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a Division of
Respiratory Medicine and Allergology, Department of Medicine,
Karolinska Institutet at Huddinge University Hospital, S-141 86 Huddinge, Sweden, b Division of Clinical Immunology and Pathology,
Departments of Immunology, Microbiology and Pathology, Karolinska
Institutet, c Respiratory
Health and Climate, National Institute of Working Life, SE-112 79 Stockholm, Sweden
Correspondence to: Dr E Mund em.mund{at}stockholm.mail.telia.com
Received 24 May 2000; Returned to authors 12 July 2000; Revised version received 12 February 2001; Accepted for publication 15 February 2001
BACKGROUND
Age related
changes in the immune system have been studied frequently but a
possible relation to sex has not, to our knowledge, previously been
examined. The effect of age and sex on the composition of lymphocyte
subsets in bronchoalveolar lavage (BAL) fluid and peripheral blood was
therefore examined.
METHODSBronchoscopy
with lavage was performed in 32 healthy non-atopic, non-smoking
volunteers (16 women aged 26-63 years (mean 44) and 16 men aged 23-63
years (mean 39)). Cytospin preparations for differential counts of BAL
fluid cells and surface antigen expression of lymphocytes from BAL
fluid and blood were analysed by flow cytometry.
RESULTSMost
parameters in the BAL fluid changed with age in women. The percentage
of CD4+ lymphocytes increased with age from a mean of 48 (SD10)% in
women aged 
40 years to 69 (11)% in women aged >43 years (p=0.001).
The percentage of CD8+ lymphocytes tended to decrease with age and the
CD4/CD8 ratio was 5.8 (1.2) in women aged >43 years compared with 2.1 (0.7) in those aged 40 years (p<0.0001). Women aged >43 years
differed from men aged >43 years as well as from younger subjects of
both sexes with respect to CD4+ cells and CD4/CD8 ratio, and from
younger women with respect to CD8+ cells. There was no age related
change in the CD4/CD8 ratio in blood. No sex related differences were
seen in the blood or BAL fluid of adults below the age of 40 years.
CONCLUSIONSThe
composition of lymphocytes with different phenotypes in the lower
respiratory tract changes with age in women but not in men. This may
have implications for some clinical conditions such as chronic dry
cough which are observed predominantly in women.
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