Sex and autoimmunity: proposed mechanisms of disease onset and severity

Carlo Selmi, M. Eric Gershwin

Research output: Contribution to journalReview article

1 Citation (Scopus)

Abstract

Introduction: Chronic autoimmune diseases affect 5–10% of the population worldwide and are largely predominant in women. Sex hormone changes have been widely investigated based on changes in the clinical phenotypes observed during pregnancy and menopause. It is known that females with autoimmune diseases manifest a higher rate of circulating leukocytes with a single X chromosome, and there have been several reports on the role of X chromosome gene dosage through inactivation or duplication in autoimmunity. However, it is also important not to overlook men with autoimmune diseases, who might manifest a more frequent loss of the Y chromosome in circulating leukocytes. Areas covered: In the present review, we will discuss the current evidence supporting the mechanisms of female predominance in rheumatic diseases, by discussing the role of reproductive history, sex hormones and abnormalities related to them, clinical differences between male and female patients, and epigenetic changes that have been evaluated through twin studies on genetic and environmental changes in rheumatic patients. Expert opinion: The influence of sex hormones and chromosomes on the function of the innate and adaptive immune systems needs to be clarified, to better understand the risk of autoimmune diseases, early diagnostic tools, and therapeutic response.

Original languageEnglish (US)
Pages (from-to)607-615
Number of pages9
JournalExpert Review of Clinical Immunology
Volume15
Issue number6
DOIs
StatePublished - Jun 3 2019

Fingerprint

Autoimmunity
Autoimmune Diseases
Gonadal Steroid Hormones
Leukocytes
X-Linked Genes
Reproductive History
Twin Studies
Sex Chromosomes
Gene Dosage
Y Chromosome
Expert Testimony
X Chromosome
Menopause
Rheumatic Diseases
Epigenomics
Immune System
Chronic Disease
Phenotype
Pregnancy
Population

Keywords

  • epigenetics
  • estrogen
  • Gender medicine
  • rheumatic diseases
  • sex chromosome
  • twins

ASJC Scopus subject areas

  • Immunology and Allergy
  • Immunology

Cite this

Sex and autoimmunity : proposed mechanisms of disease onset and severity. / Selmi, Carlo; Gershwin, M. Eric.

In: Expert Review of Clinical Immunology, Vol. 15, No. 6, 03.06.2019, p. 607-615.

Research output: Contribution to journalReview article

@article{e7a05922b94546e1a89356aa43017e95,
title = "Sex and autoimmunity: proposed mechanisms of disease onset and severity",
abstract = "Introduction: Chronic autoimmune diseases affect 5–10{\%} of the population worldwide and are largely predominant in women. Sex hormone changes have been widely investigated based on changes in the clinical phenotypes observed during pregnancy and menopause. It is known that females with autoimmune diseases manifest a higher rate of circulating leukocytes with a single X chromosome, and there have been several reports on the role of X chromosome gene dosage through inactivation or duplication in autoimmunity. However, it is also important not to overlook men with autoimmune diseases, who might manifest a more frequent loss of the Y chromosome in circulating leukocytes. Areas covered: In the present review, we will discuss the current evidence supporting the mechanisms of female predominance in rheumatic diseases, by discussing the role of reproductive history, sex hormones and abnormalities related to them, clinical differences between male and female patients, and epigenetic changes that have been evaluated through twin studies on genetic and environmental changes in rheumatic patients. Expert opinion: The influence of sex hormones and chromosomes on the function of the innate and adaptive immune systems needs to be clarified, to better understand the risk of autoimmune diseases, early diagnostic tools, and therapeutic response.",
keywords = "epigenetics, estrogen, Gender medicine, rheumatic diseases, sex chromosome, twins",
author = "Carlo Selmi and Gershwin, {M. Eric}",
year = "2019",
month = "6",
day = "3",
doi = "10.1080/1744666X.2019.1606714",
language = "English (US)",
volume = "15",
pages = "607--615",
journal = "Expert Review of Clinical Immunology",
issn = "1744-666X",
publisher = "Expert Reviews Ltd.",
number = "6",

}

TY - JOUR

T1 - Sex and autoimmunity

T2 - proposed mechanisms of disease onset and severity

AU - Selmi, Carlo

AU - Gershwin, M. Eric

PY - 2019/6/3

Y1 - 2019/6/3

N2 - Introduction: Chronic autoimmune diseases affect 5–10% of the population worldwide and are largely predominant in women. Sex hormone changes have been widely investigated based on changes in the clinical phenotypes observed during pregnancy and menopause. It is known that females with autoimmune diseases manifest a higher rate of circulating leukocytes with a single X chromosome, and there have been several reports on the role of X chromosome gene dosage through inactivation or duplication in autoimmunity. However, it is also important not to overlook men with autoimmune diseases, who might manifest a more frequent loss of the Y chromosome in circulating leukocytes. Areas covered: In the present review, we will discuss the current evidence supporting the mechanisms of female predominance in rheumatic diseases, by discussing the role of reproductive history, sex hormones and abnormalities related to them, clinical differences between male and female patients, and epigenetic changes that have been evaluated through twin studies on genetic and environmental changes in rheumatic patients. Expert opinion: The influence of sex hormones and chromosomes on the function of the innate and adaptive immune systems needs to be clarified, to better understand the risk of autoimmune diseases, early diagnostic tools, and therapeutic response.

AB - Introduction: Chronic autoimmune diseases affect 5–10% of the population worldwide and are largely predominant in women. Sex hormone changes have been widely investigated based on changes in the clinical phenotypes observed during pregnancy and menopause. It is known that females with autoimmune diseases manifest a higher rate of circulating leukocytes with a single X chromosome, and there have been several reports on the role of X chromosome gene dosage through inactivation or duplication in autoimmunity. However, it is also important not to overlook men with autoimmune diseases, who might manifest a more frequent loss of the Y chromosome in circulating leukocytes. Areas covered: In the present review, we will discuss the current evidence supporting the mechanisms of female predominance in rheumatic diseases, by discussing the role of reproductive history, sex hormones and abnormalities related to them, clinical differences between male and female patients, and epigenetic changes that have been evaluated through twin studies on genetic and environmental changes in rheumatic patients. Expert opinion: The influence of sex hormones and chromosomes on the function of the innate and adaptive immune systems needs to be clarified, to better understand the risk of autoimmune diseases, early diagnostic tools, and therapeutic response.

KW - epigenetics

KW - estrogen

KW - Gender medicine

KW - rheumatic diseases

KW - sex chromosome

KW - twins

UR - http://www.scopus.com/inward/record.url?scp=85065478164&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85065478164&partnerID=8YFLogxK

U2 - 10.1080/1744666X.2019.1606714

DO - 10.1080/1744666X.2019.1606714

M3 - Review article

C2 - 31033369

AN - SCOPUS:85065478164

VL - 15

SP - 607

EP - 615

JO - Expert Review of Clinical Immunology

JF - Expert Review of Clinical Immunology

SN - 1744-666X

IS - 6

ER -