Urinary tract infections (UTIs) are generally considered a disease of women. However, UTIs affect females throughout the lifespan, and certain male populations (including infants and elderly men) are also susceptible. Epidemiologically, pyelonephritis is more common in women but carries increased morbidity when it does occur in men. Among children, high-grade vesicoureteral reflux is a primary risk factor for upper-tract UTI in both sexes. However, among young infants with UTI, girls are outnumbered by boys; risk factors include posterior urethral valves and lack of circumcision. Recent advances in mouse models of UTI reveal sex differences in innate responses to UTI, which vary somewhat depending on the system used. Moreover, male mice and androgenized female mice suffer worse outcomes in experimental pyelonephritis; evidence suggests that androgen exposure may suppress innate control of infection in the urinary tract, but additional androgen effects, as well as non-hormonal sex effects, may yet be specified. Among other intriguing directions, recent experiments raise the hypothesis that the postnatal testosterone surge that occurs in male infants may represent an additional factor driving the higher incidence of UTI in males under 6 months of age. Ongoing work in contemporary models will further illuminate sex- and sex-hormone-specific effects on UTI pathogenesis and immune responses.

中文翻译：

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肾盂肾炎的性影响。


尿路感染（UTI）通常被认为是女性疾病。然而，尿路感染会影响女性的整个生命周期，而某些男性人群（包括婴儿和老年男性）也很容易受到影响。从流行病学角度来看，肾盂肾炎在女性中更为常见，但在男性中发生时发病率也会增加。在儿童中，高级别膀胱输尿管反流是男女上尿路感染的主要危险因素。然而，在患有尿路感染的婴儿中，女孩的数量多于男孩；危险因素包括后尿道瓣膜和缺乏包皮环切术。尿路感染小鼠模型的最新进展揭示了对尿路感染先天反应的性别差异，这种差异根据所使用的系统而有所不同。此外，雄性小鼠和雄激素化雌性小鼠在实验性肾盂肾炎中的结局更差。有证据表明，雄激素暴露可能会抑制泌尿道感染的先天控制，但额外的雄激素影响以及非激素性影响可能尚不清楚。除其他有趣的方向外，最近的实验提出了这样的假设：男性婴儿出生后睾酮激素激增可能是导致 6 个月以下男性尿路感染发病率较高的另一个因素。当代模型中正在进行的工作将进一步阐明性和性激素对尿路感染发病机制和免疫反应的特异性影响。