Gender Differences in Pulmonary Function, Respiratory Symptoms, and Macrophage Proteomics among HIV-Infected Smokers

Abstract

Background. HIV-infected subjects have an increased incidence of pulmonary emphysema. There are known gender differences in COPD phenotypic expression and diagnosis, but this is not well characterized in lung disease related to HIV. We analyzed a group at risk for the development of COPD (HIV-infected smokers) to determine gender differences in pulmonary symptoms, pulmonary function tests, and HRCT appearances. Methods. This was a cross-sectional, baseline analysis of a prospective study performed between 2006 and 2010. We performed symptomatic, pulmonary function, and computed tomography assessments in 243 HIV-infected smokers. In a subset bronchoalveolar lavage was performed with proteomic analysis of their alveolar macrophages. Results. The majority of the participants were male 213 (87.6%). There was significantly higher percentage of cough and phlegm production in males. There was also a lower FEV1 and a higher RV in males than females. Proteomic analysis revealed 29 proteins with at least a 2-fold higher expression in males and 13 identified proteins that were higher in females. Conclusions. In this group of HIV-infected smokers, airway symptoms and pulmonary function test abnormalities were higher in men than women. These gender differences may be due to differential expression of certain proteins in this group.

Classification, diagnosis of reversibility and severity assessment of patients having respiratory distress based on pulmonary function test

“…There was a significantly higher percentage of cough and phlegm production in males. There was also a lower FEV1 and a higher RV in males than females [7]. It is in accordance with the present study where it was founded that 72% of patients with abnormal PFTs are male, rest 28% are females.…”

Impaired Lung Function Due to Occupation by Exposure to Particulate Matter 2.5m (PM2.5) in Fish Smokers

“…The same results were also shown in Rahmanian's research that women had a significantly lower FEV1/FVC ratio than men (18) This can be influenced because women have smaller lung anatomy than men. Lung volume, lung elasticity, lung strength and respiratory muscle coordination will influence the peak expiratory flow (peak expiratory flow) therefore women can have lower peak expiratory flow values than men (10)…”

HIV and chronic lung disease

“…The propensity of PLWH toward COPD was first noted in 1992 when Diaz and colleagues reported 4 PLWH who had emphysema-like bullous changes, air trapping, hyperinflation, and reduced diffusion capacity, but no previous history of pulmonary infections [40]. Since then, in the cART era, the estimated prevalence of COPD has ranged between as low as less than 5% to upwards of 60% of cohorts, with definitions as varied as self-report [41,42], spirometry-confirmed [43][44][45][46][47][48][49][50][51][52][53][54][55][56][57][58][59], computed tomography (CT) presence of emphysema [60][61][62][63][64][65][66][67], International Classification of Diseases (ICD) diagnostic codes [68][69][70][71][72][73][74][75][76][77], or chart review [78,79]. A 2018 meta-analysis reported pooled prevalence values of 10.5-10.6% by spirometry, 5.6% by ICD diagnostic codes, and 8.7% by patient selfreport [80].…”