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Dabitao D, Bishai WR. Sex and Gender Differences in Tuberculosis Pathogenesis and Treatment Outcomes. Curr Top Microbiol Immunol 2023; 441:139-183. [PMID: 37695428 DOI: 10.1007/978-3-031-35139-6_6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/12/2023]
Abstract
Tuberculosis remains a daunting public health concern in many countries of the world. A consistent observation in the global epidemiology of tuberculosis is an excess of cases of active pulmonary tuberculosis among males compared with females. Data from both humans and animals also suggest that males are more susceptible than females to develop active pulmonary disease. Similarly, male sex has been associated with poor treatment outcomes. Despite this growing body of evidence, little is known about the mechanisms driving sex bias in tuberculosis disease. Two dominant hypotheses have been proposed to explain the predominance of active pulmonary tuberculosis among males. The first is based on the contribution of biological factors, such as sex hormones and genetic factors, on host immunity during tuberculosis. The second is focused on non-biological factors such as smoking, professional exposure, and health-seeking behaviors, known to be influenced by gender. In this chapter, we review the literature regarding these two prevailing hypotheses by presenting human but also experimental animal studies. In addition, we presented studies aiming at examining the impact of sex and gender on other clinical forms of tuberculosis such as latent tuberculosis infection and extrapulmonary tuberculosis, which both appear to have their own specificities in relation to sex. We also highlighted potential intersections between sex and gender in the context of tuberculosis and shared future directions that could guide in elucidating mechanisms of sex-based differences in tuberculosis pathogenesis and treatment outcomes.
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Affiliation(s)
- Djeneba Dabitao
- Faculty of Pharmacy and Faculty of Medicine and Odonto-Stomatology, University Clinical Research Center (UCRC), University of Sciences, Techniques, and Technologies of Bamako (USTTB), Bamako, Mali
| | - William R Bishai
- Division of Infectious Diseases, Department of Medicine, Johns Hopkins School of Medicine, Baltimore, MD, 21287, USA.
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2
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Kurapaty SS, Hsu WK. Sex-Based Difference in Bone Healing: A Review of Recent Pre-clinical Literature. Curr Rev Musculoskelet Med 2022; 15:651-658. [PMID: 36378466 PMCID: PMC9789279 DOI: 10.1007/s12178-022-09803-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/12/2022] [Indexed: 11/16/2022]
Abstract
PURPOSE OF REVIEW Recent literature has sought to understand differences in fusion failure, specifically considering how patient sex may play a role. Overall, there exists inconclusive data regarding any sex-based differences in bone healing. RECENT FINDINGS In vitro studies examining the roles of sex hormones, 5-LO, IGF-1, VEGF, osteoclasts, and OPCs seem to show sexually dimorphic actions. Additionally, donor characteristics and stem cell environment seem to also determine osteogenic potential. Building on this biomolecular basis, in vivo work investigates the aforementioned elements. Broadly, males tend to have a more robust healing compared to females. Taking these findings together, differences in sex hormones levels, their timing and action, and composition of the inflammatory milieu underlie variations in bone healing by sex. Clinically, a robust understanding of bone healing mechanics can inform care of the transgender patient. Transgender patients undergoing hormone therapy present a clinically nuanced scenario for which limited long-term data exist. Such advances would help inform treatment for sports-related injury due to hormonal changes in biomechanics and treatment of transgender youth. While recent advances provide more clarity, conclusive answers remain elusive.
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Affiliation(s)
- Steven S. Kurapaty
- Department of Orthopaedic Surgery, Feinberg School of Medicine, Northwestern University, 676 North St. Clair Street, Suite 1350, Chicago, IL 6061 USA ,Simpson Querrey Institute, Center for Regenerative Nanomedicine, Northwestern University, Chicago, IL USA
| | - Wellington K. Hsu
- Department of Orthopaedic Surgery, Feinberg School of Medicine, Northwestern University, 676 North St. Clair Street, Suite 1350, Chicago, IL 6061 USA ,Simpson Querrey Institute, Center for Regenerative Nanomedicine, Northwestern University, Chicago, IL USA
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3
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Braga Tibaes JR, Azarcoya-Barrera J, Wollin B, Veida-Silva H, Makarowski A, Vine D, Tsai S, Jacobs R, Richard C. Sex Differences Distinctly Impact High-Fat Diet-Induced Immune Dysfunction in Wistar Rats. J Nutr 2022; 152:1347-1357. [PMID: 35102397 DOI: 10.1093/jn/nxac024] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2021] [Revised: 12/30/2022] [Accepted: 01/27/2022] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Immune function is altered during obesity. Moreover, males and females across different species demonstrate distinct susceptibility to several diseases. However, less is known regarding the interplay between high-fat diet (HFD) and sex in the context of immune function. OBJECTIVES The objective was to determine sex differences on immune function in response to an HFD compared with a control low-fat diet (LFD) in Wistar rats. METHODS At 5 wk of age, male and female Wistar rats were randomly assigned to 1 of 2 diets for 9 wk: ad libitum control LFD (20 kcal% fat, 53 kcal% carbohydrate, and 27 kcal% protein) or HFD (50 kcal% fat, 23 kcal% carbohydrate, and 27 kcal% protein). At 13 wk of age, rats were killed and splenocytes were isolated. Immune cell subsets were determined by flow cytometry. Immune cell function was determined by measuring the ex vivo cytokine production following stimulation with mitogens. Two-factor ANOVA was used to assess the main effect of sex, diet, and their interaction. RESULTS Males gained more weight than females (410 ± 46 vs. 219 ± 45 g), independently of diet (P-sex < 0.01). The HFD led to a lower production of IL-2 while increasing the production of IL-10 (both P-diet ≤ 0.05), independently of sex. HFD-fed females had increased production of cytokines (IL-2 and IL-6) after stimulation with phorbol 12-myristate 13-acetate plus ionomycin (PMA+I), as well as a higher T-helper (Th) 1:Th2 balance compared with HFD-fed males (all P < 0.05). Males fed the HFD had significantly lower production of IL-2 upon stimulation compared with all other groups. CONCLUSIONS Female Wistar rats developed a milder obesity phenotype and maintained enhanced cytokine production compared with males fed the HFD. Sex differences modulate immune function in the context of high-fat feeding and it should be considered in research design to establish personalized health-related recommendations.
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Affiliation(s)
| | - Jessy Azarcoya-Barrera
- Department of Agricultural, Food, and Nutritional Science, University of Alberta, Edmonton, Alberta, Canada
| | - Bethany Wollin
- Department of Agricultural, Food, and Nutritional Science, University of Alberta, Edmonton, Alberta, Canada
| | - Hellen Veida-Silva
- Department of Agricultural, Food, and Nutritional Science, University of Alberta, Edmonton, Alberta, Canada
| | - Alexander Makarowski
- Department of Agricultural, Food, and Nutritional Science, University of Alberta, Edmonton, Alberta, Canada
| | - Donna Vine
- Department of Agricultural, Food, and Nutritional Science, University of Alberta, Edmonton, Alberta, Canada.,Metabolic and Cardiovascular Diseases Laboratory, University of Alberta, Edmonton, Alberta, Canada
| | - Sue Tsai
- Department of Medical Microbiology and Immunology, University of Alberta, Edmonton, Alberta, Canada
| | - René Jacobs
- Department of Agricultural, Food, and Nutritional Science, University of Alberta, Edmonton, Alberta, Canada.,Metabolic and Cardiovascular Diseases Laboratory, University of Alberta, Edmonton, Alberta, Canada
| | - Caroline Richard
- Department of Agricultural, Food, and Nutritional Science, University of Alberta, Edmonton, Alberta, Canada.,Metabolic and Cardiovascular Diseases Laboratory, University of Alberta, Edmonton, Alberta, Canada.,Department of Medical Microbiology and Immunology, University of Alberta, Edmonton, Alberta, Canada
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4
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The Multifaceted Role of Mating Type of the Fungus and Sex of the Host in Studies of Fungal Infections in Humans. J Fungi (Basel) 2022; 8:jof8050461. [PMID: 35628717 PMCID: PMC9145136 DOI: 10.3390/jof8050461] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Revised: 04/27/2022] [Accepted: 04/27/2022] [Indexed: 02/04/2023] Open
Abstract
This review discusses the inclusion of sex and gender variables in studies of fungal infections in humans at the pathogen, host, and antifungal trial levels. The mating type of some fungi, or perhaps more likely the absence of the other, appears to be associated with some infections. Sexual and parasexual reproduction of some fungi is an important mechanism for the development of antifungal drug resistance. Host sex or gender influences the incidence of some infections such as aspergillosis, cryptococcosis, paracoccidioidomycosis, dermatophytosis, and candidiasis due to differences in immune response, behavior, and awareness for early detection and treatment. Participant sex (and age) is relevant not only in clinical antifungal trials but also in preclinical studies. The dimensions of sex and gender are important determinants throughout the fungal infection process and in approaches to prevent or treat these infections, as well as in development of antifungal drugs. Failure to consider sex and gender may be detrimental to the holistic understanding of the processes involved in fungal infection.
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Harding AT, Heaton NS. The Impact of Estrogens and Their Receptors on Immunity and Inflammation during Infection. Cancers (Basel) 2022; 14:cancers14040909. [PMID: 35205657 PMCID: PMC8870346 DOI: 10.3390/cancers14040909] [Citation(s) in RCA: 41] [Impact Index Per Article: 20.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2021] [Revised: 01/31/2022] [Accepted: 02/04/2022] [Indexed: 02/07/2023] Open
Abstract
Simple Summary Human health is significantly affected by microbial infections. One of the largest determinants of the outcomes of such infections is the host immune response. Too weak of a response can lead to enhanced spread by the pathogen, while an overstimulated response can lead to immune-induced tissue damage. Thus, to effectively treat infected individuals, it is critical to understand the regulators that control inflammatory responses. Recently, it has become widely accepted that estrogens, a class of sex hormones, are capable of dramatically altering the responses of host cells to microbes. In this review, we discuss how estrogens change the host immune response, as well as how these changes can alter the outcome of the infection for the individual. Abstract Sex hormones, such as estrogen and testosterone, are steroid compounds with well-characterized effects on the coordination and development of vertebrate reproductive systems. Since their discovery, however, it has become clear that these “sex hormones” also regulate/influence a broad range of biological functions. In this review, we will summarize some current findings on how estrogens interact with and regulate inflammation and immunity. Specifically, we will focus on describing the mechanisms by which estrogens alter immune pathway activation, the impact of these changes during infection and the development of long-term immunity, and how different types of estrogens and their respective concentrations mediate these outcomes.
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Affiliation(s)
- Alfred T. Harding
- Institute for Medical Engineering and Sciences, Massachusetts Institute of Technology, Cambridge, MA 02142, USA;
| | - Nicholas S. Heaton
- Department of Molecular Genetics and Microbiology, Duke University School of Medicine, Durham, NC 27710, USA
- Duke Human Vaccine Institute, Duke University School of Medicine, Durham, NC 27710, USA
- Correspondence: ; Tel.: +1-919-684-1351; Fax: +1-919-684-2790
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Yang Q, Zhang H, Wei T, Lin A, Sun Y, Luo P, Zhang J. Single-Cell RNA Sequencing Reveals the Heterogeneity of Tumor-Associated Macrophage in Non-Small Cell Lung Cancer and Differences Between Sexes. Front Immunol 2021; 12:756722. [PMID: 34804043 PMCID: PMC8602907 DOI: 10.3389/fimmu.2021.756722] [Citation(s) in RCA: 36] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2021] [Accepted: 10/21/2021] [Indexed: 12/25/2022] Open
Abstract
Non-Small Cell Lung Cancer (NSCLC) is a disease with high morbidity and mortality, which has sex-related differences in prognosis and immunotherapy efficacy. However, the difference in the mechanisms remains unclear. Macrophages, characterized by high plasticity and heterogeneity, act as one of the key cells that exert anti-tumor effects in the tumor microenvironment (TME) and play a complicated role in the process of tumor progression. To elucidate the subtype composition and functional heterogeneity of tumor-associated macrophages (TAMs) in NSCLC and further compare the sex-mediated differences, we conducted a single-cell level analysis in early-stage smoking NSCLC patients, combined with ssGSEA analysis, pseudotime ordering, and SCENIC analysis. We found two universally presented immune-suppressive TAMs with different functional and metabolic characteristics in the TME of NSCLC. Specifically, CCL18+ macrophages exerted immune-suppressive effects by inhibiting the production of inflammatory factors and manifested high levels of fatty acid oxidative phosphorylation metabolism. Conversely, the main metabolism pathway for SPP1+ macrophage was glycolysis which contributed to tumor metastasis by promoting angiogenesis and matrix remodeling. In terms of the differentially expressed genes, the complement gene C1QC and the matrix remodeling relevant genes FN1 and SPP1 were differentially expressed in the TAMs between sexes, of which the male upregulated SPP1 showed the potential as an ideal target for adjuvant immunotherapy and improving the efficacy of immunotherapy. According to the early-stage TCGA-NSCLC cohort, high expression of the above three genes in immune cells were associated with poor prognosis and acted as independent prognostic factors. Moreover, through verification at the transcription factor, transcriptome, and protein levels, we found that TAMs from women showed stronger immunogenicity with higher interferon-producing and antigen-presenting ability, while men-derived TAMs upregulated the PPARs and matrix remodeling related pathways, thus were more inclined to be immunosuppressive. Deconstruction of the TAMs at the single-cell level deepens our understanding of the mechanism for tumor occurrence and progress, which could be helpful to achieve the precise sex-specific tumor treatment sooner.
