Different clinical presentation between male and female patients with Puumalavirus infection. Are the clinical differences related to expression of different oestrogen receptor subtypes?
Abstract number: R2338
Brundin P., Zhao C., Dahlman-Wright K., Ahlm C., Evengård B.
Objectives: To investigate the expression of estrogen receptor (ER) mRNA in peripheral blood mononuclear cells during Puumala virus infection (nephropathia epidemica).
Methods: Ambulatory and in-patients (n = 20, male/female: 10/10) at Umeå university hospital with confirmed nephropathia epidemica (NE) were followed with routine blood chemistry and sampled for peripheral blood mononuclear cells (PBMC) during day 1 and 3 and a follow-up convalescent sample after 12 weeks. The PBMC were stored in -70°C until RNA was extracted using RNeasy kit (Quiagen). cDNA synthesis was performed and expression of ER a, ER b and ER b cx (mRNA splice variant of ER b) were quantitatively estimated using real-time PCR (Applied Biosystems). The multiple variables from the blood chemistry, relative expression levels of ERs mRNA, sex, and day of onset of the disease were related to each other in a principal component analysis (PCA)(SIMCA-P, v 220.127.116.11).
Results: ER a is expressed in higher quantities than ER b cx. ER b (wild type) could not be detected. ER a is correlated to a rise in white blood cells (WBC) (p = 0.0004) in the total group of patients (n = 20) and divided into males (n = 10) and females (n = 10), a correlation is seen between ER a and urea (p = 0.03), C-reactive protein (CRP) (p = 0.04) and WBC (p = 0.01) in the male patient group, compared to a correlation between ER a and WBC (p = 0.04) in the female patient group. The PCA show a distinct dichotomy of male and female samples. Female samples tend to be correlated to a higher level of ER a, and male samples to higher levels of ER b cx.
Conclusion: Our results from the PCA indicate a different clinical presentation in men and women with NE. This could explain that more men than women (25:1) receive the clinical diagnosis NE although the serological distribution is 1:1. Females were associated with higher levels of ER a and males with ER b cx. ER b cx is known to dimerize with ER a and thereby prevent the normal function of ER a. A larger study is needed to confirm the role of ER a and ER b cx in this disease.
|Session name:||Abstracts 20th European Congress of Clinical Microbiology and Infectious Diseases|
|Location:||Vienna, Austria, 10 - 13 April 2010|
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