Virus and Pregnancy: A Review of the Literature and Clinical Considerations , 2016, American Journal of Perinatology.

[33]  S. Klein,et al.  SeXX Matters in Infectious Disease Pathogenesis , 2016, PLoS pathogens.

[34]  B. Nadel,et al.  B-cell non-Hodgkin lymphoma linked to Coxiella burnetii. , 2016, Blood.

[35]  E. Cárnio,et al.  Estradiol protects female rats against sepsis induced by Enterococcus faecalis improving leukocyte bactericidal activity , 2015, Steroids.

[36]  N. Ismail,et al.  Age and sex differences in c-Fos expression and serum corticosterone concentration following LPS treatment , 2015, Neuroscience.

[37]  E. Gotuzzo,et al.  Brucellosis in pregnancy: clinical aspects and obstetric outcomes. , 2015, International journal of infectious diseases : IJID : official publication of the International Society for Infectious Diseases.

[38]  J. Kwon,et al.  Viral Infections During Pregnancy , 2015, American journal of reproductive immunology.

[39]  R. P. Heine,et al.  Diagnosis and management of group B streptococcus in pregnancy. , 2014, Obstetrics and gynecology clinics of North America.

[40]  Yung-Yang Lin,et al.  Gender Disparities in Latent Tuberculosis Infection in High-Risk Individuals: A Cross-Sectional Study , 2014, PloS one.

[41]  A. Adegnika,et al.  Prevalence and risk factor assessment of Tropheryma whipplei in a rural community in Gabon: a community-based cross-sectional study. , 2014, Clinical microbiology and infection : the official publication of the European Society of Clinical Microbiology and Infectious Diseases.

[42]  P. Arck,et al.  Sex, immunity and influenza. , 2014, The Journal of infectious diseases.

[43]  O. Bottasso,et al.  The Influence of Sex Steroid Hormones in the Immunopathology of Experimental Pulmonary Tuberculosis , 2014, PloS one.

[44]  B. Yan,et al.  First Experimental In Vivo Model of Enhanced Dengue Disease Severity through Maternally Acquired Heterotypic Dengue Antibodies , 2014, PLoS pathogens.

[45]  Yichao Zhu,et al.  Gender Differences of B Cell Signature in Healthy Subjects Underlie Disparities in Incidence and Course of SLE Related to Estrogen , 2014, Journal of immunology research.

[46]  E. Kasahara,et al.  Gender difference in tumor necrosis factor-α production in human neutrophils stimulated by lipopolysaccharide and interferon-γ. , 2013, Biochemical and biophysical research communications.

[47]  J. Schreiber,et al.  MicroRNA-223 controls susceptibility to tuberculosis by regulating lung neutrophil recruitment. , 2013, The Journal of clinical investigation.

[48]  B. Graham,et al.  DNA priming prior to inactivated influenza A(H5N1) vaccination expands the antibody epitope repertoire and increases affinity maturation in a boost-interval-dependent manner in adults. , 2013, The Journal of infectious diseases.

[49]  D. Jamieson,et al.  Pregnancy and Susceptibility to Infectious Diseases , 2013, Infectious diseases in obstetrics and gynecology.

[50]  Q. Ali,et al.  Seroprevalence and risk factors associated with brucellosis as a professional hazard in Pakistan. , 2013, Foodborne pathogens and disease.

[51]  S. Hawkes,et al.  Gender and global health: evidence, policy, and inconvenient truths , 2013, The Lancet.

[52]  P. Brasil,et al.  Is Pregnancy Associated with Severe Dengue? A Review of Data from the Rio de Janeiro Surveillance Information System , 2013, PLoS neglected tropical diseases.

[53]  F. Abad‐Franch,et al.  Sex Bias in Infectious Disease Epidemiology: Patterns and Processes , 2013, PloS one.

[54]  V. Bollela,et al.  Endemic paracoccidioidomycosis: relationship between clinical presentation and patients' demographic features. , 2013, Medical mycology.

[55]  J. Adamski,et al.  Testosterone Increases Susceptibility to Amebic Liver Abscess in Mice and Mediates Inhibition of IFNγ Secretion in Natural Killer T Cells , 2013, PloS one.

[56]  X. Puéchal Whipple's disease , 2013, Annals of the rheumatic diseases.

[57]  O. Demaria,et al.  Sex Bias in Susceptibility to MCMV Infection: Implication of TLR9 , 2012, PloS one.

