Infectious Disease

Challenge study shows women have worse flu scores

September 04, 2021

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A challenge study showed that women are more symptomatic than men and have more symptoms of influenza.

“We got drawn into this subject after Sabra L. Small, PhD, who is also co-author of the article, gave a talk on sex differences in influenza at the NIH. There is data from both animal and human studies that characterize differences between the biological sexes in terms of outcomes of influenza disease. ” Luca T. Giurgea, MD, a clinical assistant in the clinical trials division of the Infectious Disease Laboratory of the NIH and the National Institute of Allergies and Infectious Diseases, Healio said.

flu

Women are more likely than men to be symptomatic and more symptomatic after an influenza infection, although hemagglutination inhibitors, testosterone, and estradiol did not predict these results. Source: Adobe Stock.

Giurgea stated that animal studies have shown higher rates of inflammation and more robust immune responses in women, while human studies have also shown that women can have more robust responses to vaccines, at least in terms of hemagglutination inhibition (HAI) titers. Additionally, retrospective human studies have shown that women of childbearing age are more likely to have influenza and flu-related hospitalizations, but many factors can be “difficult to unravel,” including genetic, hormonal, cultural, or behavioral factors, Giurgea said.

Luca T. Giurgea

“Our research group has conducted numerous influenza challenge studies that offer the opportunity to separate at least some of the social determinants of disease from the biological,” said Giurgea. “That’s why we decided to pool our data from previous studies to see if we also observe differences between the sexes.”

Giurgea, Klein, and colleagues compiled data from 164 healthy volunteers who had undergone Influenza A / California / 04/2009 / H1N1 challenge and compared the gender differences. According to the study, the researchers compared baseline characteristics, including hormone levels, HAI titers, neuraminidase inhibition (NAI) titers, and post-exercise results.

Overall, the study showed that HAI titers were similar between the sexes. However, the NAI titers were higher in the males than in the females 4 weeks and 8 weeks after challenge. In addition, the study showed that women had more symptoms (0.96 vs. 0.80; P = 0.003) and a higher number of symptoms (3 vs. 4; P = .011) than men.

According to the study, the modeling showed that baseline NAI titers predict all excretion and symptom outcomes assessed in the study, while HAI titers and sex hormone levels did not.

“This study confirms the observation that women have worse clinical outcomes with influenza than men,” said Giurgea. “However, this study found this interesting difference in NAI titers that hasn’t been studied very well. More major studies need to be conducted looking for differences in NAI titers between the sexes in more general populations. “

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