Sex and gender in interstitial lung disease: a 10-year overview

Giacomo Giulianelli, Ylenia Padrin, Paolo Spagnolo
J Sex Gender Specif Med 2025, 11(2): online ahead of print

Abstract. In this narrative review, we discuss the role of sex and gender in interstitial lung disease (ILD), a topic that remains poorly studied. The terms sex and gender are not interchangeable, even if they are often used as synonyms in literature. The term ‘sex’ refers to the biological characteristics, while ‘gender’ includes the entire social, environmental and behavioral aspects of identity. The aim of this study, through a review of the literature of the last 10 years, is to clarify the impact of gender and sex on disease epidemiology and how these two factors can be involved in the presentation, development and progression of the main ILD. In turn, better understanding of disease pathobiology will ease the identification of therapeutic targets and the development of novel treatments. From the research, it emerged that the literature is consistent regarding certain data (e.g., the higher prevalence of lymphangioleiomyomatosis - LAM - in females), while contradictory in others (e.g., the correlation between gender and mortality in rheumatoid arthritis-interstitial lung disease - RA-ILD). Additionally, interesting data have emerged, such as the correlation between sex and certain radiological features and how an exposure-related disease like silicosis, historically confined to males, has been shown to be relatively frequent in females as well.
Key words. Lung diseases, interstitial, gender identity, sex, male, female.