The Prevalence of Autoimmune Disorders in Women: A Narrative Review

Abstract

Autoimmune disorders are characterized as a condition in which the host's immune system mistakenly attacks itself. These disorders cause the immune system to cause a systemic reaction by attacking multiple organs or may be localized to attacking one specific organ, such as the skin. The exact mechanism of such autoimmune conditions is not well understood; however, the presumed mechanism tends to vary amongst the disorders. Autoimmune diseases present with a clear gender bias with a greater prevalence amongst women, occurring at a rate of 2 to 1. Many autoimmune disorders tend to affect women during periods of extensive stress, such as pregnancy, or during a great hormonal change. A far greater number of women are affected every year with autoimmune diseases, leading to researchers attempting to identify the underlying factors, which could be responsible for this disparity. Autoimmune disorders occur as a result of multiple factors as some disorders may be genetic, while others are sporadic. Throughout this review, various hypotheses are explored that provide insight into the increased susceptibility of autoimmune disorders within women.

Gender Specific Differences in Disease Susceptibility: The Role of Epigenetics

“…A differential susceptibility of males and females in developing autoimmune diseases, cancers, and infectious diseases, as well as regarding a different outcome of vaccination has been extensively documented (Table 1). Research estimated that 78% of all patients diagnosed with autoimmune pathologies are women [5].…”

Sex hormones, autoimmunity and gender disparity in COVID-19

“…These findings suggest that autoantibodies might play a role in the aetiology of COVID-19-associated coagulopathy by potentiating the already existing systemic inflammation and pro-thrombotic state and consequently lead to a severe form of the disease. It is also known that autoimmune disease are more common amongst women [ 56 ]. Further investigation is required to establish the exact basis of autoimmunity in COVID-19 and its influence on sex-based disparity of COVID-19 infections.…”

Identification of VIMP as a gene inhibiting cytokine production in human CD4+ effector T cells

“…Interestingly, the immune system presents a sexual dimorphism ( Klein and Flanagan, 2016 ), where females appear to have a stronger humoral and cellular immune response in general, making them more resistant to infectious diseases (vom Steeg and Klein, 2016 ), nevertheless, more susceptible to autoimmune diseases ( Angum et al., 2020 ; Jacobson et al., 1997 ). CD4 T cells, the focus of this study and the central orchestrators of immune responses, also show a differential sex-specific regulation ( Afshan et al., 2012 ; Aldridge et al., 2018 ; Klein and Flanagan, 2016 ).…”