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Affiliation(s)
- Qi Yang
- Department of Oncology, Zhujiang Hospital, Southern Medical University, Guangzhou, China
| | - Hongman Zhang
- Department of Oncology, Zhujiang Hospital, Southern Medical University, Guangzhou, China
| | - Ting Wei
- Department of Oncology, Zhujiang Hospital, Southern Medical University, Guangzhou, China
| | - Anqi Lin
- Department of Oncology, Zhujiang Hospital, Southern Medical University, Guangzhou, China
| | - Yueqin Sun
- Department of Oncology, Zhujiang Hospital, Southern Medical University, Guangzhou, China
| | - Peng Luo
- Department of Oncology, Zhujiang Hospital, Southern Medical University, Guangzhou, China
| | - Jian Zhang
- Department of Oncology, Zhujiang Hospital, Southern Medical University, Guangzhou, China
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de Brito TGN, Taborda M, Provenci B, Costa AN, Benard G. A Case-Control Study of Paracoccidioidomycosis in Women: The Hormonal Protection Revisited. J Fungi (Basel) 2021; 7:jof7080655. [PMID: 34436194 PMCID: PMC8398402 DOI: 10.3390/jof7080655] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2021] [Revised: 07/30/2021] [Accepted: 08/03/2021] [Indexed: 12/01/2022] Open
Abstract
Clinical observations have long suggested that women are protected against paracoccidioidomycosis. 17β-estradiol, the main female estrogen, inhibits conidia-to-yeast transformation (C-to-Y), which is required for the infection establishment. However, experiments in murine models have yielded conflicting results, suggesting that C-to-Y inhibition, alone, fails to explain the female-associated protection and that sexual hormones may also act by modulating the host’s immune responses. Therefore, this issue remains unsolved. Strikingly, no studies have compared the severity of paracoccidioidomycosis between men and women. This retrospective case-control study compared 36 women with 72 age-matched men for clinical–demographic, laboratory, and chest imaging findings. Overall, paracoccidioidomycosis in women presented the main features described in the acute/subacute and chronic forms seen in men. Women also showed similar demographic features and clinical–laboratory and imaging severity scores as men. We additionally reviewed 58 paracoccidioidin skin test surveys undertaken by volunteers from endemic areas. Data accumulated from 10.873 tests showed that females and males are infected with similar magnitudes (21.9% vs. 25.2%) and that reactivity steadily increased with age, peaking after the age of 60. We discuss the paradox of similar infection rates but much lower disease prevalence in women, considering the current pathogenetic views of paracoccidioidomycosis, and we raise alternative hypotheses to account for this paradox.
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Affiliation(s)
- Tereza Graciano Nascimento de Brito
- Laboratorio de Investigacao em Imunologia e Dermatologia (LIM56), Departamento de Dermatologia and Instituto de Medicina Tropical, Faculdade de Medicina, Universidade de Sao Paulo, SP, R. Dr. Enéas de Carvalho Aguiar 470, São Paulo 05403-000, Brazil;
| | - Mariane Taborda
- Divisao de Doenças Infecciosas, Hospital das Clinicas, Faculdade de Medicina, Universidade de Sao Paulo, SP, R. Dr. Enéas de Carvalho Aguiar 255, São Paulo 05403-000, Brazil;
| | - Bruna Provenci
- Divisao de Pneumologia, Instituto do Coração, Hospital das Clinicas, Faculdade de Medicina, Universidade Sao Paulo, SP, R. Dr. Enéas de Carvalho Aguiar 44, São Paulo 05403-900, Brazil; (B.P.); (A.N.C.)
| | - André Nathan Costa
- Divisao de Pneumologia, Instituto do Coração, Hospital das Clinicas, Faculdade de Medicina, Universidade Sao Paulo, SP, R. Dr. Enéas de Carvalho Aguiar 44, São Paulo 05403-900, Brazil; (B.P.); (A.N.C.)
| | - Gil Benard
- Laboratorio de Investigacao em Imunologia e Dermatologia (LIM56), Departamento de Dermatologia and Instituto de Medicina Tropical, Faculdade de Medicina, Universidade de Sao Paulo, SP, R. Dr. Enéas de Carvalho Aguiar 470, São Paulo 05403-000, Brazil;
- Laboratorio de Micologia Medica (LIM53), Departamento de Dermatologia and Instituto de Medicina Tropical, Faculdade de Medicina, Universidade de Sao Paulo, SP, R. Dr. Enéas de Carvalho Aguiar 470, São Paulo 05403-000, Brazil
- Correspondence:
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8
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Gay L, Melenotte C, Lakbar I, Mezouar S, Devaux C, Raoult D, Bendiane MK, Leone M, Mège JL. Sexual Dimorphism and Gender in Infectious Diseases. Front Immunol 2021; 12:698121. [PMID: 34367158 PMCID: PMC8339590 DOI: 10.3389/fimmu.2021.698121] [Citation(s) in RCA: 53] [Impact Index Per Article: 17.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2021] [Accepted: 07/08/2021] [Indexed: 12/19/2022] Open
Abstract
Epidemiological studies and clinical observations show evidence of sexual dimorphism in infectious diseases. Women are at less risk than men when it comes to developing most infectious diseases. However, understanding these observations requires a gender approach that takes into account an analysis of both biological and social factors. The host’s response to infection differs in males and females because sex differences have an impact on hormonal and chromosomal control of immunity. Estradiol appears to confer protective immunity, while progesterone and testosterone suppress anti-infectious responses. In addition, genetic factors, including those associated with sex chromosomes, also affect susceptibility to infections. Finally, differences in occupational activities, lifestyle, and comorbidities play major roles in exposure to pathogens and management of diseases. Hence, considering sexual dimorphism as a critical variable for infectious diseases should be one of the steps taken toward developing personalized therapeutic approaches.
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Affiliation(s)
- Laetitia Gay
- Aix-Marseille Univ, IRD, APHM, MEPHI, IHU-Méditerranée Infection, Marseille, France
| | - Cléa Melenotte
- Aix-Marseille Univ, IRD, APHM, MEPHI, IHU-Méditerranée Infection, Marseille, France.,Aix-Marseille Univ, INSERM, IRD, SESSTIM, Economy and Social Science, Health Care Systems and Societies, Marseille, France
| | - Ines Lakbar
- Department of Anaesthesia and Intensive Care, Hôpital Nord, Aix-Marseille Univ, APHM, Marseille, France
| | - Soraya Mezouar
- Aix-Marseille Univ, IRD, APHM, MEPHI, IHU-Méditerranée Infection, Marseille, France
| | - Christian Devaux
- Aix-Marseille Univ, IRD, APHM, MEPHI, IHU-Méditerranée Infection, Marseille, France
| | - Didier Raoult
- Aix-Marseille Univ, IRD, APHM, MEPHI, IHU-Méditerranée Infection, Marseille, France
| | - Marc-Karim Bendiane
- Aix-Marseille Univ, INSERM, IRD, SESSTIM, Economy and Social Science, Health Care Systems and Societies, Marseille, France
| | - Marc Leone
- Aix-Marseille Univ, IRD, APHM, MEPHI, IHU-Méditerranée Infection, Marseille, France.,Department of Anaesthesia and Intensive Care, Hôpital Nord, Aix-Marseille Univ, APHM, Marseille, France
| | - Jean-Louis Mège
- Aix-Marseille Univ, IRD, APHM, MEPHI, IHU-Méditerranée Infection, Marseille, France
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Effects of Hormone Therapy and Flavonoids Capable on Reversal of Menopausal Immune Senescence. Nutrients 2021; 13:nu13072363. [PMID: 34371873 PMCID: PMC8308838 DOI: 10.3390/nu13072363] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2021] [Revised: 06/19/2021] [Accepted: 07/07/2021] [Indexed: 01/15/2023] Open
Abstract
Menopause, probably the most important natural change in a woman’s life and a major component of female senescence, is characterized, inter alia, by cessation of ovarian estrogen and progesterone production, resulting in a gradual deterioration of the female immune system. Hormone replacement therapy (HRT) is used in postmenopausal women to relieve some of the peri- and postmenopausal symptoms, while there is also evidence that the therapy may additionally partially reverse menopausal immune senescence. Flavonoids, and especially isoflavones, are widely used for the treatment of menopausal symptoms, although it is not at present clear whether they can reverse or alleviate other menopausal changes. HRT reverses the menopausal CD4/CD8 ratio and also limits the general peri- and postmenopausal inflammatory state. Moreover, the increased levels of interleukins (IL)-1β, IL-6, and IL-8, as well as of tumor necrosis factor-α (TNF-α) are decreased after the initiation of HRT. However, some reports show no effect of HRT on IL-4, IL-10, and IL-12. It is thus evident that the molecular pathways connecting HRT and female immune senescence need to be clarified. Interestingly, recent studies have suggested that the anti-inflammatory properties of isoflavones possibly interact with inflammatory cytokines when applied in menopause treatments, thereby potentially reversing immune senescence. This narrative review presents the latest data on the effect of menopausal therapies, including administration of flavonoid-rich products, on age-associated immune senescence reversal with the aim of revealing possible directions for future research and treatment development.
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10
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Gebremariam T, Alkhazraji S, Alqarihi A, Wiederhold NP, Najvar LK, Patterson TF, Filler SG, Ibrahim AS. Evaluation of Sex Differences in Murine Diabetic Ketoacidosis and Neutropenic Models of Invasive Mucormycosis. J Fungi (Basel) 2021; 7:jof7040313. [PMID: 33919611 PMCID: PMC8072604 DOI: 10.3390/jof7040313] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2021] [Revised: 04/15/2021] [Accepted: 04/16/2021] [Indexed: 12/24/2022] Open
Abstract
There is increased concern that the quality, generalizability and reproducibility of biomedical research can be influenced by the sex of animals used. We studied the differences between male and female mice in response to invasive pulmonary mucormycosis including susceptibility to infection, host immune reaction and responses to antifungal therapy. We used diabetic ketoacidotic (DKA) or neutropenic mice infected with either Rhizopus delemar or Mucor circinelloides. The only difference detected was that when DKA mice were infected with M. circinelloides, female mice were more resistant to infection than male mice (median survival time of 5 vs. 2 days for female and male mice, respectively). However, a 100% lethality was detected among infected animals of both sexes. Treatment with either liposomal amphotericin B (L-AMB) or posaconazole (POSA) protected mice from infection and eliminated the difference seen between infected but untreated female and male mice. Treatment with L-AMB consistently outperformed POSA in prolonging survival and reducing tissue fungal burden of DKA and neutropenic mice infected with R. delemar or M. circinelloides, in both mouse sexes. While little difference was detected in cytokine levels among both sexes, mucormycosis infection in the DKA mouse model induced more inflammatory cytokines/chemokines involved in neutrophil (CXCL1) and macrophage (CXCL2) recruitment vs. uninfected mice. As expected, this inflammatory response was reduced in the neutropenic mouse model. Our studies show that there are few differences between female and male DKA or neutropenic mice infected with mucormycosis with no effect on the outcome of treatment or host immune response.
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Affiliation(s)
- Teclegiorgis Gebremariam
- The Division of Infectious Diseases, The Lundquist Institute for Biomedical Innovation at Harbor-University of California at Los Angeles (UCLA) Medical Center, Torrance, CA 90502, USA; (T.G.); (S.A.); (A.A.); (S.G.F.)
| | - Sondus Alkhazraji
- The Division of Infectious Diseases, The Lundquist Institute for Biomedical Innovation at Harbor-University of California at Los Angeles (UCLA) Medical Center, Torrance, CA 90502, USA; (T.G.); (S.A.); (A.A.); (S.G.F.)
| | - Abdullah Alqarihi
- The Division of Infectious Diseases, The Lundquist Institute for Biomedical Innovation at Harbor-University of California at Los Angeles (UCLA) Medical Center, Torrance, CA 90502, USA; (T.G.); (S.A.); (A.A.); (S.G.F.)
| | - Nathan P. Wiederhold
- University of Texas Health Science Center at San Antonio, San Antonio, TX 78229, USA; (N.P.W.); (L.K.N.); (T.F.P.)
| | - Laura K. Najvar
- University of Texas Health Science Center at San Antonio, San Antonio, TX 78229, USA; (N.P.W.); (L.K.N.); (T.F.P.)
- South Texas Veterans Health Care System, San Antonio, TX 78229, USA
| | - Thomas F. Patterson
- University of Texas Health Science Center at San Antonio, San Antonio, TX 78229, USA; (N.P.W.); (L.K.N.); (T.F.P.)
- South Texas Veterans Health Care System, San Antonio, TX 78229, USA
| | - Scott G. Filler
- The Division of Infectious Diseases, The Lundquist Institute for Biomedical Innovation at Harbor-University of California at Los Angeles (UCLA) Medical Center, Torrance, CA 90502, USA; (T.G.); (S.A.); (A.A.); (S.G.F.)
