几种免疫药理学药物可有效治疗癌症和免疫介导的疾病，对大量患者的预期寿命和临床结果产生有利影响。然而，这些药物的反应变化和不良反应是主要问题，并且总体疗效仍然不可预测。男性和女性的免疫系统反应存在明显差异，女性通常对各种刺激有更强的反应。因此，探索免疫药物疗效和安全性的性别差异将加强精准医学的实践。作为药理学靶标亮点，程序性细胞死亡 1 配体 1 (PD-L1) 是共抑制性程序性死亡受体 1 (PD-1) 的第一个功能特征配体。 PD-L1/PD-1 串扰在免疫反应中发挥着重要作用，并且与癌症、传染病和自身免疫性疾病相关。对免疫检查点抑制剂反应的性别差异已有充分记录，男性患者的反应优于女性患者。同样，据报道，在男性患者中，肿瘤坏死因子抑制剂对包括类风湿性关节炎和克罗恩病在内的慢性炎症疾病具有更高的疗效和依从性。在中风和 1 型糖尿病等其他情况下，人们正在积极研究免疫系统调节药物的性别特异性反应的药理学基础。针对内皮细胞的治疗方法的进步很快就会被用于对抗自身免疫和代谢紊乱。基于免疫相关病理生理学和疾病表现中已确定的性别二态性，性别特异性免疫药理学方案应纳入临床指南。版权所有 © 2023 作者。由爱思唯尔有限公司出版。保留所有权利。

Several immunopharmacological agents are effective in the treatment of cancer and immune-mediated conditions, with a favorable impact on life expectancy and clinical outcomes for a large number of patients. Nevertheless, response variation and undesirable effects of these drugs represent major issues, and overall efficacy remains unpredictable. Males and females show a distinct difference in immune system responses, with females generally mounting stronger responses to a variety of stimuli. Therefore, exploring sex differences in the efficacy and safety of immunopharmacological agents would strengthen the practice of precision medicine. As a pharmacological target highlight, programmed cell death 1 ligand 1 (PD-L1) is the first functionally characterized ligand of the coinhibitory programmed death receptor 1 (PD-1). The PD-L1/PD-1 crosstalk plays an important role in the immune response and is relevant in cancer, infectious and autoimmune disease. Sex differences in the response to immune checkpoint inhibitors are well documented, with male patients responding better than female patients. Similarly, higher efficacy of and adherence to tumor necrosis factor inhibitors in chronic inflammatory conditions including rheumatoid arthritis and Crohn's disease have been reported in male patients. The pharmacological basis of sex-specific responses to immune system modulating drugs is actively investigated in other settings such as stroke and type 1 diabetes. Advances in therapeutics targeting the endothelium could soon be wielded against autoimmunity and metabolic disorders. Based on the established sexual dimorphism in immune-related pathophysiology and disease presentation, sex-specific immunopharmacological protocols should be integrated into clinical guidelines.Copyright © 2023 The Authors. Published by Elsevier Ltd.. All rights reserved.