Influence of sex and age on morphological organ damage after hemorrhagic shock.

Immune function after hemorrhagic shock (shock) and subsequent sepsis is proofed to be sex- and age-related, showing an enhanced immune function and better survival of young females and a deteriorating immune response in advanced age. However, it remains unclear if the observed sex- and age-related effects observed on the immune function mirror the histomorphological changes of the affected organs. To scrutinize a possible association, male and female CBA/J mice (young, 2-3 months; aged 18-19 months) were subjected to shock (35 + 5 mmHg for 90 min and fluid resuscitation) or sham operation. At 48 h after shock, histological specimen at definite sites were harvested (lung, small bowel, liver, and kidney) and immediately stored in 10% formalin. After paraffin embedding, hematoxylin-eosin stain and immunohistochemical stains (vascular cell adhesion molecule 1 [VCAM-1], cluster of differentiation 44 [CD44], signal transducers and activators of transcription 3 [STAT-3]) were performed. In both sexes, aged animals developed significantly increased (P < 0.05) tissue damage in all analyzed organs compared with young mice. Sex differences were noticed in the lungs of young mice, showing a significantly (P < 0.05) lower organ damage score in female animals. Sex-related differences were found for VCAM-1 and cluster of differentiation 44 expression, whereas age-related changes were observed for STAT-3. These results demonstrate that the severity of tissue damage caused by hemorrhagic shock is influenced by sex- and age-related effects. Variances in the VCAM-1 and STAT-3 expression suggest that improved immune function in female and young subjects may be responsible for less shock-induced tissue damage.