Table 5.

Summary of key concepts

Women	Men
Increased PAH (2–4:1 women to men)	PAH lower in men
PAH peaks pre-menopause when estrogen highest	Increased HIV-associated PAH in men with myocarditis, which is also higher in men
Estrogen increases DCs, T cells, Th2 response, Treg, TGFβ:Th2, and TGFβ promote fibrosis	Testosterone increases mast cell and macrophage inflammation
Estrogen increases B cells, autoantibodies, and ICs	Testosterone increases TLR4 signaling, which promotes inflammation and fibrosis
Estrogen decreases BMPR2 expression on immune cells resulting in increased TGFβ and lung fibrosis	Testosterone increases profibrotic IL-1β
Increased CTD-associated PAH (9:1 women to men), especially SSc-associated PAH	More men have dcSSc form of SSc (organ involvement)
Estrogen increases SSc/lcSSc (skin involvement): pre-menopause SSc 15:1 women to men	SSc in men associated with decreased survival
SSc in women associated with increased survival	SSc in men associated with increased lung fibrosis
Estrogen decreases lung fibrosis in women with SSc
Estrogen increases Raynaud’s syndrome