[58]  G. Borgia,et al.  Hepatitis B in pregnancy. , 2012, World journal of gastroenterology.

[59]  S. Klein,et al.  Pregnancy and pregnancy-associated hormones alter immune responses and disease pathogenesis , 2012, Hormones and Behavior.

[60]  L. Nencioni,et al.  Sex Differences in the Response to Viral Infections: TLR8 and TLR9 Ligand Stimulation Induce Higher IL10 Production in Males , 2012, PloS one.

[61]  Leon N. Schulte,et al.  The mammalian microRNA response to bacterial infections , 2012, RNA biology.

[62]  H. El‐Serag,et al.  Epidemiology of viral hepatitis and hepatocellular carcinoma. , 2012, Gastroenterology.

[63]  Linde Meyaard,et al.  CD200 Receptor Controls Sex-Specific TLR7 Responses to Viral Infection , 2012, PLoS pathogens.

[64]  R. Mattina,et al.  Gender and Age-Dependent Etiology of Community-Acquired Urinary Tract Infections , 2012, TheScientificWorldJournal.

[65]  G. Bhanot,et al.  Age-Dependent Sex Bias in Clinical Malarial Disease in Hypoendemic Regions , 2012, PloS one.

[66]  R. Sperling,et al.  The influence of pregnancy on systemic immunity , 2012, Immunologic Research.

[67]  C. Saegerman,et al.  Seroprevalence and risk factors for brucellosis in a high-risk group of individuals in Bangladesh. , 2012, Foodborne pathogens and disease.

[68]  C. Teuscher,et al.  Chromosome Y Regulates Survival Following Murine Coxsackievirus B3 Infection , 2012, G3: Genes | Genomes | Genetics.

[69]  Yungtai Lo,et al.  Characterizing the Pregnancy Immune Phenotype: Results of the Viral Immunity and Pregnancy (VIP) Study , 2011, Journal of Clinical Immunology.

[70]  J. Casanova,et al.  Genetic lessons learned from X‐linked Mendelian susceptibility to mycobacterial diseases , 2011, Annals of the New York Academy of Sciences.

[71]  M. Mckee,et al.  Mining and risk of tuberculosis in sub-Saharan Africa. , 2011, American journal of public health.

[72]  N. Dalgıç,et al.  Relationship between Toll-Like Receptor 8 Gene Polymorphisms and Pediatric Pulmonary Tuberculosis , 2011, Disease markers.

[73]  T. Wang,et al.  17 β-estradiol suppresses Helicobacter pylori-induced gastric pathology in male hypergastrinemic INS-GAS mice. , 2011, Carcinogenesis.

[74]  B. Fried,et al.  Helminths in human carcinogenesis. , 2011, Cancer letters.

[75]  N. Uldbjerg,et al.  Listeriosis in human pregnancy: a systematic review , 2011, Journal of perinatal medicine.

[76]  S. Ahmed,et al.  MicroRNA, a new paradigm for understanding immunoregulation, inflammation, and autoimmune diseases. , 2011, Translational research : the journal of laboratory and clinical medicine.

[77]  N. Uldbjerg,et al.  Parvovirus B19 infection in human pregnancy , 2011, BJOG : an international journal of obstetrics and gynaecology.

[78]  R. Soares,et al.  Schistosoma haematobium: identification of new estrogenic molecules with estradiol antagonistic activity and ability to inactivate estrogen receptor in mammalian cells. , 2010, Experimental parasitology.

[79]  N. Brewer,et al.  Meta-analysis of Human Papillomavirus Infection Concordance , 2010, Cancer Epidemiology, Biomarkers & Prevention.

[80]  D. Raoult,et al.  Sex-Related Differences in Gene Expression Following Coxiella burnetii Infection in Mice: Potential Role of Circadian Rhythm , 2010, PloS one.

[81]  P. Tornos,et al.  Sex differences in native-valve infective endocarditis in a single tertiary-care hospital. , 2010, The American journal of cardiology.

[82]  M. Roque-Barreira,et al.  Immunological Basis for the Gender Differences in Murine Paracoccidioides brasiliensis Infection , 2010, PloS one.

[83]  W. Callaghan,et al.  Pandemic 2009 influenza A(H1N1) virus illness among pregnant women in the United States. , 2010, JAMA.

[84]  E. Chan,et al.  Slender, older women appear to be more susceptible to nontuberculous mycobacterial lung disease. , 2010, Gender medicine.