- David Geffen School of Medicine at UCLA, Los Angeles, CA 90095, USA
| | - Ashraf S. Ibrahim
- The Division of Infectious Diseases, The Lundquist Institute for Biomedical Innovation at Harbor-University of California at Los Angeles (UCLA) Medical Center, Torrance, CA 90502, USA; (T.G.); (S.A.); (A.A.); (S.G.F.)
- David Geffen School of Medicine at UCLA, Los Angeles, CA 90095, USA
- Correspondence: ; Tel.: +1-310-222-6424
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11
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da Silva PHL, de Castro KKG, Mendes MA, Leal-Calvo T, Leal JMP, Nery JADC, Sarno EN, Lourenço RA, Moraes MO, Lara FA, Esquenazi D. Presence of Senescent and Memory CD8+ Leukocytes as Immunocenescence Markers in Skin Lesions of Elderly Leprosy Patients. Front Immunol 2021; 12:647385. [PMID: 33777045 PMCID: PMC7991105 DOI: 10.3389/fimmu.2021.647385] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2020] [Accepted: 02/15/2021] [Indexed: 01/10/2023] Open
Abstract
Leprosy is an infectious disease that remains endemic in approximately 100 developing countries, where about 200,000 new cases are diagnosed each year. Moreover, multibacillary leprosy, the most contagious form of the disease, has been detected at continuously higher rates among Brazilian elderly people. Due to the so-called immunosenescence, characterized by several alterations in the quality of the immune response during aging, this group is more susceptible to infectious diseases. In view of such data, the purpose of our work was to investigate if age-related alterations in the immune response could influence the pathogenesis of leprosy. As such, we studied 87 individuals, 62 newly diagnosed and untreated leprosy patients distributed according to the age range and to the clinical forms of the disease and 25 healthy volunteers, who were studied as controls. The frequency of senescent and memory CD8+ leukocytes was assessed by immunofluorescence of biopsies from cutaneous lesions, while the serum levels of IgG anti-CMV antibodies were analyzed by chemiluminescence and the gene expression of T cell receptors' inhibitors by RT-qPCR. We noted an accumulation of memory CD8+ T lymphocytes, as well as reduced CD8+CD28+ cell expression in skin lesions from elderly patients, when compared to younger people. Alterations in LAG3 and PDCD1 gene expression in cutaneous lesions of young MB patients were also observed, when compared to elderly patients. Such data suggest that the age-related alterations of T lymphocyte subsets can facilitate the onset of leprosy in elderly patients, not to mention other chronic inflammatory diseases.
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Affiliation(s)
| | | | - Mayara Abud Mendes
- Laboratório de Hanseníase, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil
| | - Thyago Leal-Calvo
- Laboratório de Hanseníase, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil
| | | | | | - Euzenir Nunes Sarno
- Laboratório de Hanseníase, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil
| | - Roberto Alves Lourenço
- Laboratorio de Envelhecimento Humano, GeronLab, Policlínica Piquet Carneiro, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Milton Ozório Moraes
- Laboratório de Hanseníase, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil
| | - Flávio Alves Lara
- Laboratório de Microbiologia Celular, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil
| | - Danuza Esquenazi
- Laboratório de Hanseníase, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil.,Disciplina de Patologia Geral, Faculdade de Ciências Médicas, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, Brazil
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12
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Sato PK, Busser FD, Carvalho FMDC, Gomes Dos Santos A, Sadahiro A, Diogo CL, Kono ASG, Moretti ML, Luiz ODC, Shikanai-Yasuda MA. Polymorphism in the Promoter Region of the IL18 Gene and the Association With Severity on Paracoccidioidomycosis. Front Immunol 2020; 11:542210. [PMID: 33117339 PMCID: PMC7559583 DOI: 10.3389/fimmu.2020.542210] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2020] [Accepted: 08/21/2020] [Indexed: 01/06/2023] Open
Abstract
Paracoccidioidomycosis (PCM) is an important endemic, systemic disease in Latin America caused by Paracoccidioides spp. This mycosis has been associated with high morbidity and sequels, and its clinical manifestations depend on the virulence of the infecting strain, the degree and type of immune response, infected tissues, and intrinsic characteristics of the host. The T helper(Th)1 and Th17/Th22 cells are related to resistance and control of infection, and a Th2/Th9 response is associated with disease susceptibility. In this study, we focused on interleukin(IL)-12p35 (IL12A), IL-18 (IL18), and IFN-γ receptor 1 (IFNGR1) genetic polymorphisms because their respective roles have been described in human PCM. Real-time PCR was employed to analyze IL12A-504 G/T (rs2243115), IL18-607 C/A (rs1946518), and IFNGR1-611 A/G (rs1327474) single nucleotide polymorphisms (SNP). One hundred forty-nine patients with the acute form (AF), multifocal chronic (MC), or unifocal chronic (UC) forms of PCM and 110 non-PCM individuals as a control group were included. In the unconditional logistic regression analysis adjusted by ethnicity and sex, we observed a high risk of the IL18-607 A-allele for both AF [p = 0.015; OR = 3.10 (95% CI: 1.24–7.77)] and MC groups [p = 0.023; OR = 2.61 (95% CI: 1.14–5.96)] when compared with UC. The IL18-607 A-allele associated risk for the AF and MC groups as well as the protective role of the C-allele in UC are possibly linked to higher levels of IL-18 at different periods of the course of the disease. Therefore, a novel role of IL18-607 C/A SNP is shown in the present study, highlighting its importance in the outcome of PCM.
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Affiliation(s)
- Paula Keiko Sato
- Laboratory of Medical Investigation in Immunology (LIM48), Faculdade de Medicina, Hospital das Clínicas, University of São Paulo, São Paulo, Brazil.,Institute of Tropical Medicine, Faculdade de Medicina, University of São Paulo, São Paulo, Brazil
| | - Felipe Delatorre Busser
- Laboratory of Medical Investigation in Immunology (LIM48), Faculdade de Medicina, Hospital das Clínicas, University of São Paulo, São Paulo, Brazil.,Institute of Tropical Medicine, Faculdade de Medicina, University of São Paulo, São Paulo, Brazil
| | - Flávia Mendes da Cunha Carvalho
- Laboratory of Medical Investigation in Immunology (LIM48), Faculdade de Medicina, Hospital das Clínicas, University of São Paulo, São Paulo, Brazil.,Department of Infectious and Parasitic Diseases, Faculdade de Medicina, University of São Paulo, São Paulo, Brazil
| | - Alexandra Gomes Dos Santos
- Laboratory of Medical Investigation in Immunology (LIM48), Faculdade de Medicina, Hospital das Clínicas, University of São Paulo, São Paulo, Brazil.,Department of Infectious and Parasitic Diseases, Faculdade de Medicina, University of São Paulo, São Paulo, Brazil
| | - Aya Sadahiro
- Department of Parasitology, Instituto de Ciências Biológicas, Federal University of Amazonas, Manaus, Brazil
| | - Constancia Lima Diogo
- Laboratory of Medical Investigation in Immunology (LIM48), Faculdade de Medicina, Hospital das Clínicas, University of São Paulo, São Paulo, Brazil.,Institute of Tropical Medicine, Faculdade de Medicina, University of São Paulo, São Paulo, Brazil
| | | | - Maria Luiza Moretti
- Faculdade de Ciências Médicas, Hospital das Clínicas, State University of Campinas, Campinas, Brazil
| | - Olinda do Carmo Luiz
- Department of Preventive Medicine, Faculdade de Medicina, University of São Paulo, São Paulo, Brazil
| | - Maria Aparecida Shikanai-Yasuda
- Laboratory of Medical Investigation in Immunology (LIM48), Faculdade de Medicina, Hospital das Clínicas, University of São Paulo, São Paulo, Brazil.,Institute of Tropical Medicine, Faculdade de Medicina, University of São Paulo, São Paulo, Brazil.,Department of Infectious and Parasitic Diseases, Faculdade de Medicina, University of São Paulo, São Paulo, Brazil
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13
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Peron G, Oliveira J, Thomaz LDL, Bonfanti AP, Thomé R, Rapôso C, Cardoso Verinaud LM. Paracoccidioides brasiliensis infection increases regulatory T cell counts in female C57BL/6 mice infected via two distinct routes. Immunobiology 2020; 225:151963. [PMID: 32747019 DOI: 10.1016/j.imbio.2020.151963] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2020] [Revised: 04/06/2020] [Accepted: 05/18/2020] [Indexed: 01/24/2023]
Abstract
Studies that show an overview of the peripheral immune response in a model of Paracoccidioides brasiliensis (Pb) infection in females are scarce in the literature. We sought to characterize the innate and adaptive immune responses in female C57BL/6 mice infected with Pb through two distinct routes of administration, intranasal and intravenous. In addition to the lung, P. brasiliensis yeast cells were observed in liver and brain tissues of females infected intravenously. To our knowledge, our study is the first to prove the presence of this pathogenic fungus in the cerebral cortex of female mice. During the initial stages of infection, augmented expression of both MHCII and CD86 was observed on the surface of CD11c+ pulmonary antigen-presenting cells (APCs) in intranasally and intravenously infected females. However, CD40 expression was downregulated in these cells. Concomitantly with increasing serum IL-10 levels, we noted that splenic dendritic cells (DCs) from both intravenously- and intranasally-infected female mice had acquired an immature phenotype. Further, increased T regulatory cell counts were observed in female mice infected via both routes, along with an increase in the infiltration of IL-10-producing CD8+ T cells into the lungs. Moreover, we noted that P. brasiliensis infection resulted in enhanced IL-10 production - by CD11c+ APCs in the lung tissue - and induction of Th17 polarization. Taken together, our results suggest that P. brasiliensis could modulates the immune response in female mice by influencing the balance between regulatory T cells (Tregs) and Th17 polarization.
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Affiliation(s)
- Gabriela Peron
- Department of Structural and Functional Biology, Institute of Biology, State University of Campinas, Campinas, SP, Brazil.
| | - Janine Oliveira
- Department of Structural and Functional Biology, Institute of Biology, State University of Campinas, Campinas, SP, Brazil
| | - Livia de Lima Thomaz
- Department of Structural and Functional Biology, Institute of Biology, State University of Campinas, Campinas, SP, Brazil
| | - Amanda Pires Bonfanti
- Department of Structural and Functional Biology, Institute of Biology, State University of Campinas, Campinas, SP, Brazil
| | - Rodolfo Thomé
- Department of Neurology, Thomas Jefferson University, Philadelphia, PA, USA
| | - Catarina Rapôso
- Faculty of Pharmaceutical Sciences, State University of Campinas, Campinas, SP, Brazil
| | - Liana M Cardoso Verinaud
- Department of Structural and Functional Biology, Institute of Biology, State University of Campinas, Campinas, SP, Brazil
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14
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Gilli F, DiSano KD, Pachner AR. SeXX Matters in Multiple Sclerosis. Front Neurol 2020; 11:616. [PMID: 32719651 PMCID: PMC7347971 DOI: 10.3389/fneur.2020.00616] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2020] [Accepted: 05/27/2020] [Indexed: 12/12/2022] Open
Abstract
Multiple sclerosis (MS) is the most common chronic inflammatory and neurodegenerative disease of the central nervous system (CNS). An interesting feature that this debilitating disease shares with many other inflammatory disorders is that susceptibility is higher in females than in males, with the risk of MS being three times higher in women compared to men. Nonetheless, while men have a decreased risk of developing MS, many studies suggest that males have a worse clinical outcome. MS exhibits an apparent sexual dimorphism in both the immune response and the pathophysiology of the CNS damage, ultimately affecting disease susceptibility and progression differently. Overall, women are predisposed to higher rates of inflammatory relapses than men, but men are more likely to manifest signs of disease progression and worse CNS damage. The observed sexual dimorphism in MS may be due to sex hormones and sex chromosomes, acting in parallel or combination. In this review, we outline current knowledge on the sexual dimorphism in MS and discuss the interplay of sex chromosomes, sex hormones, and the immune system in driving MS disease susceptibility and progression.
