Understanding the biological differences in susceptibility to chronic obstructive pulmonary disease between men and women

Proc Am Thorac Soc. 2007 Dec;4(8):671-4. doi: 10.1513/pats.200706-082SD.


There is a worldwide epidemic of chronic obstructive pulmonary disease (COPD) in women. Some large epidemiologic studies suggest that female smokers may have increased susceptibility to COPD. The biological mechanisms to explain these observations are far from certain. However, the susceptibility to the effects of cigarette smoke in women could be due to a greater deposition of toxic substances in the lung, impaired clearance of the toxins that are deposited, and/or an exaggerated biologic response to these toxins. The latter effect could be due to an increased ability to convert certain xenobiotics to more toxic metabolites or to a decreased ability to conjugate and excrete metabolites of these toxins. Female hormones, in particular estrogen, can up-regulate certain cytochrome P450 enzymes without altering detoxifying enzymes, leading to a disturbance in the balance between metabolism and conjugation. This article reviews this and other potential mechanisms that may confer increased susceptibility of COPD to female smokers.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Animals
  • Bronchial Hyperreactivity / epidemiology
  • Bronchial Hyperreactivity / physiopathology
  • DNA Damage / physiology
  • Disease Susceptibility*
  • Female
  • Humans
  • Male
  • Oxidative Stress / physiology
  • Phenotype
  • Pulmonary Disease, Chronic Obstructive / epidemiology
  • Pulmonary Disease, Chronic Obstructive / physiopathology*
  • Sex Factors
  • Smoking / adverse effects