Sexual dimorphism in the immune response in cardiovascular disease

Cardiovascular disease (CVD) is a collective term for inflammatory pathologies including coronary artery disease and heart failure. Although sex-based differences in prevalence, progression and manifestation of CVD are well-established—mainly linked to hormonal status and Y-chromosome mosaicism—the exact role of the immune system in sexual dimorphism in CVD remains elusive. Immune responses differ in males and females and are primarily dictated by sex steroids and X-linked gene expression. Given the critical role of the immune system in CVD pathogenesis, we address the question, to what extent do these sexually dimorphic immune responses underpin the sex differences observed in CVD.