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Affiliation(s)
- Francesca Gilli
- Department of Neurology, Dartmouth Hitchcock Medical Center, Geisel School of Medicine at Dartmouth, Lebanon, NH, United States
| | - Krista D DiSano
- Department of Neurology, Dartmouth Hitchcock Medical Center, Geisel School of Medicine at Dartmouth, Lebanon, NH, United States
| | - Andrew R Pachner
- Department of Neurology, Dartmouth Hitchcock Medical Center, Geisel School of Medicine at Dartmouth, Lebanon, NH, United States
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15
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Costa MC, de Barros Fernandes H, Gonçalves GKN, Santos APN, Ferreira GF, de Freitas GJC, do Carmo PHF, Hubner J, Emídio ECP, Santos JRA, Dos Santos JL, Dos Reis AM, Fagundes CT, da Silva AM, Santos DA. 17-β-Estradiol increases macrophage activity through activation of the G-protein-coupled estrogen receptor and improves the response of female mice to Cryptococcus gattii. Cell Microbiol 2020; 22:e13179. [PMID: 32017324 DOI: 10.1111/cmi.13179] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2019] [Revised: 12/03/2019] [Accepted: 01/26/2020] [Indexed: 11/29/2022]
Abstract
Cryptococcus gattii (Cg) is one of the agents of cryptococcosis, a severe systemic mycosis with a higher prevalence in men than women, but the influence of the female sex hormone, 17-β-estradiol (E2), on cryptococcosis remains unclear. Our study shows that female mice presented delayed mortality, increased neutrophil recruitment in bronchoalveolar lavage fluid, and reduced fungal load after 24 hr of infection compared to male and ovariectomised female mice (OVX). E2 replacement restored OVX female survival. Female macrophages have more efficient fungicidal activity, which was increased by E2 and reversed by the antagonist of G-protein-coupled oestrogen receptor (GPER), which negatively modulates PI3K activation. Furthermore, E2 induces a reduction in Cg cell diameter, cell charge, and antioxidant peroxidase activity. In conclusion, female mice present improved control of Cg infection, and GPER is important for E2 modulation of the female response.
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Affiliation(s)
- Marliete C Costa
- Laboratório de Micologia, Departamento de Microbiologia, ICB-UFMG, Belo Horizonte, Brazil
| | | | - Gleisy K N Gonçalves
- Laboratório de Endocrinologia e Metabolismo, Departamento de Fisiologia, ICB-UFMG, Belo Horizonte, Brazil
| | - Anderson P N Santos
- Laboratório de Micologia, Departamento de Microbiologia, ICB-UFMG, Belo Horizonte, Brazil
| | - Gabriella F Ferreira
- Campus Governador Valadares, Programa Multicêntrico de Pós Graduação em Bioquímica e Biologia Molecular-UFJF, Juiz de Fora, Brazil
| | - Gustavo J C de Freitas
- Laboratório de Micologia, Departamento de Microbiologia, ICB-UFMG, Belo Horizonte, Brazil
| | - Paulo H F do Carmo
- Laboratório de Micologia, Departamento de Microbiologia, ICB-UFMG, Belo Horizonte, Brazil
| | - Jôsy Hubner
- Laboratório de Genes Inflamatórios, Departamento de Morfologia, ICB-UFMG, Belo Horizonte, Brazil
| | - Elúzia C P Emídio
- Laboratório de Micologia, Departamento de Microbiologia, ICB-UFMG, Belo Horizonte, Brazil
| | | | | | - Adelina M Dos Reis
- Laboratório de Endocrinologia e Metabolismo, Departamento de Fisiologia, ICB-UFMG, Belo Horizonte, Brazil
| | - Caio T Fagundes
- Laboratório de Interação Microrganismo-Hospedeiro, Departamento de Microbiologia, ICB-UFMG, Belo Horizonte, Brazil
| | - Aristóbolo M da Silva
- Laboratório de Genes Inflamatórios, Departamento de Morfologia, ICB-UFMG, Belo Horizonte, Brazil
| | - Daniel A Santos
- Laboratório de Micologia, Departamento de Microbiologia, ICB-UFMG, Belo Horizonte, Brazil
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16
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Sex-Related Differences in Immune Response and Symptomatic Manifestations to Infection with Leishmania Species. J Immunol Res 2019; 2019:4103819. [PMID: 30756088 PMCID: PMC6348913 DOI: 10.1155/2019/4103819] [Citation(s) in RCA: 42] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2018] [Revised: 10/22/2018] [Accepted: 12/11/2018] [Indexed: 12/19/2022] Open
Abstract
Worldwide, an estimated 12 million people are infected with Leishmania spp. and an additional 350 million are at risk of infection. Leishmania are intracellular parasites that cause disease by suppressing macrophage microbicidal responses. Infection can remain asymptomatic or lead to a spectrum of diseases including cutaneous, mucocutaneous, and visceral leishmaniasis. Ultimately, the combination of both pathogen and host factors determines the outcome of infection. Leishmaniasis, as well as numerous other infectious diseases, exhibits sex-related differences that cannot be explained solely in terms of environmental exposure or healthcare access. Furthermore, transcriptomic evidence is revealing that biological sex is a variable impacting physiology, immune response, drug metabolism, and consequently, the progression of disease. Herein, we review the distribution, morbidity, and mortality among male and female leishmaniasis patients. Additionally, we discuss experimental findings and new avenues of research concerning sex-specific responses in cutaneous and visceral leishmaniasis. The limitations of current therapies and the emergence of drug-resistant parasites underscore the need for new treatments that could harness the host immune response. As such, understanding the mechanisms driving the differential immune response and disease outcome of males versus females is a necessary step in the development of safer and more effective treatments against leishmaniasis.
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17
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Schurz H, Salie M, Tromp G, Hoal EG, Kinnear CJ, Möller M. The X chromosome and sex-specific effects in infectious disease susceptibility. Hum Genomics 2019; 13:2. [PMID: 30621780 PMCID: PMC6325731 DOI: 10.1186/s40246-018-0185-z] [Citation(s) in RCA: 223] [Impact Index Per Article: 44.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2018] [Accepted: 11/30/2018] [Indexed: 12/18/2022] Open
Abstract
The X chromosome and X-linked variants have largely been ignored in genome-wide and candidate association studies of infectious diseases due to the complexity of statistical analysis of the X chromosome. This exclusion is significant, since the X chromosome contains a high density of immune-related genes and regulatory elements that are extensively involved in both the innate and adaptive immune responses. Many diseases present with a clear sex bias, and apart from the influence of sex hormones and socioeconomic and behavioural factors, the X chromosome, X-linked genes and X chromosome inactivation mechanisms contribute to this difference. Females are functional mosaics for X-linked genes due to X chromosome inactivation and this, combined with other X chromosome inactivation mechanisms such as genes that escape silencing and skewed inactivation, could contribute to an immunological advantage for females in many infections. In this review, we discuss the involvement of the X chromosome and X inactivation in immunity and address its role in sexual dimorphism of infectious diseases using tuberculosis susceptibility as an example, in which male sex bias is clear, yet not fully explored.
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Affiliation(s)
- Haiko Schurz
- DST-NRF Centre of Excellence for Biomedical Tuberculosis Research, South African Medical Research Council Centre for Tuberculosis Research, Division of Molecular Biology and Human Genetics, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
- South African Tuberculosis Bioinformatics Initiative (SATBBI), Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Muneeb Salie
- Department of Genetics, St. Jude Children’s Research Hospital, Memphis, TN 38105 USA
| | - Gerard Tromp
- DST-NRF Centre of Excellence for Biomedical Tuberculosis Research, South African Medical Research Council Centre for Tuberculosis Research, Division of Molecular Biology and Human Genetics, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
- South African Tuberculosis Bioinformatics Initiative (SATBBI), Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Eileen G. Hoal
- DST-NRF Centre of Excellence for Biomedical Tuberculosis Research, South African Medical Research Council Centre for Tuberculosis Research, Division of Molecular Biology and Human Genetics, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Craig J. Kinnear
- DST-NRF Centre of Excellence for Biomedical Tuberculosis Research, South African Medical Research Council Centre for Tuberculosis Research, Division of Molecular Biology and Human Genetics, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Marlo Möller
- DST-NRF Centre of Excellence for Biomedical Tuberculosis Research, South African Medical Research Council Centre for Tuberculosis Research, Division of Molecular Biology and Human Genetics, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
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18
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Differential Susceptibility of Male Versus Female Laboratory Mice to Anaplasma phagocytophilum Infection. Trop Med Infect Dis 2018; 3:tropicalmed3030078. [PMID: 30274474 PMCID: PMC6161277 DOI: 10.3390/tropicalmed3030078] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2018] [Revised: 07/07/2018] [Accepted: 07/18/2018] [Indexed: 12/20/2022] Open
Abstract
Human granulocytic anaplasmosis (HGA) is a debilitating, non-specific febrile illness caused by the granulocytotropic obligate intracellular bacterium called Anaplasma phagocytophilum. Surveillance studies indicate a higher prevalence of HGA in male versus female patients. Whether this discrepancy correlates with differential susceptibility of males and females to A. phagocytophilum infection is unknown. Laboratory mice have long been used to study granulocytic anaplasmosis. Yet, sex as a biological variable (SABV) in this model has not been evaluated. In this paper, groups of male and female C57Bl/6 mice that had been infected with A. phagocytophilum were assessed for the bacterial DNA load in the peripheral blood, the percentage of neutrophils harboring bacterial inclusions called morulae, and splenomegaly. Infected male mice exhibited as much as a 1.85-fold increase in the number of infected neutrophils, which is up to a 1.88-fold increase in the A. phagocytophilum DNA load, and a significant increase in spleen size when compared to infected female mice. The propensity of male mice to develop a higher level of A. phagocytophilum infection is relevant for studies utilizing the mouse model. This stresses the importance of including SABV and aligns with the observed higher incidence of infection in male versus female patients.
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19
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Fungal Dimorphism and Virulence: Molecular Mechanisms for Temperature Adaptation, Immune Evasion, and In Vivo Survival. Mediators Inflamm 2017. [PMID: 28626345 PMCID: PMC5463121 DOI: 10.1155/2017/8491383] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023] Open
Abstract
The thermally dimorphic fungi are a unique group of fungi within the Ascomycota phylum that respond to shifts in temperature by converting between hyphae (22–25°C) and yeast (37°C). This morphologic switch, known as the phase transition, defines the biology and lifestyle of these fungi. The conversion to yeast within healthy and immunocompromised mammalian hosts is essential for virulence. In the yeast phase, the thermally dimorphic fungi upregulate genes involved with subverting host immune defenses. This review highlights the molecular mechanisms governing the phase transition and recent advances in how the phase transition promotes infection.
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20
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Camacho E, Niño-Vega GA. Paracoccidioides Spp.: Virulence Factors and Immune-Evasion Strategies. Mediators Inflamm 2017; 2017:5313691. [PMID: 28553014 PMCID: PMC5434249 DOI: 10.1155/2017/5313691] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2016] [Revised: 02/01/2017] [Accepted: 02/21/2017] [Indexed: 12/21/2022] Open
Abstract
Paracoccidioides spp. are dimorphic fungal pathogens responsible for one of the most relevant systemic mycoses in Latin America, paracoccidioidomycosis (PCM). Their exact ecological niche remains unknown; however, they have been isolated from soil samples and armadillos (Dasypus novemcinctus), which have been proposed as animal reservoir for these fungi. Human infection occurs by inhalation of conidia or mycelia fragments and is mostly associated with immunocompetent hosts inhabiting and/or working in endemic rural areas. In this review focusing on the pathogen perspective, we will discuss some of the microbial attributes and molecular mechanisms that enable Paracoccidioides spp. to tolerate, adapt, and ultimately avoid the host immune response, establishing infection.
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Affiliation(s)
- Emma Camacho
- Department of Molecular Microbiology and Immunobiology, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
| | - Gustavo A. Niño-Vega
- Departamento de Biología, División de Ciencias Naturales y Exactas, Universidad de Guanajuato, Guanajuato, GTO, Mexico
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21
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Nobre ML, Illarramendi X, Dupnik KM, Hacker MDA, Nery JADC, Jerônimo SMB, Sarno EN. Multibacillary leprosy by population groups in Brazil: Lessons from an observational study. PLoS Negl Trop Dis 2017; 11:e0005364. [PMID: 28192426 PMCID: PMC5325588 DOI: 10.1371/journal.pntd.0005364] [Citation(s) in RCA: 46] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2016] [Revised: 02/24/2017] [Accepted: 01/27/2017] [Indexed: 11/25/2022] Open
Abstract
Background Leprosy remains an important public health problem in Brazil where 28,761 new cases were diagnosed in 2015, the second highest number of new cases detected globally. The disease is caused by Mycobacterium leprae, a pathogen spread by patients with multibacillary (MB) leprosy. This study was designed to identify population groups most at risk for MB disease in Brazil, contributing to new ideas for early diagnosis and leprosy control. Methods A national databank of cases reported in Brazil (2001–2013) was used to evaluate epidemiological characteristics of MB leprosy. Additionally, the databank of a leprosy reference center was used to determine factors associated with higher bacillary loads. Results A total of 541,090 cases were analyzed. New case detection rates (NCDRs) increased with age, especially for men with MB leprosy, reaching 44.8 new cases/100,000 population in 65–69 year olds. Males and subjects older than 59 years had twice the odds of MB leprosy than females and younger cases (OR = 2.36, CI95% = 2.33–2.38; OR = 1.99, CI95% = 1.96–2.02, respectively). Bacillary load was higher in male and in patients aged 20–39 and 40–59 years compared to females and other age groups. From 2003 to 2013, there was a progressive reduction in annual NCDRs and an increase in the percentage of MB cases and of elderly patients in Brazil. These data suggest reduction of leprosy transmission in the country. Conclusion Public health policies for leprosy control in endemic areas in Brazil should include activities especially addressed to men and to the elderly in order to further reduce M. leprae transmission. Leprosy is caused by Mycobacterium leprae, a bacillus transmitted by patients with multibacillary (MB) disease. Men and elderly are more likely to have MB leprosy, which has been attributed to an increased exposure to infection by male sex, decreased access of men to healthcare resulting in delayed diagnosis and long incubation period for MB disease. In this study, we found that the odds ratio for MB leprosy is two-fold higher for men than for women in all Brazilian states, independent of their endemic level. The same was observed for patients aged 60 or older compared to younger cases. Detection rates for MB leprosy remained higher for men and elderly patients timely detected (without physical disabilities), showing that late diagnosis is not enough to explain this association. Additionally, we showed that M. leprae load is higher in men than in women, despite early detection. These findings are relevant, because main activities to diagnose new cases of leprosy in Brazil have been focused on school surveys, detecting children who most likely have paucibacillary leprosy, which is non-contagious. To prevent transmission within the community, additional activities need to include groups at greater risk for MB leprosy. As such, we suggest that specific strategies for disease control should be adopted to effectively reach males and the elderly in endemic areas for leprosy.
