Impact of Sex and Gender on Autoimmune Lung Disease: Opportunities for Future Research: NHLBI Working Group Report.

Pulmonary complications are a leading cause of morbidity and mortality in patients with autoimmune disease. Substantial evidence suggests that biological sex (i.e., regulated by genes, hormonal profiles) and gender (i.e., a social construct based on environmental, cultural and behavioral factors and choices that affect a person's self-identity) uniquely affect fundamental molecular and cellular processes related to autoimmune lung disease pathogenesis. In addition, both sex and gender can influence disease susceptibility, clinical manifestations and response to therapy in patients with autoimmune lung disease. However, female mammals are usually excluded from basic science research, and clinical studies in this area often fail to explore the impact of sex/gender on outcomes. Recognizing the inherent value in the study of sex and gender differences in autoimmune lung diseases, the National Heart, Lung, and Blood Institute (NHLBI) partnered with the National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS) and the Office of Research on Women's Health (ORWH) to organize a two-day virtual sex- and gender-related autoimmune lung diseases (SG-RAILD) workshop in June 2021. The goals of the workshop were to discuss the influences of sex and gender on autoimmune lung diseases with a focus on novel experimental methods. Specifically, Workshop participants from diverse areas suggested innovative strategies for enhancing scientific rigor and facilitating new discovery in this area. The present Workshop report summarizes opportunities for future sex- and gender-informed preclinical and clinical research. The report also provides suggestions for training future scientists to carry this research forward.