Autoimmune disease and gender: Plausible mechanisms for the female predominance of autoimmunity

Quintero, O. Lucía; Amador-Patarroyo, Manuel J.; Montoya-Ortiz, Gladys; Rojas-Villarraga, Adriana; Anaya, Juan Manuel

doi:10.1016/j.jaut.2011.10.003

Cited by 273 publications

(239 citation statements)

References 123 publications

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“…3 and seems plausible as women are significantly more often affected by autoimmune diseases than men. Five percent of the world's population have an autoimmune disease and, of them, 78% are women (79). Even in Klinefelter's syndrome, a doubled chromosome X and a low androgento-estrogen ratio were supposed to play a role in the The role of sex hormones in the pathogenesis of autoimmunity.…”

Section: The Role Of Sex Hormonesmentioning

confidence: 99%

“…In women, the onset of autoimmune diseases is earlier than that in men and often coincides with a rise in sex hormone levels (79). Accordingly, a female-to-male ratio in pre-pubertal children with chronic autoimmune thyroiditis has been shown to be significantly lower compared with pubertal adolescents or adults (1.6, 6.7, and 10.3 respectively) (81).…”

Section: European Journal Of Endocrinologymentioning

confidence: 99%

“…Autoantibody production was higher in female mice than in male mice (94). Estrogens were described to decrease the activity of T suppressor cells, increase the activity of B cells, increase also the secretion of Th2 cytokine IL6, and to direct the immune response to Th2 and the formation of antibodies (33,79). Women have a higher CD4 C /CD8 C ratio with higher CD4 C levels and more antibodies than men (79).…”

Section: European Journal Of Endocrinologymentioning

confidence: 99%

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MECHANISMS IN ENDOCRINOLOGY: Thyroid and polycystic ovary syndrome

Gaberšček

Zaletel

Schwetz

et al. 2015

European Journal of Endocrinology

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Thyroid disorders, especially Hashimoto's thyroiditis (HT), and polycystic ovary syndrome (PCOS) are closely associated, based on a number of studies showing a significantly higher prevalence of HT in women with PCOS than in controls. However, the mechanisms of this association are not as clear. Certainly, genetic susceptibility contributes an important part to the development of HT and PCOS. However, a common genetic background has not yet been established. Polymorphisms of the PCOS-related gene for fibrillin 3 (FBN3) could be involved in the pathogenesis of HT and PCOS. Fibrillins influence the activity of transforming growth factor beta (TGFb). Multifunctional TGFb is also a key regulator of immune tolerance by stimulating regulatory T cells (Tregs), which are known to inhibit excessive immune response. With lower TGFb and Treg levels, the autoimmune processes, well known in HT and assumed in PCOS, might develop. In fact, lower levels of TGFb1 were found in HT as well as in PCOS women carrying allele 8 of D19S884 in the FBN3 gene. Additionally, vitamin D deficiency was shown to decrease Tregs. Finally, high estrogen-to-progesterone ratio owing to anovulatory cycles in PCOS women could enhance the immune response. Harmful metabolic and reproductive effects were shown to be more pronounced in women with HT and PCOS when compared with women with HT alone or with controls. In conclusion, HT and PCOS are associated not only with respect to their prevalence, but also with regard to etiology and clinical consequences. However, a possible crosstalk of this association is yet to be elucidated.

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Section: The Role Of Sex Hormonesmentioning

confidence: 99%

Section: European Journal Of Endocrinologymentioning

confidence: 99%

Section: European Journal Of Endocrinologymentioning

confidence: 99%

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MECHANISMS IN ENDOCRINOLOGY: Thyroid and polycystic ovary syndrome

Gaberšček

Zaletel

Schwetz

et al. 2015

European Journal of Endocrinology

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“…It has been maintained that attention should also be directed at why men so seldom are affected, with focus on possible protective factors in men (22).…”

Section: Deviant Number Of X Chromosomes and Autoimmunitymentioning

confidence: 99%

Hvorfor er autoimmune sykdommer hyppigere hos kvinner?

Ørstavik¹

2017

Tidsskriftet

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The author has completed the ICMJE form and reports no conflicts of interest.Women are less susceptible to infectious diseases than men, but are more often prone to autoimmune diseases. This higher prevalence is partly attributable to the X chromosome, which has many genes relating to the immune system. It is advantageous for women to have two X chromosomes, but the price is a greater tendency to develop autoimmunity. Illustration: Ørjan Jensen/SuperpopWomen are healthier and live longer than men. They are less susceptible to infectious diseases (1), but on the other hand 80% of individuals with autoimmune diseases are women. These diseases affect 5-10% of the population, are often chronic, and represent a considerable burden on healthcare budgets (2, 3).The autoimmune diseases are a heterogeneous group with multifactorial causes. The common denominator is an immunological reaction that leads to the breakdown, either systemic or organ-specific, of tolerance for the subject's own tissue. Most autoimmune

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“…La raison d'une plus forte prévalence de l'HTAP chez les femmes n'est pas claire. Certaines hypothèses avancent le rôle des hormones sexuelles (oestrogènes), de l'auto-immunité, ou d'un locus lié à l'X dans la prédisposition à la maladie [13]. La théorie hormonale, qui stipule que les oestrogènes orientent vers une réponse immunitaire CD4 de type Th2, avec pour conséquence une plus forte activation des cellules B et une augmentation de la production d'anticorps est l'observation la plus convaincante pour expliquer le biais de fréquence des affections auto-immunes en faveur des femmes.…”

Section: Prédominance Féminineunclassified