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Affiliation(s)
- Mauricio Lisboa Nobre
- Pós-Graduação em Medicina Tropical, Instituto Oswaldo Cruz, Fiocruz, Rio de Janeiro, RJ, Brazil
- Hospital Giselda Trigueiro, Secretaria Estadual de Saúde, Natal, RN, Brazil
- Instituto de Medicina Tropical do Rio Grande do Norte, Universidade Federal do Rio Grande do Norte, Natal, RN, Brazil
- * E-mail:
| | - Ximena Illarramendi
- Centro de Desenvolvimento Tecnológico em Saúde, Fiocruz, Rio de Janeiro, RJ, Brazil
| | - Kathryn Margaret Dupnik
- Division of Infectious Diseases and Center for Global Health, Weill Cornell Medical College, New York, NY, United States of America
| | | | | | - Selma Maria Bezerra Jerônimo
- Instituto de Medicina Tropical do Rio Grande do Norte, Universidade Federal do Rio Grande do Norte, Natal, RN, Brazil
- Departamento de Bioquímica, Centro de Biociências, Universidade Federal do Rio Grande do Norte, Natal, RN, Brazil
- Instituto Nacional de Ciência e Tecnologia de Doenças Tropicais, INCT-DT, Natal, RN, Brazil
| | - Euzenir Nunes Sarno
- Laboratório de Hanseníase, Instituto Oswaldo Cruz, Fiocruz, Rio de Janeiro, RJ, Brazil
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Vallabhaneni S, Benedict K, Derado G, Mody RK. Trends in Hospitalizations Related to Invasive Aspergillosis and Mucormycosis in the United States, 2000-2013. Open Forum Infect Dis 2017; 4:ofw268. [PMID: 28480260 DOI: 10.1093/ofid/ofw268] [Citation(s) in RCA: 63] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2016] [Accepted: 01/09/2017] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND Invasive aspergillosis (IA) and mucormycosis contribute to substantial mortality, especially among immunocompromised persons, including those with hematopoietic stem cell transplant (HSCT), hematologic malignancy (HM), and solid organ transplant (SOT). METHODS Using International Classification of Diseases, Ninth Revision codes available in the National Inpatient Sample, a hospital discharge database, we estimated IA-related hospitalizations (IA-RH), mucormycosis-RH (M-RH), HSCT-RH, HM-RH, and SOT-RH during 2000-2013. United States census data were used to calculate overall M-RH and IA-RH rates and present trends; estimated annual numbers of HSCT-RH, HM-RH, and SOT-RH served as denominators to calculate M-RH and IA-RH rates occurring with these conditions. Weighted least-squares technique was used to test for linear trends and calculate average annual percentage change (APC). RESULTS There were an estimated 169 110 IA-RH and 9966 M-RH during 2000-2013. Overall, IA-RH and M-RH rates per million persons rose from 32.8 to 46.0 (APC = +2.9; P < .001) and 1.7 to 3.4 (APC = +5.2%; P < .001), respectively, from 2000 to 2013. Among HSCT-RH, there was no significant change in M-RH rate, but a significant decline occurred in IA-RH rate (APC = -4.6%; P = .004). Among HM-RH, the rate of M-RH increased (APC = +7.0%; P < .001), but the IA-RH rate did not change significantly (APC = +1.2%; P = .073). Among SOT-RH, M-RH (APC = +6.3%; P = .038) and IA-RH rates (APC = +4.1%; P < .001) both increased. CONCLUSIONS Overall IA-RH and M-RH rates increased during 2000-2013, with a doubling of M-RH. Mucormycosis-related hospitalization occurring in conjunction with certain comorbidities increased, whereas IA-RH rates among patients with the comorbidities, decreased, remained stable, or increased to a lesser extent than M-RH.
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Affiliation(s)
- Snigdha Vallabhaneni
- Mycotic Diseases Branch, Division for Food, Water, and Environmental Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Kaitlin Benedict
- Mycotic Diseases Branch, Division for Food, Water, and Environmental Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Gordana Derado
- Biostatistics and Information Management Office, Division of Foodborne, Waterborne and Environmental Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Rajal K Mody
- Mycotic Diseases Branch, Division for Food, Water, and Environmental Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
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Bortolini MJS, Silva MV, Alonso FM, Medeiros LA, Carvalho FR, Costa LF, Silva NM, Penha-Silva N, Mineo TWP, Mineo JR. Strength and Aerobic Physical Exercises Are Able to Increase Survival of Toxoplasma gondii-Infected C57BL/6 Mice by Interfering in the IFN-γ Expression. Front Physiol 2016; 7:641. [PMID: 28066269 PMCID: PMC5179569 DOI: 10.3389/fphys.2016.00641] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2016] [Accepted: 12/06/2016] [Indexed: 11/23/2022] Open
Abstract
Physical exercise has been implicated in several immunophysiological improvements, particularly during the aging process, when an immunocompromised status could be established. Toxoplasma gondii is a protozoan parasite that causes a widespread opportunistic infection, which may present severe consequences, mainly to the fetus and immunocompromised patients. It is estimated that one-third of the human population worldwide has been infected by this parasite, being the reactivation during immunesenescence an unexplored public health issue. The major purpose of the present study was to observe the immunophysiological differences between exercised vs. sedentary C57BL/6 male mice that have been experimentally infected by T. gondii. In the first set of experiments, the animals were infected after exercising and three groups were set up: experimental groups—infected sedentary (IS, n = 6); infected exercised (IEx, n = 6) and control group—non-infected sedentary (NIS, n = 6). When stimulated in vitro by T. gondii-soluble tachyzoite antigen, it was found that splenocytes from exercised group produced higher levels of IFN-γ, as well as of IFN-γ/IL-10 ratios in comparison with splenocytes from sedentary animals (P < 0.001). However, it was not found significant differences concerning quantification of T. gondii genomic DNA by qRT-PCR and immunohistochemistry analysis in brain cysts from both group of animals (P > 0.05). In order to further investigate the consequences of these data for the host, a second set of experiments was performed, when the animals were infected before exercising and four groups of animals were established for comparison purpose, as follows: experimental groups—infected sedentary (IS, n = 7); infected exercised (IEx, n = 6) and control groups—non-infected sedentary (NIS, n = 6) and non-infected exercised (NIEx, n = 6). It was found significant differences in the survival rates of the exercised group the animals, as they survived longer than sedentary groups (P = 0.0005). In both sets of experiments, mice have been submitted to moderate exercises: aerobic (14 m/min; 3 x/week) and strength (60–80% of one maximum repetition; 2 x/week). Overall, our findings are showing that the aerobic and strength exercises are able to modulate immune response against T. gondii infection, being these immunological features beneficial to the host.
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Affiliation(s)
- Miguel J S Bortolini
- Laboratório de Imunoparasitologia, Instituto de Ciências Biomédicas, Universidade Federal de UberlândiaUberlândia, Brazil; Laboratório de Exercícios Físicos Resistidos e Aeróbicos, Centro de Ciências da Saúde e do Desporto, Universidade Federal do AcreRio Branco, Brazil
| | - Murilo V Silva
- Laboratório de Imunoparasitologia, Instituto de Ciências Biomédicas, Universidade Federal de Uberlândia Uberlândia, Brazil
| | - Fábio M Alonso
- Laboratório de Imunoparasitologia, Instituto de Ciências Biomédicas, Universidade Federal de Uberlândia Uberlândia, Brazil
| | - Luciana A Medeiros
- Laboratório de Imunoparasitologia, Instituto de Ciências Biomédicas, Universidade Federal de Uberlândia Uberlândia, Brazil
| | - Fernando R Carvalho
- Laboratório de Imunoparasitologia, Instituto de Ciências Biomédicas, Universidade Federal de Uberlândia Uberlândia, Brazil
| | - Lourenço F Costa
- Laboratório de Imunoparasitologia, Instituto de Ciências Biomédicas, Universidade Federal de Uberlândia Uberlândia, Brazil
| | - Neide M Silva
- Laboratório de Imunopatologia, Instituto de Ciências Biomédicas Uberlândia, Brazil
| | - Nilson Penha-Silva
- Laboratório de Biofisicoquímica, Instituto de Genética e Bioquímica Uberlândia, Brazil
| | - Tiago W P Mineo
- Laboratório de Imunoparasitologia, Instituto de Ciências Biomédicas, Universidade Federal de Uberlândia Uberlândia, Brazil
| | - José R Mineo
- Laboratório de Imunoparasitologia, Instituto de Ciências Biomédicas, Universidade Federal de Uberlândia Uberlândia, Brazil
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de Oliveira HC, Assato PA, Marcos CM, Scorzoni L, de Paula E Silva ACA, Da Silva JDF, Singulani JDL, Alarcon KM, Fusco-Almeida AM, Mendes-Giannini MJS. Paracoccidioides-host Interaction: An Overview on Recent Advances in the Paracoccidioidomycosis. Front Microbiol 2015; 6:1319. [PMID: 26635779 PMCID: PMC4658449 DOI: 10.3389/fmicb.2015.01319] [Citation(s) in RCA: 57] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2015] [Accepted: 11/09/2015] [Indexed: 11/13/2022] Open
Abstract
Paracoccidioides brasiliensis and P. lutzii are etiologic agents of paracoccidioidomycosis (PCM), an important endemic mycosis in Latin America. During its evolution, these fungi have developed characteristics and mechanisms that allow their growth in adverse conditions within their host through which they efficiently cause disease. This process is multi-factorial and involves host-pathogen interactions (adaptation, adhesion, and invasion), as well as fungal virulence and host immune response. In this review, we demonstrated the glycoproteins and polysaccharides network, which composes the cell wall of Paracoccidioides spp. These are important for the change of conidia or mycelial (26°C) to parasitic yeast (37°C). The morphological switch, a mechanism for the pathogen to adapt and thrive inside the host, is obligatory for the establishment of the infection and seems to be related to pathogenicity. For these fungi, one of the most important steps during the interaction with the host is the adhesion. Cell surface proteins called adhesins, responsible for the first contact with host cells, contribute to host colonization and invasion by mediating this process. These fungi also present the capacity to form biofilm and through which they may evade the host's immune system. During infection, Paracoccidioides spp. can interact with different host cell types and has the ability to modulate the host's adaptive and/or innate immune response. In addition, it participates and interferes in the coagulation system and phenomena like cytoskeletal rearrangement and apoptosis. In recent years, Paracoccidioides spp. have had their endemic areas expanding in correlation with the expansion of agriculture. In response, several studies were developed to understand the infection using in vitro and in vivo systems, including alternative non-mammal models. Moreover, new advances were made in treating these infections using both well-established and new antifungal agents. These included natural and/or derivate synthetic substances as well as vaccines, peptides, and anti-adhesins sera. Because of all the advances in the PCM study, this review has the objective to summarize all of the recent discoveries on Paracoccidioides-host interaction, with particular emphasis on fungi surface proteins (molecules that play a fundamental role in the adhesion and/or dissemination of the fungi to host-cells), as well as advances in the treatment of PCM with new and well-established antifungal agents and approaches.
