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REVIEW article

Front. Immunol.
Sec. Autoimmune and Autoinflammatory Disorders : Autoimmune Disorders
Volume 15 - 2024 | doi: 10.3389/fimmu.2024.1501364
This article is part of the Research Topic Gender Affirming Hormone Therapy and its Immunological Implications View all articles

Immune Dynamics Throughout Life in Relation to Sex Hormones and Perspectives Gained from Gender-Affirming Hormone Therapy

Provisionally accepted
Ahmet Yalcinkaya Ahmet Yalcinkaya 1,2*Rumeysa Yalcinkaya Rumeysa Yalcinkaya 3Nils Landegren Nils Landegren 1,4
  • 1 Department of Medical Biochemistry and Microbiology, Faculty of Medicine and Pharmacy, Uppsala University, Uppsala, Uppsala, Sweden
  • 2 Department of Medical Biochemistry, Faculty of Medicine, Hacettepe University, Ankara, Ankara, Türkiye
  • 3 Ankara Etlik City Hospital, Ankara, Ankara, Türkiye
  • 4 Center for Molecular Medicine, Karolinska University Hospital, Stockholm, Stockholm, Sweden

The final, formatted version of the article will be published soon.

    Biological sex is closely associated with the properties and extent of the immune response, with males and females showing different susceptibilities to diseases and variations in immunity. Androgens, predominantly in males, generally suppress immune responses, while estrogens, more abundant in females, tend to enhance immunity. It is also established that sex hormones at least partially explain sex biases in different diseases, particularly autoimmune diseases in females. These differences are influenced by hormonal, genetic, and environmental factors, and vary throughout life stages.The advent of gender-affirming hormone therapy offers a novel opportunity to study the immunological effects of sex hormones. Despite the limited studies on this topic, available research has revealed that testosterone therapy in transgender men may suppress certain immune functions, such as type I interferon responses, while increasing inflammation markers like TNF-α. Transgender women on estrogen therapy show changes in coagulation and inflammatory profiles, highlighting the systemic effects of sex hormones on immune functioning. Furthermore, other possible alterations in immune regulation are evident from the reported impacts on inflammatory and autoimmune markers in transgender individuals receiving hormone therapy.Understanding the complex interactions between sex hormones and the immune system, particularly through the unique perspective offered by gender-affirming hormone therapies, may facilitate the development of targeted therapies for infections and autoimmune diseases while also improving healthcare outcomes for transgender individuals. Here we summarize known alterations in immune characteristics between the sexes and provide a review of novel findings drawn from studies exploring gender-affirming hormone therapy.

    Keywords: Immune System, sex difference, Gender-Affirming hormone therapy, Androgens, Estrogens, Autoimmune Diseases, infectious diseases

    Received: 24 Sep 2024; Accepted: 23 Dec 2024.

    Copyright: © 2024 Yalcinkaya, Yalcinkaya and Landegren. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence: Ahmet Yalcinkaya, Department of Medical Biochemistry and Microbiology, Faculty of Medicine and Pharmacy, Uppsala University, Uppsala, 75123, Uppsala, Sweden

    Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.