McGowan Institute for Regenerative Medicine faculty members Derek Angus, MD, MPH, FRCP, FCCM, FCCP (pictured top), vice chair for research in the Department of Critical Care Medicine, University of Pittsburgh School of Medicine (top), and John Kellum, MD, FACP, FCCM (pictured bottom), professor of Critical Care Medicine at the University of Pittsburgh (bottom), were co-authors along with other colleagues on a study which recently reported that men who come to the hospital with pneumonia generally are sicker than women and have a higher risk of dying over the next year, despite aggressive medical care. The study’s findings, despite adjustments for health behaviors and chronic conditions, may be linked to differences in immune response.
The study team of University of Pittsburgh researchers evaluated data from 1,136 men and 1,047 women with symptoms of pneumonia who were treated at 28 hospital emergency departments in the United States. Investigators adjusted results for age, race, tobacco use, other demographic characteristics, chronic health conditions, health behaviors, and levels of treatment. On average, men arrived at the emergency departments with poorer vital signs, were more likely to be smokers, and had a greater variety of complicating health conditions. After hospitalization, men received timely antibiotic treatments more often than women and were twice as likely to be admitted immediately to intensive-care units.
Using the patient data, the study team next examined a series of molecules important to the body’s immune response to infection, finding significant differences between men and women in levels of tumor necrosis factor, interleukin-6, interleukin-10, antithrombin III, Factor IX, plasminogen activator inhibitor-1, and D-dimer. By comparison between the genders, some concentrations were lower, while others were higher.
Gender differences in immune response to infection are an area of intensive research, with investigations into the role of X chromosomes, which encode genes for several important immune system mediators.
Dr. Angus is also a professor in Critical Care Medicine and Health Policy and Management at the University of Pittsburgh. Dr. Kellum is also a transplant physician in anesthesiology at the Thomas E. Starzl Transplantation Institute and co-director at the Mechanisms and Novel Therapies for Resuscitation and Acute Illness (MANTRA) Lab.
Presentation at the 104th International Conference of the American Thoracic Society, 05/16-21/08, Toronto, Canada: Sex Disparities in Treatment and Outcome of Community-Acquired Pneumonia. M.C. Reade, M.B.B.S., D.Phil., F.J.F.I.C.M., S. Yende, M.D., M., G. DAngelo, Ph.D., E.B. Milbrandt, M.D., M., J.A. Kellum, M.D., A.E. Barnato, M.D., M., F.B. Mayr, M.D., L.A. Weissfeld, Ph.D., D.C. Angus, M.D., M.
Illustration: McGowan Institute for Regenerative Medicine.
UPMC/University of Pittsburgh Schools of the Health Sciences Media Relations (05/18/08)
Medical News Today (05/19/08)
Science Blog (05/19/08)