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Affiliation(s)
- Haroldo C de Oliveira
- Faculdade de Ciências Farmacêuticas, UNESP - Universidade Estadual Paulista, Campus Araraquara, Departamento de Análises Clínicas, Laboratório de Micologia Clínica São Paulo, Brazil
| | - Patrícia A Assato
- Faculdade de Ciências Farmacêuticas, UNESP - Universidade Estadual Paulista, Campus Araraquara, Departamento de Análises Clínicas, Laboratório de Micologia Clínica São Paulo, Brazil
| | - Caroline M Marcos
- Faculdade de Ciências Farmacêuticas, UNESP - Universidade Estadual Paulista, Campus Araraquara, Departamento de Análises Clínicas, Laboratório de Micologia Clínica São Paulo, Brazil
| | - Liliana Scorzoni
- Faculdade de Ciências Farmacêuticas, UNESP - Universidade Estadual Paulista, Campus Araraquara, Departamento de Análises Clínicas, Laboratório de Micologia Clínica São Paulo, Brazil
| | - Ana C A de Paula E Silva
- Faculdade de Ciências Farmacêuticas, UNESP - Universidade Estadual Paulista, Campus Araraquara, Departamento de Análises Clínicas, Laboratório de Micologia Clínica São Paulo, Brazil
| | - Julhiany De Fátima Da Silva
- Faculdade de Ciências Farmacêuticas, UNESP - Universidade Estadual Paulista, Campus Araraquara, Departamento de Análises Clínicas, Laboratório de Micologia Clínica São Paulo, Brazil
| | - Junya de Lacorte Singulani
- Faculdade de Ciências Farmacêuticas, UNESP - Universidade Estadual Paulista, Campus Araraquara, Departamento de Análises Clínicas, Laboratório de Micologia Clínica São Paulo, Brazil
| | - Kaila M Alarcon
- Faculdade de Ciências Farmacêuticas, UNESP - Universidade Estadual Paulista, Campus Araraquara, Departamento de Análises Clínicas, Laboratório de Micologia Clínica São Paulo, Brazil
| | - Ana M Fusco-Almeida
- Faculdade de Ciências Farmacêuticas, UNESP - Universidade Estadual Paulista, Campus Araraquara, Departamento de Análises Clínicas, Laboratório de Micologia Clínica São Paulo, Brazil
| | - Maria J S Mendes-Giannini
- Faculdade de Ciências Farmacêuticas, UNESP - Universidade Estadual Paulista, Campus Araraquara, Departamento de Análises Clínicas, Laboratório de Micologia Clínica São Paulo, Brazil
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25
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Brown SG, Shirachi S, Zandbergen D. HEALTH SELECTION THEORY: AN EXPLANATION FOR THE PARADOX BETWEEN PERCEIVED MALE WELL-BEING AND MORTALITY. QUARTERLY REVIEW OF BIOLOGY 2015; 90:3-21. [PMID: 26434163 DOI: 10.1086/679761] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Paradoxically, men report better health and quality of life than women, but men experience higher mortality rates than women at most ages. One conclusion from these findings is that men have been selected to disregard signs of ill health, or even to deceive themselves about their health, to their detriment because presenting themselves as healthy has fitness benefits. We hypothesize that men have been sexually selected to present themselves to women as healthy but that the cost of not attending to their minor health problems results in earlier mortality than women. We present a review of the human and primate literature that supports health selection theory, the hypothesis that females have preferentially selected males who present themselves as healthy.
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26
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Tavares AH, Fernandes L, Bocca AL, Silva-Pereira I, Felipe MS. Transcriptomic reprogramming of genus Paracoccidioides in dimorphism and host niches. Fungal Genet Biol 2015; 81:98-109. [DOI: 10.1016/j.fgb.2014.01.008] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2013] [Revised: 01/27/2014] [Accepted: 01/31/2014] [Indexed: 01/04/2023]
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27
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Rubtsova K, Marrack P, Rubtsov AV. TLR7, IFNγ, and T-bet: their roles in the development of ABCs in female-biased autoimmunity. Cell Immunol 2014; 294:80-3. [PMID: 25541140 PMCID: PMC4380581 DOI: 10.1016/j.cellimm.2014.12.002] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2014] [Revised: 12/04/2014] [Accepted: 12/05/2014] [Indexed: 01/21/2023]
Abstract
The majority of autoimmune diseases have a strong gender bias, affecting mostly females. Gender-specific factors like sex-hormones, the presence or absence of a second X chromosome, and gender-specific gut microbiota may contribute to this bias. In this review we will discuss the role of the X chromosome encoded toll-like receptor 7 (TLR7) and interferon gamma (IFNγ) in the development of autoimmunity. We will also review recent data indicating how these factors may affect an immune response in a gender-dependent manner.
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Affiliation(s)
- Kira Rubtsova
- Howard Hughes Medical Institute, Denver, CO 80206, USA; Department of Biomedical Science, National Jewish Health and Department of Immunology and Microbiology, University of Colorado Health Sciences Center, Denver, CO 80206, USA.
| | - Philippa Marrack
- Howard Hughes Medical Institute, Denver, CO 80206, USA; Department of Biomedical Science, National Jewish Health and Department of Immunology and Microbiology, University of Colorado Health Sciences Center, Denver, CO 80206, USA; Department of Medicine, University of Colorado School of Medicine, Aurora, CO 80045, USA; Department of Biochemistry and Molecular Genetics, University of Colorado Health Sciences Center, Aurora, CO 80045, USA
| | - Anatoly V Rubtsov
- Howard Hughes Medical Institute, Denver, CO 80206, USA; Department of Biomedical Science, National Jewish Health and Department of Immunology and Microbiology, University of Colorado Health Sciences Center, Denver, CO 80206, USA
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28
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Cousineau SV, Alizon S. Parasite evolution in response to sex-based host heterogeneity in resistance and tolerance. J Evol Biol 2014; 27:2753-66. [PMID: 25376168 DOI: 10.1111/jeb.12541] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2013] [Revised: 10/22/2014] [Accepted: 10/23/2014] [Indexed: 12/17/2022]
Abstract
Heterogenity between sexes in terms of both the level and the type of immune response to infection is documented in many species, but its role on parasite evolution is only beginning to be explored. We adopt an evolutionary epidemiology approach to study how the ability of a host to respond to infection through active immunity (resistance) or through minimizing deleterious effects of a given parasite load (tolerance) affects the evolution of parasite virulence. Consistently with earlier models, we find that increases in host resistance and tolerance both favour more virulent parasite strains. However, we show that qualitatively different results can be obtained if dimorphism between the sexes occurs through resistance or through tolerance depending on the contact pattern between the sexes. Finally, we find that variations in host sex ratio can amplify the consequences of heterogeneity for parasite evolution. These results are analysed in the light of several examples from the literature to illustrate the prevalence of sexually dimorphic immune responses and the potential for further study of the role of sexual dimorphism on parasite evolution. Such studies are likely to be highly relevant for improving treatment of chronic infections and control of infectious diseases, and understanding the role of sex in immune function.
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Affiliation(s)
- S V Cousineau
- Laboratoire MIVEGEC (UMR CNRS 5290, IRD 224, UM1, UM2), Montpellier Cedex 5, France
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29
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Magalhães EMDS, Ribeiro CDF, Dâmaso CS, Coelho LFL, Silva RR, Ferreira EB, Rodrigues MR, Camargo ZPD, Velloso TRG, Malaquias LCC. Prevalence of paracoccidioidomycosis infection by intradermal reaction in rural areas in Alfenas, Minas Gerais, Brazil. Rev Inst Med Trop Sao Paulo 2014; 56:281-5. [PMID: 25076426 PMCID: PMC4131811 DOI: 10.1590/s0036-46652014000400002] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2013] [Accepted: 01/28/2014] [Indexed: 01/11/2023] Open
Abstract
This study aimed to estimate the prevalence of paracoccidioidal infection by intradermal reaction (Delayed-Type Hypersensitivity, DTH) to Paracoccidioides brasiliensis in rural areas in Alfenas, Southern Minas Gerais (MG) State, Brazil, and to assess risk factors (gender, occupation, age, alcohol intake and smoking) associated with infection. We conducted a population-based cross-sectional study using intradermal tests with gp 43 paracoccidioidin in 542 participants, who were previously contacted by local health agents and so spontaneously attended the test. Participants underwent an interview by filling out a registration form with epidemiological data and were tested with an intradermal administration of 0.1 mL of paracoccidioidin in the left forearm. The test was read 48 hours after injection and was considered positive if induration was greater than or equal to 5 mm. Out of 542 participants, 46.67% were positive to the skin test. Prevalence increased in accordance with an increase of age. There was statistical significance only for males. Occupation, alcohol intake and smoking habits were not significantly associated with the risk of paracoccidioidomycosis infection. There is relevance of paracoccidioidomycosis infection in such rural areas, which suggests that further epidemiological and clinical studies on this mycosis should be done in the southern part of Minas Gerais State.
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Affiliation(s)
| | | | - Carla Silva Dâmaso
- Instituto de Ciências Biomédicas, Universidade Federal de Alfenas, MG, Brazil
| | | | | | | | - Maria Rita Rodrigues
- Faculdade de Ciências Farmacêuticas, Universidade Federal de Alfenas, MG, Brazil
| | - Zoilo Pires de Camargo
- Departamento de Biologia Celular, Universidade Federal do Estado de São Paulo, SP, Brazil
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30
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Bernin H, Lotter H. Sex bias in the outcome of human tropical infectious diseases: influence of steroid hormones. J Infect Dis 2014; 209 Suppl 3:S107-13. [PMID: 24966190 DOI: 10.1093/infdis/jit610] [Citation(s) in RCA: 80] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
Numerous investigations have revealed a bias toward males in the susceptibility to and severity of a variety of infectious diseases, especially parasitic diseases. Although different external factors may influence the exposure to infection sources among males and females, one recurrent phenomenon indicative of a hormonal influence is the simultaneous increase in disease occurrence and hormonal activity during the aging process. Substantial evidence to support the influence of hormones on disease requires rigorously controlled human population studies, as well as the same sex dimorphism being observed under controlled laboratory conditions. To date, only very few studies conducted have fulfilled these criteria. Herein, we introduce tropical infectious diseases, including amebiasis, malaria, leishmaniasis, toxoplasmosis, schistosomiasis, and paracoccidioidomycosis, in which hormones are suspected to play a role in disease processes. We summarize the most recent findings from epidemiologic studies in humans and from hormone replacement studies in animal models, as well as data regarding the influence of hormones on immune responses underlying the pathology of the diseases.
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Affiliation(s)
- Hannah Bernin
- Department of Molecular Parasitology, Bernhard Nocht Institute for Tropical Medicine, Hamburg, Germany
| | - Hanna Lotter
- Department of Molecular Parasitology, Bernhard Nocht Institute for Tropical Medicine, Hamburg, Germany
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31
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Nhamoyebonde S, Leslie A. Biological differences between the sexes and susceptibility to tuberculosis. J Infect Dis 2014; 209 Suppl 3:S100-6. [PMID: 24966189 DOI: 10.1093/infdis/jiu147] [Citation(s) in RCA: 140] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Globally, far more men than women have tuberculosis. Although the cause of this bias is uncertain, epidemiological factors have historically been considered the driving force. Here, we discuss evidence that biological differences between the sexes may also be important and can affect susceptibility to mycobacterial infection. We discuss the possible underlying mechanisms, with particular focus on how sex hormones modulate the immune responses necessary for resistance to tuberculosis. Studying these differences may provide valuable insight into the components that constitute an effective immune response to this deadly pathogen.
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Affiliation(s)
- Shepherd Nhamoyebonde
- KwaZulu-Natal Research Institute for Tuberculosis and HIV, Nelson R. Mandela School of Medicine, University of KwaZulu-Natal, Durban, South Africa
| | - Alasdair Leslie
- KwaZulu-Natal Research Institute for Tuberculosis and HIV, Nelson R. Mandela School of Medicine, University of KwaZulu-Natal, Durban, South Africa
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Cardoso RMN, Jham BC, do Carmo GM, Batista AC, de Oliveira FA, de Paula ÉC, Mesquita RA, da Silva TA, Duarte ECB. The relation between FoxP3+regulatory T cells and fungal density in oral paracoccidioidomycosis: a preliminary study. Mycoses 2014; 57:771-4. [DOI: 10.1111/myc.12226] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2014] [Revised: 06/13/2014] [Accepted: 07/23/2014] [Indexed: 11/28/2022]
Affiliation(s)
| | - Bruno Correia Jham
- College of Dental Medicine - Illinois; Midwestern University; Downers Grove IL USA
| | - Gabriela Mota do Carmo
- Department of Pathology; Institute of Tropical Pathology and Public Health; Federal University of Goiás; Goiânia Brazil
| | - Aline Carvalho Batista
- Department of Oral Pathology; School of Dentistry; Federal University of Goiás; Goiânia Brazil
| | - Flávia Aparecida de Oliveira
- Department of Pathology; Institute of Tropical Pathology and Public Health; Federal University of Goiás; Goiânia Brazil
| | - Élbio Candido de Paula
- Department of Anatomic Pathology; Araújo Jorge Hospital; Association of Cancer Combat of Goiás; Goiânia Brazil
| | - Ricardo Alves Mesquita
- Department of Oral Surgery and Pathology; School of Dentistry; Federal University of Minas Gerais; Belo Horizonte Brazil
| | - Tarcília Aparecida da Silva
- Department of Oral Surgery and Pathology; School of Dentistry; Federal University of Minas Gerais; Belo Horizonte Brazil
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Vrachnis N, Zygouris D, Iliodromiti Z, Daniilidis A, Valsamakis G, Kalantaridou S. Probing the impact of sex steroids and menopause-related sex steroid deprivation on modulation of immune senescence. Maturitas 2014; 78:174-8. [PMID: 24852404 DOI: 10.1016/j.maturitas.2014.04.014] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2014] [Revised: 04/17/2014] [Accepted: 04/18/2014] [Indexed: 12/22/2022]
Abstract
Immune senescence denotes the general decline in immune system function, characterized by a reduced immune response and an increased inflammatory state. Menopause is a natural change in a women's life, the menopause-related low estrogen levels affecting many body functions, among them the immune system. Numerous human studies with menopausal women and animal models with surgically induced menopause show a clear impact of sex steroids in immune responses. Female superiority in vaccination response and predisposition to infections are eliminated after menopause, while during menopause inflammatory cytokines such as Tumor Necrosis Factor-α (TNF-α), Interleukins-1β, 6, 8 and 13 (IL-1β, IL-6, IL-8, IL-13) and Monocyte Chemoattractant Protein-1 (MCP-1) are increased, implying a molecular connection of sex steroid loss with immune senescence. Moreover, immune cells modify their number and function after the menopausal transition, this offering another explanation for immune senescence. Until now most of the existing studies have concluded that menopause plays an additional role to aging in immune senescence. While it is clear that we are as yet far from thoroughly understanding the molecular pathways connecting sex steroids and menopause with immune senescence, such knowledge is highly likely to enable future targeted interventions in treatment and prevention of age-related diseases in women.
