Role of sex and aging in mucosal health

The current population in the United States is aging and predicted to top 64 million over the next 10 years. Additionally, chronic disease management is a very important component of care in the elderly as many acute diseases can now be medically managed and chronicity can be induced. Older women outnumber older men at 25.9 million older women to 20.4 million older men. This is a staggering number. The other component that includes sex and aging is relatively new. Mucosal surfaces have the largest combined surface area in the body, contain the majority of the “gatekeeper” CD4+ T cells, and are the site of important host-microbe interactions, especially in the gut. The mucosa is influenced greatly by sex hormones and is being susceptible to injury. This susceptibility increases with age. Healing following injury is also age- and sex related. Thus, it is important to understand the interplay between aging, injury at the mucosal surface, and sex differences in healing as these processes are altered by the presence, absence, and levels of sex hormones such as estradiol and testosterone. This chapter highlights some of the most important aspects of this complex interaction.