[85]  Ding‐Shinn Chen,et al.  Identification of androgen response elements in the enhancer I of hepatitis B virus: A mechanism for sex disparity in chronic hepatitis B , 2009, Hepatology.

[86]  G. Gmel,et al.  Gender and alcohol consumption: patterns from the multinational GENACIS project. , 2009, Addiction.

[87]  J. Fellay,et al.  X chromosomal variation is associated with slow progression to AIDS in HIV-1-infected women. , 2009, American journal of human genetics.

[88]  J. Morales-Montor,et al.  Gonadectomy inhibits development of experimental amoebic liver abscess in hamsters through downregulation of the inflammatory immune response , 2009, Parasite immunology.

[89]  Mark Honigsbaum,et al.  Pandemic , 2009, The Lancet.

[90]  D. Raoult,et al.  Q Fever during Pregnancy , 2009, Annals of the New York Academy of Sciences.

[91]  A. Arnold,et al.  What does the “four core genotypes” mouse model tell us about sex differences in the brain and other tissues? , 2009, Frontiers in Neuroendocrinology.

[92]  S. Meshnick,et al.  Prevalence Distribution and Risk Factors for Schistosoma hematobium Infection among School Children in Blantyre, Malawi , 2009, PLoS neglected tropical diseases.

[93]  C. Kaushic,et al.  Intranasal and subcutaneous immunization under the effect of estradiol leads to better protection against genital HSV-2 challenge compared to progesterone. , 2008, Vaccine.

[94]  E. Fish The X-files in immunity: sex-based differences predispose immune responses , 2008, Nature Reviews Immunology.

[95]  M. J. van de Laar,et al.  Surveillance and epidemiology of hepatitis B and C in Europe - a review. , 2008, Euro surveillance : bulletin Europeen sur les maladies transmissibles = European communicable disease bulletin.

[96]  D. Raoult,et al.  Persistent Coxiella burnetii Infection in Mice Overexpressing IL-10: An Efficient Model for Chronic Q Fever Pathogenesis , 2008, PLoS pathogens.

[97]  J. Casanova,et al.  Host genetics of mycobacterial diseases in mice and men: forward genetic studies of BCG-osis and tuberculosis. , 2007, Annual review of genomics and human genetics.

[98]  M. Falagas,et al.  Sex differences in the incidence and severity of respiratory tract infections. , 2007, Respiratory medicine.

[99]  R. Straub,et al.  The complex role of estrogens in inflammation. , 2007, Endocrine reviews.

[100]  P. Correa,et al.  Carcinogenesis of Helicobacter pylori. , 2007, Gastroenterology.

[101]  T. Berg,et al.  Gender-dependent association of CTLA4 polymorphisms with resolution of hepatitis C virus infection. , 2007, Journal of hepatology.

[102]  D. Sexton,et al.  Gender differences in infective endocarditis: Pre- and co-morbid conditions lead to different management and outcomes in female patients , 2007, Scandinavian journal of infectious diseases.

[103]  S. Rasmussen,et al.  Emerging Infections and Pregnancy , 2006, Emerging infectious diseases.

[104]  G. Royo,et al.  The influence of age and gender on the population-based incidence of community-acquired pneumonia caused by different microbial pathogens. , 2006, The Journal of infection.

[105]  A. Scott,et al.  Involvement of Gonadal Steroids and Gamma Interferon in Sex Differences in Response to Blood-Stage Malaria Infection , 2006, Infection and Immunity.

[106]  Michael C. Wendl,et al.  Argonaute—a database for gene regulation by mammalian microRNAs , 2005, BMC Bioinformatics.

[107]  S. El-Kafrawy,et al.  Higher clearance of hepatitis C virus infection in females compared with males , 2005, Gut.

[108]  R. E. Watkins,et al.  Does smoking explain sex differences in the global tuberculosis epidemic? , 2005, Epidemiology and Infection.

[109]  M. Heineman,et al.  Sex hormones and the immune response in humans. , 2005, Human reproduction update.

[110]  Didier Raoult,et al.  Blood Culture-Negative Endocarditis in a Reference Center: Etiologic Diagnosis of 348 Cases , 2005, Medicine.

[111]  H. Willard,et al.  X-inactivation profile reveals extensive variability in X-linked gene expression in females , 2005, Nature.

