ArticleRheumatology international2024
Sex bias in immune response: it is time to include the sex variable in studies of autoimmune rheumatic diseases.
Article in Rheumatology international, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers.
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Who cites it
14 citing papers in PubMed, 14 citations in OpenAlex.
- Influence of sex and systemic lupus erythematosus disease status on cerebral cortex structure.Lupus science & medicine · 2026Trial
- Demyelinating disorders in women: epidemiology, immunology, and clinical implications across MS, NMOSD, and MOGAD.Journal of neurology · 2026Review
- Comparison of innate and adaptive immune responses to joint injury during the onset and progression of post-traumatic osteoarthritis in common murine models.Scientific reports · 2026Article
- Sex-specific insights in atherosclerosis and pulmonary arterial hypertension: an overlooked comorbidity.Frontiers in cardiovascular medicine · 2026Review
- Correlation of autoantibody profiles with clinical parameters in exfoliative glaucoma patients.International ophthalmology · 2025Article
- Understanding Sex Differences in Autoimmune Diseases: Immunologic Mechanisms.International journal of molecular sciences · 2025Review
- Sex Bias in Systemic Sclerosis: from Clinical to Immunological Differences.Clinical reviews in allergy & immunology · 2025Review
- Sex Differences in the Regulation of Interleukins in Chronic Pain: A Widely Recognized but Difficult-to-Tackle Factor.International journal of molecular sciences · 2025Review
- Sex-specific and regional differences in the prevalence of diagnosed autoimmune diseases in Germany, 2022.Research in health services & regions · 2025Article
- Nonlinearity and sex differences in the performance of a polygenic risk score for juvenile idiopathic arthritis.Frontiers in immunology · 2025Article
- Association between antinuclear antibodies status and preterm birth in Japanese pregnant women: a prospective cohort study from Adjunct Study of the Japan Environment and Children's Study.BMC pregnancy and childbirth · 2024Article
- Giant cell arteritis: insights from a monocentric retrospective cohort study.Rheumatology international · 2024Article
- Epidemiology of SLE in Italy: an observational study using a primary care database.Lupus science & medicine · 2024Observational
- Exploring complex links: inflammatory rheumatic diseases and men's health.Rheumatology international · 2024Review
Corrections and comments
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Authors and funding
2 authors at 2 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Healthy females and males differ in their immune cell composition and function and females generally mount stronger immune response than males and are much more susceptible to autoimmune rheumatic diseases. Females differ from males in sex hormones, and X-chromosome genes. Sex hormones affect immune cells and responses, and may induce epigenetic DNA changes. The importance of X-chromosome genes is exemplified in men with the Klinefelter syndrome (47,XXY) who have an additional X-chromosome and develop systemic lupus erythematosus(SLE) as frequently as women. X-chromosome contains genes critical for the immune response, such as FOXP3, toll-like receptor(TLR)7, TLR8, CD40 Ligand, IL2RG, IL9R, BTK, and others. Whereas one X-chromosome in females is randomly inactivated early in embryonic development, around 25% of X-linked genes escape inactivation and result in more X-linked gene dosage in females. We use two key female-biased autoimmune rheumatic diseases, SLE and systemic sclerosis, to review differences in immune response, and clinical manifestations between females and males. The inclusion of sex variable in research will facilitate precision medicine and optimal patient outcome.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.