A preclinical systematic review and meta-analysis assessing the effect of biological sex in lipopolysaccharide-induced acute lung injury

Am J Physiol Lung Cell Mol Physiol. 2024 Feb 13. doi: 10.1152/ajplung.00336.2023. Online ahead of print.ABSTRACTIt is unclear what effect biological sex has on the outcomes of acute lung injury (ALI). Clinical studies are confounded by their observational design. We addressed this knowledge gap with a preclinical systematic review of ALI animal studies. We searched MEDLINE and Embase for studies of intratracheal/intranasal/aerosolized lipopolysaccharide (LPS) administration, the most common ALI model, and reported sex-stratified data. Screening and data extraction were conducted in duplicate. Our primary outcome was histological tissue injury and secondary outcomes included alveolar-capillary barrier alterations and inflammatory markers. We used a random effects inverse variance meta-analysis, expressing data as standardized mean difference (SMD) with 95% confidence intervals (CI). Risk of bias was assessed using the SYRCLE tool. We identified six studies involving 132 animals across 11 independent experiments. A total of 41 outcomes were extracted, with the direction of effect suggesting greater severity in males than females in 26/41 outcomes (63%). One study reported on lung histology and found that male mice exhibited greater injury than females (SMD 1.61, 95% CI 0.53 to 2.69). Meta-analysis demonstrated significantly elevated albumin levels (SMD 2.17, 95% CI 0.63 to 3.70) and total cell counts (SMD 0.80, 95% CI 0.27 to 1.33) in bronchoalveolar lavage fluid from male mice...
Source: American Journal of Physiology. Lung Cellular and Molecular Physiology - Category: Cytology Authors: Source Type: research