[112]  P. Chappell Clocks and the Black Box: Circadian Influences on Gonadotropin‐Releasing Hormone Secretion , 2005, Journal of neuroendocrinology.

[113]  D. Raoult,et al.  Link between impaired maturation of phagosomes and defective Coxiella burnetii killing in patients with chronic Q fever. , 2004, The Journal of infectious diseases.

[114]  M. Boiocchi,et al.  Evidence for an association between Chlamydia psittaci and ocular adnexal lymphomas. , 2004, Journal of the National Cancer Institute.

[115]  T. Frieden,et al.  Gender disparities in tuberculosis: report from a rural DOTS programme in south India. , 2004, The international journal of tuberculosis and lung disease : the official journal of the International Union against Tuberculosis and Lung Disease.

[116]  H. Kerl,et al.  Borrelia burgdorferi‐associated lymphocytoma cutis: clinicopathologic, immunophenotypic, and molecular study of 106 cases , 2004, Journal of cutaneous pathology.

[117]  D. Raoult,et al.  Effect of sex on Coxiella burnetii infection: protective role of 17beta-estradiol. , 2004, The Journal of infectious diseases.

[118]  P. Watanapa,et al.  Liver fluke‐associated cholangiocarcinoma , 2002, The British journal of surgery.

[119]  C. Grimaldi,et al.  Estrogen alters thresholds for B cell apoptosis and activation. , 2002, The Journal of clinical investigation.

[120]  P. Gros,et al.  Complex genetic control of susceptibility to malaria in mice , 2002, Genes and Immunity.

[121]  B. Chandrasekar,et al.  Gender Is a Major Determinant of the Clinical Evolution and Immune Response in Hamsters Infected with Leishmania spp , 2002, Infection and Immunity.

[122]  J. Morales-Montor,et al.  Taenia crassiceps: androgen reconstitution of the host leads to protection during cysticercosis. , 2002, Experimental parasitology.

[123]  D. Raoult,et al.  Whipple's disease. , 2002, Joint, bone, spine : revue du rhumatisme.

[124]  O. Liesenfeld,et al.  Importance of Gender and Sex Hormones in Regulation of Susceptibility of the Small Intestine to Peroral Infection with Toxoplasma gondii Tissue Cysts , 2001, The Journal of parasitology.

[125]  M. Kaminishi,et al.  Gender differences in cytokine secretion by human peripheral blood mononuclear cells: role of estrogen in modulating LPS-induced cytokine secretion in an ex vivo septic model. , 2001, Shock.

[126]  Sandra M. Merkel,et al.  Essential Role for Estrogen in Protection againstVibrio vulnificus-Induced Endotoxic Shock , 2001, Infection and Immunity.

[127]  K. Suzuki,et al.  Effect of oestrogen on Mycobacterium avium complex pulmonary infection in mice , 2001, Clinical and experimental immunology.

[128]  D. Spiegelman,et al.  Sex‐specific mortality from adult T‐cell leukemia among carriers of human T‐lymphotropic virus type I , 2001, International journal of cancer.

[129]  P. Marx,et al.  Estrogen protects against vaginal transmission of simian immunodeficiency virus , 2001 .

[130]  P. Marx,et al.  Estrogen protects against vaginal transmission of simian immunodeficiency virus. , 2000, The Journal of infectious diseases.

[131]  Fan Zhou,et al.  Effects of Estradiol and Progesterone on Susceptibility and Early Immune Responses to Chlamydia trachomatis Infection in the Female Reproductive Tract , 2000, Infection and Immunity.

[132]  D. Wirth,et al.  Gender distribution in asymptomatic and invasive amebiasis , 2000, American Journal of Gastroenterology.

[133]  S. Shirahama,et al.  Evaluation of adult T‐cell leukemia/lymphoma incidence and its impact on non‐Hodgkin lymphoma incidence in southwestern Japan , 2000, International journal of cancer.

[134]  D. Kochar,et al.  Mortality trends in falciparum malaria--effect of gender difference and pregnancy. , 1999, The Journal of the Association of Physicians of India.

[135]  L. Castagnetta,et al.  Sex Hormones Modulate Inflammatory Mediators Produced by Macrophages a , 1999, Annals of the New York Academy of Sciences.

[136]  P. Zabel,et al.  Gender differences in human sepsis. , 1998, Archives of surgery.

[137]  R. Clark,et al.  Clinical manifestations and predictors of survival in older women infected with HIV. , 1997, Journal of acquired immune deficiency syndromes and human retrovirology : official publication of the International Retrovirology Association.

