This guest blog was submitted by the Society for for Women’s Health Research and is being published in conjunction with National Women’s Health Week, which is May 11-17.
Autoimmune diseases (ADs) are conditions characterized by inflammatory responses from misdirected attacks by the immune system on the body’s organ systems. Currently, there are more than 80 ADs that have been identified, and they are the third most common major illness in the United States. These diseases can affect any part of the body, from the heart, to the brain, to the eyes and digestive tract. ADs affect roughly 7-10 percent of the U.S. population, and disproportionately affect women, who make up nearly 80 percent of patients with ADs.
Even worse, ADs are the fifth leading cause of death among women under age 65. The diseases can significantly impact a woman’s daily life, due to their chronic nature and the presence of additional diseases and disorders that occur simultaneously. The high health care costs, loss of work productivity, reduced quality of life and potentially lifelong disabilities demonstrate the impact of ADs on society and individuals.
There are sex differences when it comes to autoimmunity; these differences are biological and physiological differences between women and men. Sex chromosomes and the gonadal hormones primarily contribute to these differences at the cellular, organ and system levels. A combination of environmental, social and cultural influences on the biological factors also contributes to sex differences. Women have stronger immune systems compared to men, which increases their resistance to infections but also increases their susceptibility to autoimmune diseases.
This evolutionary change has helped protect women in their reproductive roles. Women are 2.7 times more likely than men to acquire an AD, typically during their childbearing years. Other factors can increase a woman’s likelihood of acquiring an AD, such as family history, environmental exposures to chemicals, viral and bacterial infections, and racial or ethnic background.
In several rare autoimmune diseases, women are also disproportionately affected. Myasthenia gravis, a rare disease in which the immune system attacks the nerves and muscles throughout the body, has a sex distribution of up to 75 percent. Antiphospholipid antibody syndrome, Graves’ disease and hemolytic anemia are only a few of the numerous ADs that affect women more than men. By increasing research into biological sex differences, not only can we better understand common ADs, but we can apply that knowledge to the diagnosis and treatment of rare diseases.
Many well-known diseases disproportionately affect women; among patients with rheumatoid arthritis, multiple sclerosis and myasthenia gravis, the sex distribution is 60 to 75 percent female. In some ADs, this female patient population rises to 80 percent or more, particularly in scleroderma, lupus and autoimmune thyroid disease.
The Society for Women’s Health Research (SWHR®) is the leading advocate for increased research on biological differences in disease conditions and is dedicated to transforming women’s health through science, policy, and education. SWHR has advocated for the increased study of sex differences in ADs for several years. In 2012, SWHR convened an interdisciplinary roundtable discussion of expert researchers in Washington, D.C., to discuss the role of environment and sex differences on AD and factors contributing to the rise in AD rates.
The roundtable discussion resulted in several research recommendations, which can be found in a meeting report published by SWHR in 2013. Although progress has been made in AD research, by expanding further to other ADs, including rare diseases, we can better understand the genetic, environmental and sex-based factors that may have contributed to the rise in AD prevalence in recent decades. More research into sex differences is needed to help us understand why men and women are differently affected by ADs, particularly in rare diseases. Ultimately, this knowledge will help diagnose, treat and improve the quality of life for millions of American women who suffer from these diseases.
This piece was written by guest bloggers: Jessica Pic, MFA, Online Communications Coordinator, and Monica Mallampalli, PhD, Director of Scientific Programs
Mallampalli, Monica P., Erika Davies, Debra Wood, Hillary Robertson, Federica Polato, and Christine L. Carter. “Role of Environment and Sex Differences in the Development of Autoimmune Diseases: A Roundtable Meeting Report.” Journal of Women’s Health 22.7 (2013): 578-86. Print.
“Autoimmune Diseases Fact Sheet.” Womenshealth.gov. Office on Women’s Health, 16 July 2012. Web. 28 Apr. 2014.
“Autoimmune Diseases.” – Society for Women’s Health Research. SWHR, n.d. Web. 28 Apr. 2014.
RareDisease Dialog is the official blog for the National Organization for Rare Disorders (NORD). NORD’s staff and friends will share information of interest to the entire rare disease community.
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