{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,26]],"date-time":"2026-09-26T17:47:00Z","timestamp":1790444820685,"version":"4.1.0"},"reference-count":206,"publisher":"MDPI AG","issue":"8","license":[{"start":{"date-parts":[[2025,4,18]],"date-time":"2025-04-18T00:00:00Z","timestamp":1744934400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJMS"],"abstract":"<jats:p>Sexual dimorphism significantly impacts the lacrimal gland\u2019s structure, function, and ageing processes, playing an important role in dry eye disease (DED) pathophysiology. This multifactorial disorder, characterised by tear film instability, inflammation, and visual impairment, disproportionately affects women, especially after menopause. It highlights the interplay between sex steroid hormones, lacrimal gland function, and environmental factors. Systemic and local androgens are vital for maintaining lacrimal gland health and tear production, while the role of oestrogens remains less clear. Evidence suggests dose and context-dependent effects on inflammation and glandular function. Histopathological and molecular studies reveal significant sex differences in the lacrimal gland, with women exhibiting more pronounced age-related degenerative changes, including fibrosis and acinar atrophy, contributing to their increased susceptibility to DED. Despite these findings, the underlying mechanisms connecting sex steroid hormones, receptor expression, and local tissue regulation to these disparities remain poorly understood, highlighting the need for further research. This review synthesises the current knowledge of sex-specific differences in the lacrimal gland, emphasising the importance of integrating systemic and local biomarkers, histological data, and molecular insights into personalised therapeutic strategies. By tailoring treatments to patients\u2019 unique hormonal and molecular profiles, personalised medicine has the potential to transform DED management, addressing unmet clinical needs and improving outcomes.<\/jats:p>","DOI":"10.3390\/ijms26083833","type":"journal-article","created":{"date-parts":[[2025,4,18]],"date-time":"2025-04-18T05:11:16Z","timestamp":1744953076000},"page":"3833","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":16,"title":["Sex Differences in the Lacrimal Gland: Implications for Dry Eye Disease"],"prefix":"10.3390","volume":"26","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3983-1157","authenticated-orcid":false,"given":"Snje\u017eana","family":"Ka\u0161telan","sequence":"first","affiliation":[{"name":"Department of Ophthalmology, Clinical Hospital Dubrava, School of Medicine, University of Zagreb, 10000 Zagreb, Croatia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7058-4123","authenticated-orcid":false,"given":"Koraljka","family":"Hat","sequence":"additional","affiliation":[{"name":"Department of Maxillofacial Surgery, Clinical Hospital Dubrava, University of Zagreb School of Dental Medicine, 10000 Zagreb, Croatia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zora","family":"Tomi\u0107","sequence":"additional","affiliation":[{"name":"Health Centre of the Croatian Department of Internal Affairs, 10000 Zagreb, Croatia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tomislav","family":"Mateji\u0107","sequence":"additional","affiliation":[{"name":"Surgery Clinic, Clinical Hospital Sveti Duh, 10000 Zagreb, Croatia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nikola","family":"Gotovac","sequence":"additional","affiliation":[{"name":"Department of Clinical Radiology, General Hospital Po\u017eega, Faculty of Dental Medicine and Health, J. J. Strossmayer University of Osijek, 31000 Osijek, Croatia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,4,18]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"291","DOI":"10.1002\/jnr.23884","article-title":"A General Theory of Sexual Differentiation","volume":"95","author":"Arnold","year":"2017","journal-title":"J. Neurosci. Res."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"114038","DOI":"10.1016\/j.physbeh.2022.114038","article-title":"Sex Differences Matter: Males and Females Are Equal but Not the Same","volume":"259","year":"2023","journal-title":"Physiol. Behav."},{"key":"ref_3","doi-asserted-by":"crossref","unstructured":"Ka\u0161telan, S., Tomi\u0107, M., Salopek-Rabati\u0107, J., and Novak, B. (2013). Diagnostic Procedures and Management of Dry Eye. BioMed Res. 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