[138]  F. Wunderlich,et al.  Testosterone-induced susceptibility to Plasmodium chabaudi malaria: persistence after withdrawal of testosterone. , 1997, The Journal of endocrinology.

[139]  N. Olsen,et al.  Schistosoma mansoni: susceptibility differences between male and female mice can be mediated by testosterone during early infection. , 1997, Experimental parasitology.

[140]  J. S. Hunt,et al.  Sex steroid hormones and macrophage function. , 1996, Life sciences.

[141]  K. Klontz,et al.  The epidemiology of Vibrio infections in Florida, 1981-1993. , 1996, The Journal of infectious diseases.

[142]  D. Brownstein,et al.  Chromosome mapping of Rmp-4, a gonad-dependent gene encoding host resistance to mousepox , 1995, Journal of virology.

[143]  P. Malloy,et al.  Candida albicans estrogen-binding protein gene encodes an oxidoreductase that is inhibited by estradiol. , 1994, Proceedings of the National Academy of Sciences of the United States of America.

[144]  D. Raoult,et al.  Epidemiologic features and clinical presentation of acute Q fever in hospitalized patients: 323 French cases. , 1992, The American journal of medicine.

[145]  H. Tomioka,et al.  Sex differences in host resistance to Mycobacterium marinum infection in mice , 1991, Infection and immunity.

[146]  J. Blackwell,et al.  GENETIC ANALYSIS OF LEISHMANIA MEXICANA INFECTION IN MICE: SINGLE GENE (Scl‐2) CONTROLLED PREDISPOSITION TO CUTANEOUS LESION DEVELOPMENT , 1990, Journal of immunogenetics.

[147]  H. Bernard,et al.  Progesterone and glucocorticoid response elements occur in the long control regions of several human papillomaviruses involved in anogenital neoplasia , 1989, Journal of virology.

[148]  A. N. Tucker,et al.  Influence of estrogen on host resistance: increased susceptibility of mice to Listeria monocytogenes correlates with depressed production of interleukin 2 , 1985, Infection and immunity.

[149]  L. Svanberg Effects of Estrogen Deficiency in Women Castrated When Young , 1982, Acta obstetricia et gynecologica Scandinavica. Supplement.

[150]  D. Rifkind,et al.  Influence of Gonadectomy on Candida albicans Urinary Tract Infection in CFW Mice , 1972, Infection and immunity.

[151]  J. Neufeld,et al.  The State of Food and Agriculture , 1970 .

[152]  J. Hamilton,et al.  Mortality and survival: comparison of eunuchs with intact men and women in a mentally retarded population. , 1969, Journal of gerontology.

[153]  B. Sen The State of Food and Agriculture , 1962 .

[154]  D. Schwartz,et al.  Zika Virus Infection in Pregnancy, Microcephaly, and Maternal and Fetal Health: What We Think, What We Know, and What We Think We Know. , 2017, Archives of pathology & laboratory medicine.

[155]  Self-Concept Variables Sex Differences in , 2016 .

[156]  B. Guillot,et al.  [Syphilis in Montpellier, France, from 2002 to 2011: Survey in a free hospital screening centre for venereal disease and in the dermatology unit of a regional public hospital]. , 2015, Annales de dermatologie et de vénéréologie.

[157]  M. Abdullah,et al.  Gender effect on in vitro lymphocyte subset levels of healthy individuals. , 2012, Cellular immunology.

[158]  A. Schaeffer,et al.  Urinary tract infections in women. , 2011, The Medical clinics of North America.

[159]  M. Pirisi,et al.  Interleukin 6 promoter polymorphisms influence the outcome of chronic hepatitis C , 2010, Immunogenetics.

[160]  Hemant Agrawal,et al.  Sex Steroid Receptors in Immune Cells , 2010 .

[161]  G. Escobedo,et al.  Sex Differences in Parasitic Infections: Beyond the Dogma of Female-Biased Resistance , 2010 .

[162]  S. Akira,et al.  TLR signaling , 2006, Cell Death and Differentiation.

[163]  R. Harrington,et al.  Urinary tract infection risk factors and gender. , 2000, The journal of gender-specific medicine : JGSM : the official journal of the Partnership for Women's Health at Columbia.

[164]  S. Porter,et al.  AIDS update , 1988, British Dental Journal.