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Affiliation(s)
- Nikolaos Vrachnis
- 2nd Department of Obstetrics and Gynecology, University of Athens Medical School, Aretaieio Hospital, Athens, Greece.
| | | | - Zoe Iliodromiti
- Department of Neonatology, University of Athens Medical School, Aretaieio Hospital, Athens, Greece
| | - Angelos Daniilidis
- Department of Obstetrics and Gynecology, University of Thessaloniki Medical School, Ippokrateio Hospital, Thessaloniki, Greece
| | - Georgios Valsamakis
- 2nd Department of Obstetrics and Gynecology, University of Athens Medical School, Aretaieio Hospital, Athens, Greece
| | - Sophia Kalantaridou
- Department of Obstetrics and Gynecology, University of Ioannina Medical School, Ioannina University Hospital, Ioannina, Greece
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Oliveira DTD, Sherlock J, Melo EVD, Rollemberg KCV, Paixão TRSD, Abuawad YG, Simon MDV, Duthie M, Jesus ARD. Clinical variables associated with leprosy reactions and persistence of physical impairment. Rev Soc Bras Med Trop 2014; 46:600-4. [PMID: 24270251 DOI: 10.1590/0037-8682-0100-2013] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2013] [Accepted: 10/04/2013] [Indexed: 11/22/2022] Open
Abstract
INTRODUCTION Leprosy is a chronic disease that affects skin and peripheral nerves. Disease complications include reactional episodes and physical impairment. One World Health Organization (WHO) goal of leprosy programs is to decrease the number of grade 2 impairment diagnoses by 2015. This study aims to evaluate clinical factors associated with the occurrence of leprosy reactions and physical impairment in leprosy patients. METHODS We conducted a retrospective study of data from medical records of patients followed in two important centers for the treatment of leprosy in Aracaju, Sergipe, Brazil, from 2005 to 2011. We used the chi-square test to analyze associations between the following categorical variables: gender, age, operational classification, clinical forms, leprosy reactions, corticosteroid treatment, and physical impairment at the diagnosis and after cure. Clinical variables associated with multibacillary leprosy and/or reactional episodes and the presence of any grade of physical impairment after cure were evaluated using the logistic regression model. RESULTS We found that men were more affected by multibacillary forms, reactional episodes, and grade 2 physical impairment at diagnosis. Leprosy reactions were detected in a total of 40% of patients and all were treated with corticosteroids. However, physical impairment was observed in 29.8% of the patients analyzed at the end of the treatment and our multivariate analysis associated a low dose and short period of corticosteroid treatment with persistence of physical impairments. CONCLUSIONS Physical impairment should receive an increased attention before and after treatment, and adequate treatment should be emphasized.
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Baltazar LDM, Santos PC, Paula TPD, Rachid MA, Cisalpino PS, Souza DG, Santos DA. IFN-γ impairs Trichophyton rubrum proliferation in a murine model of dermatophytosis through the production of IL-1β and reactive oxygen species. Med Mycol 2014; 52:293-302. [PMID: 24577006 DOI: 10.1093/mmy/myt011] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Trichophyton rubrum is the main etiological agent of dermatophytosis, an infection of the skin that affects millions of people worldwide. In this study, we developed a murine model of the dermatophytosis caused by T. rubrum in which C57BL/6 wild-type, interleukin (IL)-12(-/-), and interferon-gamma (IFN-γ(-/-)) mice were inoculated with 1 × 10(6) conidia/animal. The fungal burden, myeloperoxidase and N-acetylglucosaminidase activities, cytokine and chemokine profiles, and histopathology of the skin were evaluated on the seventh and fourteenth days post infection. Phagocytic indices, intracellular proliferation rates, and oxidative bursts generated by macrophages from WT and IFN-γ(-/-) mice were determined. On day 7 post infection, higher fungal burdens were observed comparison with burdens on day 14 post infection. The IL-12(-/-) and IFN-γ(-/-) mice showed higher fungal burdens on the skin and lower levels of IL-1β. Conversely, the WT mice showed lower fungal burdens with higher production of TNF-α, IL-1β, and chemokine ligand 1/keratinocyte chemoattractant (CXCL1/KC). The macrophages from WT mice proved to be more efficient at engulfing and killing T. rubrum conidia through the production of reactive oxygen species. The results show that our model is a useful tool for understanding the pathogenesis of dermatophytosis caused by T. rubrum and that IL-12 and IFN-γ are pivotal in controlling the infection through the recruitment and activation of neutrophils and macrophages.
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Affiliation(s)
- Ludmila de Matos Baltazar
- Departamento de Microbiologia, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Belo Horizonte Minas Gerais
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Medeiros VLSD, Arruda L. Sarcoid-like lesions in paracoccidioidomycosis: immunological factors. An Bras Dermatol 2013; 88:113-6. [PMID: 23539015 PMCID: PMC3699936 DOI: 10.1590/s0365-05962013000100017] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2011] [Accepted: 11/08/2012] [Indexed: 11/22/2022] Open
Abstract
The clinical presentation of paracoccidioidomycosis is spectral. Spontaneous cure,
state of latency or active disease with different levels of severity can occur after
the hematogenous dissemination. The morphology and number of skin lesions will depend
on the interaction of host immunity, which is specific and individual, and fungus
virulence. Some individuals have natural good immunity, which added to the low
virulence of the fungus maintain the presence of well-marked granulomas with no
microorganism and negative serology for a long time, making the diagnosis a
challenge. Factors inherent to the fungus, however, may modulate the immune response
and modify the clinical picture over the time. We present a sarcoidosis-like clinical
presentation and discuss the immunological factors involved.
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Sterclova M, Matej R, Mandakova P, Skibova J, Vasakova M. Role of interleukin 4 and its receptor in clinical presentation of chronic extrinsic allergic alveolitis: a pilot study. Multidiscip Respir Med 2013; 8:35. [PMID: 23721656 PMCID: PMC3682858 DOI: 10.1186/2049-6958-8-35] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2013] [Accepted: 05/03/2013] [Indexed: 11/10/2022] Open
Abstract
Background Th-2 cytokine milieu including interleukin 4 (IL-4) was detected in fibrotic lung diseases. Chronic extrinsic allergic alveolitis (EAA) may be also accompanied by marked fibrogenesis. The aim of this study was to determine if IL-4 and its receptor (IL-4R-alpha) play any role in the clinical presentation and pathogenesis of chronic EAA. Methods Twenty patients originally investigated for interstitial lung disease and finally diagnosed affected with chronic EAA and sarcoidosis were prospectively enrolled into the study. Concentrations of IL-4, IL-4R-aplha and total protein were assessed in the bronchoalveolar lavage fluid (BALF) of all enrolled subjects as well as high resolution computed tomography (HRCT) scores and pulmonary function tests. Results BALF IL-4R-alpha and total protein concentrations were significantly higher in chronic EAA patients (p < 0.05). Concentrations of BALF IL-4R-alpha were significantly higher in men than in women (p < 0.05) in EAA group. Total protein BALF levels were significantly elevated in ex-smokers with EAA compared to nonsmokers (p < 0.05). A positive correlation (p < 0.01) between IL-4R-alpha BALF concentrations and HRCT interstitial scores were observed in chronic EAA group; the IL-4R-alpha/total protein ratio showed the same significant positive correlation. A negative correlation between lung function results and IL-4R-alpha, and IL-4R-alpha/total protein as well, was also found (p < 0.05). Conclusions We suggest a clinical relevance for the IL-4/IL-4R axis in the etiopathogenesis of chronic EAA. IL-4R-alpha could serve as a potential biomarker of lung fibrogenesis.
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Affiliation(s)
- Martina Sterclova
- Department of Respiratory Diseases, ThomayerHospital, Videnska 800, Prague 4 140 00, Czech Republic.
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Sex differences in prophylaxis and therapeutic treatments for viral diseases. Handb Exp Pharmacol 2013:499-522. [PMID: 23027464 DOI: 10.1007/978-3-642-30726-3_22] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
The intensity and prevalence of viral infections are typically higher in males than in females. In contrast, disease outcome can be worse for females. Males and females also differ in their responses to prophylaxis and therapeutic treatments for viral diseases. In response to vaccines against herpes viruses, hepatitis viruses, influenza viruses, and others, females consistently mount higher humoral immune responses and experience more frequent and severe adverse reactions than males. Males and females also differ in the absorption, metabolism, and clearance of antiviral drugs. The pharmacological effects, including toxicity and adverse reactions, of antiviral drugs are typically greater in females than males. The efficacy of antiviral drugs at reducing viral load also differs between the sexes, with antiviral treatments being better at clearing HIV and hepatitis C virus in females, but showing greater reduction of herpes simplex virus and influenza A virus loads in males. Biological variables, including hormone and genes, as well as gender-specific factors related to access and compliance to drug regimens must be considered when evaluating male-female differences in responses to treatments for viral diseases. Clinicians, epidemiologists, and basic biomedical scientists should design experiments that include both males and females, develop a priori hypotheses that the sexes will differ in their responses to and the outcome of vaccines and antiviral treatments, and statistically analyze outcome data by sex. Knowledge that the sexes differ in response to prophylaxis and therapeutic treatments for viral diseases should influence the recommended course of treatment differently for males and females.
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Sasaki M, Fujii Y, Iwamoto M, Ikadai H. Effect of sex steroids on Babesia microti infection in mice. Am J Trop Med Hyg 2012; 88:367-75. [PMID: 23249689 DOI: 10.4269/ajtmh.2012.12-0338] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
Sex-based-differences are known to affect susceptibility to protozoan infections, but their effects on parasitemia and clinical symptoms in Babesia infections remain unclear. We examined the sex-based susceptibility of various mouse strains to Babesia microti Munich strain infection. In all strains, male mice exhibited significantly higher peak parasitemia and more severe anemia than female mice. Testosterone and estradiol-17β treatment caused an increase in parasitemia and aggravation of anemia. Orchidectomized male mice receiving testosterone exhibited smaller splenic macrophage populations three days after infection, smaller B cell populations 10 days after infection, and reduced splenic tumor necrosis factor-α and interferon-γ mRNA expression than mice that did not receive testosterone. Mice receiving estradiol-17β did not exhibit immunosuppressive effects. Thus, a weakened and delayed innate immunity response may lead to acquired immunity failure. The results suggested that testosterone directly affects T or B cells, leading to delayed acquired immunity, dramatically increased parasitemia, and severe anemia.
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Affiliation(s)
- Mizuki Sasaki
- Department of Veterinary Parasitology, School of Veterinary Medicine, Kitasato University, Towada, Aomori, Japan.
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Klein SL. Sex influences immune responses to viruses, and efficacy of prophylaxis and treatments for viral diseases. Bioessays 2012; 34:1050-9. [PMID: 23012250 DOI: 10.1002/bies.201200099] [Citation(s) in RCA: 186] [Impact Index Per Article: 15.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
The intensity and prevalence of viral infections are typically higher in males, whereas disease outcome can be worse for females. Females mount higher innate and adaptive immune responses than males, which can result in faster clearance of viruses, but also contributes to increased development of immunopathology. In response to viral vaccines, females mount higher antibody responses and experience more adverse reactions than males. The efficacy of antiviral drugs at reducing viral load differs between the sexes, and the adverse reactions to antiviral drugs are typically greater in females than males. Several variables should be considered when evaluating male/female differences in responses to viral infection and treatment: these include hormones, genes, and gender-specific factors related to access to, and compliance with, treatment. Knowledge that the sexes differ in their responses to viruses and to treatments for viral diseases should influence the recommended course of action differently for males and females. Editor's suggested further reading in BioEssays X-chromosome-located microRNAs in immunity: Might they explain male/female differences Abstract.
