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09/11/2021 - Press release

Differences in lung disease severity between women and men determined for the first time

The physiology of women and men does not react in the same way to either diseases or treatments. A new example can be found in a recent multicentre study led by the Muscle Wasting and Cachexia in Chronic Respiratory Diseases and Lung Cancer research group at the Hospital del Mar Medical Research Institute (IMIM-Hospital del Mar), published in the journal Biomedicines. The study highlights the fact that the sex of the patient affected by bronchiectasis, a lung disease, is a determining factor in establishing its severity, making it necessary to take this finding into account when monitoring the patient.

Autors de l'estudi. D'esquerra a dreta, Yingchen Xia, Xuejie Wang, Liyun Qin, Maria Guitart, Esther Barreiro, Mireia Admetlló, Mariela Alvarado i Jianhua Zha

The study analysed data on 2,121 patients from the Spanish Computerised Registry of Patients with Bronchiectasis (Registre Informatitzat Espanyol de Pacients amb Bronquièctasi; RIBRON), of whom two out of three (1,368) were women. Several clinical parameters were taken into account when classifying their level of severity on three different scales, including clinical parameters such as lung function, sputum, nutritional status, colonisation by more aggressive germs and the radiological extent of the bronchiectasis. Taking these factors into account, women had clearly lower severity indices than men on all three clinical scales used in the study. In this respect, it is worth noting that there were more smokers in the group of men. There were also important differences in nutritional parameters between the two sexes, with a higher body mass index seen in men than in women.

"These results indicate that, for patients with bronchiectasis, it is necessary to take their sex into account when considering the management of the disease", says Dr. Esther Barreiro, lead author of the study and a researcher at the IMIM and the CIBER on Respiratory Diseases (CIBERES). She also points out that the study shows several nutritional parameters, as well as inflammation biomarkers, should be studied as potential predictors of patient evolution.

Eosinophil levels as a marker of severity

A second study, also led by Dr. Barreiro, analysed the blood concentrations of eosinophils, an immune system cell present in the lungs in response to the inflammatory process caused by bronchiectasis, from 906 patients from the RIBRON registry. A cut-off threshold was established to divide the sample. Contrary to expectations, the patients with the highest concentrations, 70% of the total, were those with the least severe disease. Conversely, those with lower eosinophil concentrations had more severe respiratory disease, scored higher on the severity scales, had worse lung function and a poorer nutritional status, with higher levels of systemic inflammation.

Dr. Barreiro explains that, given these data, "We need to better characterise patients with bronchiectasis in customised phenotypic profiles to offer personalised treatment strategies, especially in those with low eosinophil concentrations." She goes on to say that, "This fact must be taken into account when choosing certain treatments that target these cells, to avoid any reduction that could lead to the patients' condition deteriorating." The study will be published in the International Journal of Environmental Research and Public Health.

Reference articles

Wang, X.; Villa, C.; Dobarganes, Y.; Olveira, C.; Girón, R.; García-Clemente, M.; Maíz, L.; Sibila, O.; Golpe, R.; Menéndez, R.; Rodríguez-López, J.; Prados, C.; Martinez-García, M.A.; Rodriguez, J.L.; de la Rosa, D.; Duran, X.; Barreiro, E. Differences in Nutritional Status and Inflammatory Biomarkers between Female and Male Patients with Bronchiectasis: A Large-Cohort Study. Biomedicines 2021, 9, 905. https://doi.org/10.3390/biomedicines9080905

Wang, X.; Villa, C.; Dobarganes, Y.; Olveira, C.; Girón, R.; García-Clemente, M.; Máiz, L.; Sibila, O.; Golpe, R.; Menéndez, R.; Rodríguez-López, J.; Prados, C.; Martinez-García, M.A.; Rodriguez, J.L.; de la Rosa, D.; Duran, X.; Garcia-Ojalvo, J.; Barreiro, E. Phenotypic Clustering in Non-Cystic Fibrosis Bronchiectasis Patients: The Role of Eosinophils in Disease Severity. Int. J. Environ. Res. Public Health 2021, 18, 8431. https://doi.org/10.3390/ijerph18168431

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