Alcohol consumption and immune cell profiles: Insights from the Framingham Heart Study

Alcohol consumption influences immune function, with excessive intake linked to immune suppression and inflammation. However, its effect on immune cell phenotypes remains uncertain. A study explored the relationship between alcohol consumption and immune cell profiles in a Framingham Heart Study (FHS) cohort, while also examining sex-specific differences in the associations between alcohol and immune cells.
The researchers analysed data from 996 participants of the FHS Offspring cohort who underwent immune cell phenotyping and completed an alcohol questionnaire during Exam 7 (1998-2001). Alcohol intake was categorised as abstainer, moderate, at-risk, or heavy drinking. Associations between alcohol intake and 15 immune cell phenotypes were analysed, adjusting for age, sex, and Cytomegalovirus (CMV) (Model 1) and additional covariates (Model 2). False discovery rate (FDR) correction was applied for multiple testing.
The CD4+ Tn/Tm ratio measures the balance between naive (Tn) and memory (Tm) CD4+ T cells in the immune system, indicating the health and function of T-cell populations. A higher CD4+ Tn/Tm ratio typically shows more naive T cells relative to memory T cells, whereas a lower ratio suggests a larger proportion of memory cells. This ratio can be an indicator of immune health, immunosenescence (age-related immune decline), and disease progression or prognosis in conditions like cancer and viral infections. The CD8+ Tn/Tm ratio refers to the ratio of naive (Tn) to memory (Tm) CD8+ T cells in blood or tissue, with a higher ratio often signalling a healthier, less antigen-experienced immune system, as naive T cells have the ability to mount diverse immune responses. Conversely, a lower ratio, especially in chronic infections or ageing, can indicate more frequent immune encounters and potential signs of senescence or exhaustion.
The CD4+ Tn/Tm ratio demonstrated a significant nonlinear relationship with alcohol categories in Model 1, with higher ratios in moderate (β = 0.26) and at-risk drinkers (β = 0.26) compared to abstainers; effects were smaller in Model 2 (β = 0.23 and β = 0.23, respectively). Sex-stratified analyses showed that among males, alcohol consumption was linked to several immune cell phenotypes in Model 1, and to the CD8+ Tn/Tm ratio in Model 2, where moderate drinking was associated with a higher CD8+ Tn/Tm ratio compared to abstainers (β = 0.29). Among male drinkers, consumption level was also associated with the CD8+ Tn/Tm ratio in both models: at-risk and heavy consumption correlated with significantly lower CD8+ Tn/Tm ratios compared to moderate drinkers (β = -0.43 and β = -0.46, respectively, in Model 2).
Alcohol consumption shows a nonlinear relationship with certain immune cells, where moderate intake may benefit immunity, whereas higher consumption could disrupt immune homeostasis. The authors note that, due to the study’s cross-sectional design, causality cannot be established; however, the sex-specific, dose-dependent findings deserve confirmation in longitudinal cohorts.
Source: Ragab AAY, Doyle MF, Chen J, Lunetta KL, & Murabito JM. (2025) Alcohol consumption and immune cell profiles: Insights from the Framingham Heart Study. Alcoholism: Clinical and Experimental Research (Hoboken).