Immunity, inflammation and disease
Dynamic Shifts in Lymphocyte Subsets During the Menopausal Transition and Sexual Dimorphism in Immunosenescence
By Xuan C, He L, Bohan Z and 3 others.
Abstract
Background
Immunosenescence demonstrates marked sexual dimorphism, yet the dynamic changes in lymphocyte subsets across the female menopausal transition are poorly defined. This study characterized these age- and sex-related immune variations in a large Chinese cohort.
Methods
In this cross-sectional study, we analyzed 4209 healthy adults using flow cytometry to quantify lymphocyte subsets and PD-1 expression. Females were stratified by age and reproductive stage. Sex comparisons were performed after propensity score age-matching.
Results
Analysis of the female cohort revealed dynamic immune shifts during the menopausal transition, characterized by a "scissor-like" pattern: CD3+CD4+ T cells (%) and the CD4/CD8 ratio peaked at 55-59 years, while CD3+CD8+ T cells (%) declined continuously (all p < 0.001). Notably, CD19+ B cells (%) increased with age in females but decreased in males. After age-matching, pronounced sexual dimorphism was confirmed: females exhibited significantly higher levels of CD3+ T cells, CD3+CD4+ T cells, CD19+ B cells, NK cells, and CD4/CD8 ratio, alongside lower PD-1 expression on CD4+ T cells and NK cells (all p < 0.001). In contrast, PD-1 expression on CD8+ T cells was higher in females (p < 0.001).