For the flutamide studies, 8 week old male and female mice were implanted with either a placebo pellet or a flutamide pellet (100 mg, 21 day release, A-152; Innovative Research of America) one week prior to B16 implantation. Thus, it may be beneficial to assess hormone levels in this subset of melanoma patients and elucidate the impact that neutrophils may have on the progression of cancer. In addition, while men and women initially have a similar incidence of melanoma, the risk rises in males dramatically after age 504, correlating with an age-dependent drop in testosterone level64 and in line with our observations in castrated mice. These results need functional validation in an in vivo setting, but lead to the hypothesis that testosterone could exert an anti-inflammatory effect on macrophages which could be explored in the CHD setting (70). However, more research is warranted to demonstrate a direct effect of androgens on the function and phenotype of macrophages. Besides, macrophage dysfunction is recognized as one of the main causes for sepsis-induced immunosuppression in mice and humans (67). The impact of androgens on macrophage function has been addressed in several studies and overall point to an (immuno)suppressive effect. Macrophages and monocytes, their precursors, are the "big eaters" of the immune system. As neutrophils mature in the bone marrow, CXCR2 expression increases, whereas the expression of CXCR4 and VLA-4 decrease26. Unlike humans, mouse adrenal glands do not synthesize androgens22, so removal of the testes in these models should result in full loss of testosterone production. We observe that prostate cancer (PCa) patients undergoing androgen deprivation therapy also exhibit impairments in neutrophil maturation and function. Here, we used multiple syngeneic metastatic mouse models to elucidate the underlying cause of the sexual dimorphism in tumor burden in melanoma. Finally, STAT3 expression, which impacts the retention and release of neutrophils in the bone marrow27, was similarly decreased in castrated and female-derived neutrophils and may underlie the reduced neutrophil chemotaxis to the lung in those groups (Supplementary Fig. 3g). Similarly, female-derived neutrophils had decreased expression of CXCR2 and increased expression of VLA-4, but there was no difference in CXCR4 (Supplementary Fig. 3g). Interestingly, neutrophil depletion also led to a significant reduction in IFNγ-producing NK cells in males (Fig. 3c), indicating cross-talk between neutrophils and NK cells. Representative lung images (c) and tumor colonies numbers (d) in the lungs of Rag1−/− male and female mice following B16 tail-vein injection. In agreement with these results, there were also no significant differences in the percent of CD69-expressing or CD44-expressing T or NKT cells, although the percent of IFNγ-expressing NKT cells tended to be higher in sham male mice (Fig. 2b; Supplementary Fig. 2b). We observed no differences between sham males, castrated males, or females in the percent of lung-localized alveolar macrophages, interstitial macrophages, dendritic cells, NK cells, NKT cells, CD4+ T cells, or CD8+ T cells (Fig. 2a; Supplementary Fig. 2a). The increased tumor burden in female mice was maintained in this model, even in the setting of diet-induced weight gain and increased cholesterol (Supplementary Fig. 1d–g). Lack of Tregs in male mice and men lead to immune tolerance failure and autoimmunity in different organs. Androgens not only influence the numbers of peripheral T cells but also affect their responses. The reasons for this discrepancy remain unclear at present but it has to be taken into account that androgen deprivation therapy can also inhibit T cells via off-target effects (please see below). Thus, androgens inhibit the number and the receptor repertoire of thymic T cells entering the periphery. Consistently, this increase in peripheral T cells was reversed by androgen replacement (87). Alterations in circulating levels of gonadal steroids not only affect thymus size, but also affect thymic egression of T cells. In another autoimmune disease study, a similar sex biased effect of AIRE expression in medullar TECs (mTECs) was observed. Briefly, unstimulated cells were maintained in a 37 °C incubator for 1 and 3 h and then fixed with 4% paraformaldehyde. NETosis was induced in 2.5 × 104 neutrophils suspended in 250 μL of EBM2 media in 8-well Millicell EZ glass chamber slides (Millipore, PEZGS0816). The cells were then stained for neutrophil markers as above and analyzed by flow cytometry. The cells were lifted by incubating for 15 min in PBS/5 mM EDTA/1 mM sodium azide plus proteinase K to cleave any beads on the surface of the cells. Neutrophils from the lungs of B16-tumor bearing mice were plated at 2.5 × 105/well in a 24 well plate and 5 µL/well of FITC-labeled zymosan A S.