Sex differences in the immune response to acute COVID-19 respiratory tract infection.
Sex differences in the immune response to acute COVID-19 respiratory tract infection.
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DOI：
10.1186/s13293-021-00410-2
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发表时间：
2021-12-20
影响因子：
7.9
通讯作者：
Liu F
中科院分区：
文献类型：
--
作者：
Qi S;Ngwa C;Morales Scheihing DA;Al Mamun A;Ahnstedt HW;Finger CE;Colpo GD;Sharmeen R;Kim Y;Choi HA;McCullough LD;Liu F
全球范围内越来越多地认识到 COVID-19 中的性别差异。尽管男女之间的感染率相似，但男性的病情更为严重。这些性别差异背后的机制尚不清楚，但最近的几项研究表明，对 COVID-19 的免疫反应存在差异。然而，性别差异如何影响对 COVID-19 的免疫反应仍有待研究。我们收集了2020年5月24日至2021年4月28日期间诊断为COVID-19的600多名住院患者的人口统计数据和血液样本。这些患者被分为两个队列：队列1根据疾病的严重程度进一步分为三组（轻度、中度和重度）；队列1根据疾病的严重程度进一步分为三组；队列1根据疾病的严重程度进一步分为三组。对队列 2 患者在入院后的三个时间点（1 天、7 天和 14 天）进行纵向随访。 MultiPlex 和常规 ELISA 用于检查两个队列中血浆中炎症介质的水平。采用流式细胞术检查队列 2 中的白细胞反应。整个队列中的 COVID+ 男性较多，且男性死亡率高于女性。在大多数年龄组（以 10 年为增量）和大多数种族中，男性患者较多。患有严重疾病的男性促炎细胞因子（IL-6、IL-8、MCP-1）水平显着高于女性；与轻度或对照患者相比，男性重症患者的 IL-8、GRO、sCD40L、MIP-1β、MCP-1 水平也显着升高，但女性则不然。与男性相比，女性在14天时的抗炎细胞因子IL-10水平显着高于男性，并且与对照组相比，女性中度IL-10水平显着升高，而男性则没有。在第7天和第14天时，雄性的循环中性粒细胞和单核细胞明显多于雌性；然而，女性的 B 细胞数量明显高于男性。急性 COVID-19 呼吸道感染住院患者存在性别差异。即使疾病严重程度相匹配，男性患者与女性患者的炎症反应也会加剧。男性似乎对 COVID-19 呼吸道感染有更强的先天免疫反应，而女性则有更强的适应性免疫反应。在线版本包含可在 10.1186/s13293-021-00410-2 获取的补充材料。
Sex differences in COVID-19 are increasingly recognized globally. Although infection rates are similar between the sexes, men have more severe illness. The mechanism underlying these sex differences is unknown, but a differential immune response to COVID-19 has been implicated in several recent studies. However, how sex differences shape the immune response to COVID-19 remains understudied. We collected demographics and blood samples from over 600 hospitalized patients diagnosed with COVID-19 from May 24th 2020 to April 28th, 2021. These patients were divided into two cohorts: Cohort 1 was further classified into three groups based on the severity of the disease (mild, moderate and severe); Cohort 2 patients were longitudinally followed at three time points from hospital admission (1 day, 7 days, and 14 days). MultiPlex and conventional ELISA were used to examine inflammatory mediator levels in the plasma in both cohorts. Flow cytometry was conducted to examine leukocyte responses in Cohort 2. There were more COVID+ males in the total cohort, and the mortality rate was higher in males vs. females. More male patients were seen in most age groups (in 10-year increments), and in most ethnic groups. Males with severe disease had significantly higher levels of pro-inflammatory cytokines (IL-6, IL-8, MCP-1) than females; levels of IL-8, GRO, sCD40L, MIP-1β, MCP-1 were also significantly higher in severe vs. mild or control patients in males but not in females. Females had significantly higher anti-inflammatory cytokine IL-10 levels at 14 days compared to males, and the level of IL-10 significantly increased in moderate vs. the control group in females but not in males. At 7 days and 14 days, males had significantly more circulating neutrophils and monocytes than females; however, B cell numbers were significantly higher in females vs. males. Sex differences exist in hospitalized patients with acute COVID-19 respiratory tract infection. Exacerbated inflammatory responses were seen in male vs. female patients, even when matched for disease severity. Males appear to have a more robust innate immune response, and females mount a stronger adaptive immune response to COVID-19 respiratory tract infection. The online version contains supplementary material available at 10.1186/s13293-021-00410-2.
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