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Affiliation(s)
- Sabra L Klein
- The W. Harry Feinstone Department of Molecular Microbiology and Immunology, Department of Biochemistry and Molecular Biology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
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Age-specific sex-related differences in infections: a statistical analysis of national surveillance data in Japan. PLoS One 2012; 7:e42261. [PMID: 22848753 PMCID: PMC3407080 DOI: 10.1371/journal.pone.0042261] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2012] [Accepted: 07/03/2012] [Indexed: 11/19/2022] Open
Abstract
Background To prevent and control infectious diseases, it is important to understand how sex and age influence morbidity rates, but consistent clear descriptions of differences in the reported incidence of infectious diseases in terms of sex and age are sparse. Methods and Findings Data from the Japanese surveillance system for infectious diseases from 2000 to 2009 were used in the analysis of seven viral and four bacterial infectious diseases with relatively large impact on the Japanese community. The male-to-female morbidity (MFM) ratios in different age groups were estimated to compare incidence rates of symptomatic reported infection between the sexes at different ages. MFM ratios were >1 for five viral infections out of seven in childhood, i.e. male children were more frequently reported as infected than females with pharyngoconjunctival fever, herpangina, hand-foot-and-mouth disease, mumps, and varicella. More males were also reported to be infected with erythema infectiosum and exanthema subitum, but only in children 1 year of age. By contrast, in adulthood the MFM ratios decreased to <1 for all of the viral infections above except varicella, i.e. adult women were more frequently reported to be infected than men. Sex- and age-related differences in reported morbidity were also documented for bacterial infections. Reported morbidity for enterohemorrhagic Escherichia coli infection was higher in adult females and females were reportedly more infected with mycoplasma pneumonia than males in all age groups up to 70 years. Conclusions Sex-related differences in reported morbidity for viral and bacterial infections were documented among different age groups. Changes in MFM ratios with age may reflect differences between the sexes in underlying development processes, including those affecting the immune, endocrine, and reproductive systems, or differences in reporting rates.
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Abstract
Males and females have the same immunological cells, proteins, and pathways in place to protect against the development of disease. The kinetics, magnitude, and skewing of the responses mounted against pathogens, allergens, toxins, or self-antigens, however, can differ dramatically between the sexes. Generally, females mount higher innate and adaptive immune responses than males, which can result in faster clearance of pathogens but also contributes to increased susceptibility to inflammatory and autoimmune diseases in females compared with males. Hormonal and genetic factors contribute significantly to sex differences in immune function and disease pathogenesis. In particular, the expression of X-linked genes and microRNA as well as sex steroid hormones signaling through hormone receptors in immune cells can affect responses to immunological stimuli differently in males and females. Despite data illustrating profound differences between the sexes in immune function, sex differences in the pathogenesis of disease are often overlooked in biomedical research. Establishing journal policies that require authors to report the sex of their cells, animals, and subjects will improve our understanding of the pathogenesis of diseases, with the long-term goal of personalizing treatments for immune-mediated diseases differently for males and females in an effort to protect us equally.
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Affiliation(s)
- Sabra L Klein
- The W. Harry Feinstone Department of Molecular Microbiology and Immunology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland 21205, USA.
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Bordes F, Ponlet N, de Bellocq JG, Ribas A, Krasnov BR, Morand S. Is there sex-biased resistance and tolerance in Mediterranean wood mouse (Apodemus sylvaticus) populations facing multiple helminth infections? Oecologia 2012; 170:123-35. [DOI: 10.1007/s00442-012-2300-5] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2011] [Accepted: 03/01/2012] [Indexed: 10/28/2022]
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Sifuentes-Osornio J, Corzo-León DE, Ponce-de-León LA. Epidemiology of Invasive Fungal Infections in Latin America. CURRENT FUNGAL INFECTION REPORTS 2012; 6:23-34. [PMID: 22363832 PMCID: PMC3277824 DOI: 10.1007/s12281-011-0081-7] [Citation(s) in RCA: 64] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
The pathogenic role of invasive fungal infections (IFIs) has increased during the past two decades in Latin America and worldwide, and the number of patients at risk has risen dramatically. Working habits and leisure activities have also been a focus of attention by public health officials, as endemic mycoses have provoked a number of outbreaks. An extensive search of medical literature from Latin America suggests that the incidence of IFIs from both endemic and opportunistic fungi has increased. The increase in endemic mycoses is probably related to population changes (migration, tourism, and increased population growth), whereas the increase in opportunistic mycoses may be associated with the greater number of people at risk. In both cases, the early and appropriate use of diagnostic procedures has improved diagnosis and outcome.
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Affiliation(s)
- Jose Sifuentes-Osornio
- Laboratory of Microbiology, Salvador Zubiran National Institute of Medical Science and Nutrition, 15 Vasco de Quiroga, sección XVI, Tlalpan, México City, ZC 14000 Mexico
| | - Dora E. Corzo-León
- Infectious Diseases, Salvador Zubiran National Institute of Medical Science and Nutrition, México City, Mexico
| | - L. Alfredo Ponce-de-León
- Laboratory of Microbiology, Salvador Zubiran National Institute of Medical Science and Nutrition, 15 Vasco de Quiroga, sección XVI, Tlalpan, México City, ZC 14000 Mexico
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Fortes MRP, Miot HA, Kurokawa CS, Marques MEA, Marques SA. Immunology of paracoccidioidomycosis. An Bras Dermatol 2012; 86:516-24. [PMID: 21738969 DOI: 10.1590/s0365-05962011000300014] [Citation(s) in RCA: 63] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2010] [Indexed: 11/22/2022] Open
Abstract
Paracoccidioidomycosis is the most prevalent systemic mycosis in Latin America, among immunecompetent patients. It's caused by the dimorphic fungus Paracoccidioiddes brasiliensis. Investigations regarding its immunopathogenesis are very important in the understanding of aspects related to natural history, as the protective immunity, and the relationship between host and parasite; also favoring the knowledge about clinical patterns and the elaboration of therapeutic strategies. The disease clinical polymorphism depends, at least, of the immune response profile according to the tissue and blood released citokynes, resulting in tissue damage.
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Engelmann F, Barron A, Urbanski H, Neuringer M, Kohama SG, Park B, Messaoudi I. Accelerated immune senescence and reduced response to vaccination in ovariectomized female rhesus macaques. AGE (DORDRECHT, NETHERLANDS) 2011; 33:275-289. [PMID: 20814751 PMCID: PMC3168610 DOI: 10.1007/s11357-010-9178-0] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/06/2010] [Accepted: 08/19/2010] [Indexed: 05/29/2023]
Abstract
Aging is associated with a general dysregulation in immune function, commonly referred to as "immune senescence". Several studies have shown that female sex steroids can modulate the immune response. However, the impact of menopause-associated loss of estrogen and progestins on immune senescence remains poorly understood. To help answer this question, we examined the effect of ovariectomy on T-cell homeostasis and function in adult and aged female rhesus macaques. Our data show that in adult female rhesus macaques, ovariectomy increased the frequency of naïve CD4 T cells. In contrast, ovariectomized (ovx) aged female rhesus macaques had increased frequency of terminally differentiated CD4 effector memory T cells and inflammatory cytokine-secreting memory T cells. Moreover, ovariectomy reduced the immune response (T-cell cytokine and IgG production) following vaccination with modified vaccinia ankara in both adult and aged female rhesus macaques compared to ovary-intact age-matched controls. Interestingly, hormone therapy (estradiol alone or in conjunction with progesterone) partially improved the T-cell response to vaccination in aged ovariectomized female rhesus macaques. These data suggest that the loss of ovarian steroids, notably estradiol and progesterone, may contribute to reduced immune function in post-menopausal women and that hormone therapy may improve immune response to vaccination in this growing segment of the population.
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Affiliation(s)
- Flora Engelmann
- Vaccine and Gene Therapy Institute, Oregon Health and Science University, 505 NW 185th Avenue, Beaverton, OR 09006 USA
| | - Alex Barron
- Vaccine and Gene Therapy Institute, Oregon Health and Science University, 505 NW 185th Avenue, Beaverton, OR 09006 USA
| | - Henryk Urbanski
- Department of Physiology and Pharmacology, Oregon Health and Science University, Portland, OR 97239 USA
- Department of Behavioral Neuroscience, Oregon Health and Science University, Portland, OR 97239 USA
- Division of Neuroscience, Oregon National Primate Research Center, Beaverton, OR 97006 USA
| | - Martha Neuringer
- Division of Neuroscience, Oregon National Primate Research Center, Beaverton, OR 97006 USA
| | - Steven G. Kohama
- Division of Neuroscience, Oregon National Primate Research Center, Beaverton, OR 97006 USA
| | - Byung Park
- Division of Biostatistics, Department of Public Health and Preventive Medicine, Oregon Health and Science University, Portland, OR 97239 USA
| | - Ilhem Messaoudi
- Vaccine and Gene Therapy Institute, Oregon Health and Science University, 505 NW 185th Avenue, Beaverton, OR 09006 USA
- Division of Neuroscience, Oregon National Primate Research Center, Beaverton, OR 97006 USA
- Division of Pathobiology and Immunology, Oregon National Primate Research Center, Beaverton, OR 97006 USA
- Division of Reproductive Sciences, Oregon National Primate Research Center, Beaverton, OR 97006 USA
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Abstract
Paracoccidioidomycosis, one of the most important endemic and systemic mycoses in Latin America, presents several clinical pictures. Epidemiological studies indicate a striking rarity of disease (but not infection) in females, but only during the reproductive years. This suggested a hormonal interaction between female hormones and the etiologic dimorphic fungus Paracoccidioides brasiliensis. Many fungi have been shown to use hormonal (pheromonal) fungal molecules for intercellular communication, and there are increasing numbers of examples of interactions between mammalian hormones and fungi, including the specific binding of mammalian hormones by fungal proteins, and suggestions of mammalian hormonal modulation of fungal behavior. This suggests an evolutionary conservation of hormonal receptor systems. We recount studies showing the specific hormonal binding of mammalian estrogen to proteins in P. brasiliensis and an action of estrogen to specifically block the transition from the saprophytic form to the invasive form of the fungus in vitro. This block has been demonstrated to occur in vivo in animal studies. These unique observations are consistent with an estrogen-fungus receptor-mediated effect on pathogenesis. The fungal genes responsive to estrogen action are under study.
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McClelland EE, Smith JM. Gender specific differences in the immune response to infection. Arch Immunol Ther Exp (Warsz) 2011; 59:203-13. [PMID: 21442309 DOI: 10.1007/s00005-011-0124-3] [Citation(s) in RCA: 130] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2010] [Accepted: 12/15/2010] [Indexed: 12/17/2022]
Abstract
There are many instances where males and females differ in the susceptibility to infections. The reason for these differences in susceptibility is multifactorial. The primary cause is thought to be due to differences induced by sex hormones and their effects on gene expression as well as the immune system, but may also be due to innate physiological differences between males and females. This review summarizes gender specific differences seen in infections caused by bacteria, fungi, parasites and viruses. Ultimately, gender specific differences appear to be dependent on the microbe causing the infection, as not every infection with a specific microbial type results in increased susceptibility of one gender over the other. This suggests that there is an interaction between gender specific immune differences and the specific immune response to individual microbes.
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Affiliation(s)
- Erin E McClelland
- Department of Basic Sciences, The Commonwealth Medical College, 501 Madison Avenue, Scranton, PA 18510, USA.
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Abstract
Fungal diseases represent an important paradigm in immunology, as they can result from either a lack of recognition by the immune system or overactivation of the inflammatory response. Research in this field is entering an exciting period of transition from studying the molecular and cellular bases of fungal virulence to determining the cellular and molecular mechanisms that maintain immune homeostasis with fungi. The fine line between these two research areas is central to our understanding of tissue homeostasis and its possible breakdown in fungal infections and diseases. Recent insights into immune responses to fungi suggest that functionally distinct mechanisms have evolved to achieve optimal host-fungus interactions in mammals.
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Fernandes VC, Martins EMN, Boeloni JN, Coitinho JB, Serakides R, Goes AM. Additive effect of rPb27 immunization and chemotherapy in experimental paracoccidioidomycosis. PLoS One 2011; 6:e17885. [PMID: 21423771 PMCID: PMC3053394 DOI: 10.1371/journal.pone.0017885] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2010] [Accepted: 02/16/2011] [Indexed: 11/19/2022] Open
Abstract
Paracoccidioidomycosis, PCM, the major systemic mycosis in Latin America, is caused by the termally dimorphic fungus Paracoccidioides brasiliensis and requires extended periods of chemotherapy with a significant frequency of relapsing disease. The search for new alternatives of treatment is necessary. rPb27 is an antigenic protein from P. brasiliensis that already showed a significant protective activity as a vaccine for PCM in experimental models. The cDNA of rPb27 was subcloned into a pET-DEST 42 plasmid, expressed in E. coli with a his-tag and purified by affinity chromatography. Immunization with this recombinant protein and chemotherapy were used together in an attempt to improve treatment of PCM. For this, BALB/c mice were challenged with pathogenic P. brasiliensis strain and after immunized with rPb27, in the presence of Corynebacterium parvum and Al(OH)3, some groups were also treated with fluconazole. After 40 days of treatment, the combined drug/rPb27 administration controlled PCM in the liver and spleen, with long lasting protection, and largely preserved tissues structures of these organs. Additionally, in the lungs after 40 days of treatment there was a significant reduction in the fungal load and size of lesions. At the same time, the levels of TNF-α were higher than infected-only mice. Moreover, significant levels of anti-rPb27 specific IgG1, IgG2a and IgG2b isotypes were detected in the sera of mice immunized with rPb27 fluconazole treated or not. These results showed an additive protective effect of rPb27 immunization and chemotherapy, suggesting that an rPb27-based vaccine can be used to enhance PCM antifungal treatment.
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Affiliation(s)
- Viviane C Fernandes
- Departamento de Bioquímica e Imunologia, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil.
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