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Intro
Contents
Genetics of Sex Differences in Immunity
1 Evolutionary Perspective
2 Sex Chromosomes
2.1 X Chromosome Inactivation
2.2 Immune-Related Genes on the Sex Chromosomes
2.3 Sex Chromosome Abnormalities and the Immune System
3 Experimental Models for Studying the Sex Effect on Immunity
3.1 Four Core Genotypes Mouse Model
3.2 Human Cell Lines with Sex Chromosome Aberrations
3.3 Additional Mouse Models
4 Female-Specific States and Their Immune Consequences
4.1 Pregnancy as a Graft
4.2 Microchimerism in Fetal Cells
5 Concluding Remarks

4 Sex Differences in Allergic Asthma: A Prominent Role of Sex Steroid Hormone Signaling
4.1 Sex Bias in Asthma Prevalence and Severity
4.2 Impact of Sex Hormones in Type 2 Mediated Allergic Airway Inflammation
5 Biological Sex Influences Natural Immunity to Neonatal Pathogens and Cancer
5.1 Sex-Biased Dimorphism in Bloodstream Infections: The Role of Estrogens/Peritoneal Macrophages/B-1 Cells Axis
5.2 Sex Dimorphism in Solid Tumor Control: From Innate to Acquired Immunity
References
Sex Differences in HIV Infection
1 Introduction
2 Sex Differences in HIV Acquisition

3 Sex Differences in HIV Pathogenesis
4 Immune Mechanisms Underlying Sex Differences
5 Sex Differences in ART-Treated Disease
6 Summary
References
Effects of Biological Sex and Pregnancy on SARS-CoV-2 Pathogenesis and Vaccine Outcomes
1 Sex Differences in Viral Pathogenesis
2 Sex Differences in SARS-CoV-2 Pathogenesis
2.1 SARS-CoV-2 Entry, Replication, and Transmission
2.2 Development of Innate and Adaptive Immune Responses
2.3 Sex Differences in Post-Acute Sequelae SARS-CoV-2 Infection (PASC)
2.4 Comorbidities, Sex Difference, and COVID-19

2.5 Role of Sex Steroids
2.6 Role of Genetic Variations
3 Pregnancy and SARS-CoV-2 Pathogenesis
4 Sex Differences in COVID-19 Vaccine Outcomes
4.1 Immunogenicity
4.2 Effectiveness
4.3 Vaccine Reactogenicity
5 Pregnancy and COVID-19 Vaccines
6 Conclusions and Future Directions
References
Biological Sex and Pregnancy Affect Influenza Pathogenesis and Vaccination
1 Introduction
2 Sex Differences in Influenza Pathogenesis
2.1 Seasonal Influenza Epidemics
2.2 Outbreaks of Avian Influenza
2.3 Influenza A Virus Pandemics

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