Sexual Dimorphism in Allergic and Mast Cell-Associated Diseases

Allergic diseases are common, affecting more than one-third of the global population and varying widely in severity. A consistent theme in asthma, food allergy, atopic dermatitis, and chronic urticaria is a female-dominant prevalence in adulthood. Some of these begin with male predominance in childhood and shift with puberty. A smaller subset of allergic diseases, including eosinophilic esophagitis and vernal keratoconjunctivitis, has a clear male prevalence. In fact, nearly all allergic diseases exhibit sexual dimorphism in either prevalence or severity. These striking disparities are being unraveled to reveal mechanisms that might be clinically targeted. In this review, we discuss the current state of knowledge about sexual dimorphism for these important inflammatory disorders. These insights are foundational for optimizing personalized medicine.