Sex and gender differences in lupus - intersection between immunometabolism, epigenetic remodeling and cardiac involvement

狼疮主要是女性疾病，然而患有狼疮的男性通常具有更严重的症状， 包括心血管疾病在内的器官受累，这是狼疮死亡的主要原因。环境和 性别差异，如阳光照射和维生素D水平也被证明在狼疮中发挥作用 进展和心血管疾病。代谢活动的差异也被认为是导致 性二型免疫反应和自身免疫。我们最近的数据显示，女性狼疮合并心脏 代谢组学成像显示心脏受累和代谢 狼疮单核细胞的重编程。这项建议调查的假设，性别偏见在代谢 单核细胞的活性驱动单核细胞的表观遗传重编程，从而驱动功能差异。其次 将解决如何性二型反应维生素D有助于单核细胞重编程。作为 单核细胞的表观遗传变化与心血管疾病（CVD）有关， 在男性和女性狼疮中，这项建议将解决代谢和遗传方面的性别特异性变化是否 重编程驱动狼疮单核细胞的表型差异，并询问这与CMD患病率的关系 以及使用最先进的心脏成像技术的CVD。 目的1：确定男性和女性狼疮患者单核细胞的代谢途径是否不同。 我们将讨论如何在免疫反应和免疫代谢的单核细胞整合性二型性 使用代谢、蛋白质组学和流式细胞术方法来影响男性和女性患者之间的结果。 目的2：确定遗传重编程如何驱动狼疮性二型单核细胞功能。 单细胞下一代测序将用于确定单核细胞亚群中的染色质可及性 并询问这如何影响男性和女性狼疮的基因表达程序和功能差异。 目的3：使用非侵入性心脏成像技术评估男性狼疮患者CVD的相对风险。 心脏成像将确定男性和女性狼疮患者CVD的患病率，并与代谢相关。 改变或基因表达模式，以确定决定风险的性二态反应。 影响：确定代谢重编程和表观遗传重塑是否在狼疮中具有性二态性 单核细胞将可能影响治疗方法，因为我们进入了一个时代， 免疫代谢在狼疮中试验。

Lupus is predominantly a female disease, however men with lupus frequently have more severe symptoms and organ involvement including cardiovascular disease, a leading cause of death in lupus. Environmental and gender differences such as sunlight exposure and vitamin D levels have also been shown to play a role in lupus progression and cardiovascular disease. Differences in metabolic activity have also been suggested to contribute to sexually dimorphic immune responses and autoimmunity. Our recent data in female lupus combining cardiac imaging with metabolomic profiling has shown potential links between cardiac involvement and metabolic reprogramming of lupus monocytes. This proposal investigates the hypothesis that sex biases in metabolic activity of monocytes drives epigenetic reprogramming of monocytes, driving functional differences. Secondly, it will address how sexually dimorphic responses to vitamin D contribute to monocytic reprogramming. As epigenetic changes in monocytes is linked with cardiovascular disease (CVD), and given the prevalence of CVD in both male and female lupus, this proposal will address whether sex-specific changes in metabolic and genetic reprogramming drive phenotypic differences in lupus monocytes and ask how this relates to prevalence of CMD and CVD using state of the art cardiac imaging. Aim 1: Determine whether metabolic pathways differ in monocytes from male and female lupus patients. We will address how sexual dimorphism in immune responses and immunometabolism in monocytes integrate to affect outcome between male and female patients using metabolic, proteomic and flow cytometry approaches. Aim 2: Determine how genetic reprogramming drives sexually dimorphic monocytic function in lupus. Single cell next generation sequencing will be used to determine chromatin accessibility in monocyte subsets and ask how this influences gene expression programs and functional differences in male and female lupus. Aim 3: Assess relative risk of CVD in male lupus using non-invasive cardiac imaging techniques. Cardiac imaging will determine prevalence of CVD in male and female lupus and correlated with metabolic changes or gene expression patterns to determine sexually dimorphic responses that determine risk. Impact: Determining whether metabolic reprograming and epigenetic remodeling are sexually dimorphic in lupus monocytes will potentially impact treatment approaches as we enter an era where drugs targeting immunometabolism as being trialed in lupus.