What makes women more susceptible to autoimmune diseases?

senior women
senior women

The third most common category of disease in the United States (number one is cardiovascular disease and number two is cancer) are autoimmune diseases, sometimes referred to as autoimmune disorders. An autoimmune disease (AD) occurs when the body’s immune system is unable to tell the difference between your own cells and those of foreign cells. This results in the body mistakenly attacking normal, healthy cells, and then depending on the location, an AD develops.

Autoimmune diseases affect both men and women, however, women are far more likely to be diagnosed with one. About 8% of the U.S. population is affected by AD but of that percentage, the overwhelming majority of these cases (78%) are in women. Due to this statistic, the National Institutes of Health has designated AD as a major health issue in women.

There are more than 80 types of AD that affect a wide range of body parts.  The most common in women are:

  • Rheumatoid arthritis, a form of arthritis that attacks the joints
  • Psoriasis, a condition marked by thick, scaly patches of skin
  • Psoriatic arthritis, a type of arthritis affecting some people with psoriasis
  • Lupus, a disease that damages areas of the body that include joints, skin, and organs
  • Thyroid disease, including Graves’ disease in which the body makes too much thyroid hormone, and Hashimoto’s thyroiditis, in which the body doesn’t make enough of the hormone.

Three theories why women are more prone to developing autoimmune diseases

AD is very complex which makes it difficult to know how to predict who may be at risk and when they may occur. Recently, studies have found evidence to support three theories to explain why women are much more likely to have ED than men:

  1. Testosterone’s protective effect against AD

It’s been known that men are far less likely to develop AD than women.  It’s believed that the male hormone testosterone may hold some clues as to why. While both men and women produce testosterone, women only have one-tenth as much of this hormone as men. A study conducted at the University of Gothenburg concluded that testosterone reduces the number of B cells, a type of lymphocyte that releases harmful antibodies. Having more testosterone as men do, suppresses the protein BAFF, which makes the harmful B cells more viable. Since women have a much smaller amount of testosterone than men, they are not able to have the same protective effect against these B cells.

A previous study, also conducted at the University of Gothenburg, also found a link between varying levels of BAFF and systemic lupus erythematosus (SLE), an AD that affects nine women for every one man.

  1. Too much VGLL3 in skin

Is it possible that one reason why women are more susceptible to developing AD than men is because of a substance found in their skin?  This is what research is theorizing.  A 2019 study from the University of Michigan found that having too much of a molecular switch called VGLL3 in skin cells can cause the immune system to go into overdrive. Women have more VGLL3 in their skin than men do – it is not understood why women do.  It is believed that this overabundance of VGLL3 could be what is leading to the immune system attacking internal organs that ultimately can lead to AD.

It has been shown that the same gene expression-level changes in skin cells with extra VGLL3 are also seen in AD’s such as lupus; men who develop lupus also show the same VGLL3 pathway activated as what is shown in women with lupus.

  1. Hormonal changes

During a woman’s lifetime, there are several major endocrine transitions that include puberty, pregnancy, and menopause. Each time a woman transitions during these phases, changes from these transitions can influence the immune system. It is believed this is due to the interaction between hormones, the immune system, and other organs in the body. Women experience more dramatic and frequent hormonal changes than men and have been suspected to be one part of the puzzle why women are more prone to AD than their male counterparts.

In conclusion

Autoimmune disease can be especially difficult to diagnose since they often share many of the same symptoms similar to other conditions. In addition, while some AD can be diagnosed with blood marker tests and tissue biopsies, unfortunately, there is no one test that can accurately diagnose all AD.

Always begin with your healthcare provider if you suspect you may have an AD and then they can refer you to a specialist.

What makes women more susceptible to autoimmune diseases?
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Dr. David Samadi

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Dr. David Samadi