Sex different responses and immunomodulation in severe sepsis

Different responses among the sexes have been reported following trauma and sepsis and have been reported in various articles, revealing that female patients had a better outcome than male patients. In addition, several animal and clinical studies have also demonstrated differences among the sexes in susceptibility to septic challenge. Sex steroids may contribute to the above differences regarding sexual dimorphism, and androgens have been found to have an immunosuppressive effect. Sexual dimorphism may be influenced by the effects of sex hormones and a different ratio of proinflammatory and anti-inflammatory cytokines in women than men. Enhanced immune response with an immune-enhancing diet for male rats was demonstrated to reduce their mortality in sepsis, which was less important for female rats unless their ovaries were removed. Immunonutrition was more beneficial for males than for females following sepsis, especially when combined with liver cirrhosis.