Women and autoimmune diseases: Understanding causes, trends, and treatments

Equity in healthcare series – part 4

Introduction

Autoimmune diseases occur when the immune system malfunctions and mistakenly attacks the body’s healthy cells, tissues, and organs. According to the National Institutes of Health (NIH), women are disproportionately affected—four out of five individuals with an autoimmune disease are female.

How many autoimmune diseases exist?

The Autoimmune Association reports that there are over 100 known autoimmune diseases. Some of the most common include:

• Type 1 diabetes
• Celiac disease
• Psoriasis
• Graves’ disease
• Hashimoto’s disease
• Inflammatory bowel disease (IBD)
• Rheumatoid arthritis
• Multiple sclerosis (MS)
• Lupus

Why are autoimmune diseases on the rise?

Autoimmune diseases are increasing at an alarming rate—between 3% and 12% annually, according to the National Health Council. Experts suggest several contributing factors, including:

• Genetics
• Dietary changes
• Pollution & chemical exposure
• Climate change
• Chronic stress & lifestyle factors
• Infections & viral triggers

What are more women affected?

Researchers are exploring the role of the X chromosome in autoimmune diseases. A molecule called Xist, involved in X-chromosome inactivation, may create abnormal RNA combinations that trigger strong immune responses.

Environmental and lifestyle factors

• Stress: Up to 80% of autoimmune patients report experiencing emotional stress before disease onset.
• Gut health: Diet and environmental factors can disrupt the gut microbiome, contributing to immune dysfunction.
• UV radiation: Overexposure has been linked to lupus and Sjogren’s disease.
• Air pollution: Exposure has been associated with increased lupus risk.
• Chronic viral infections: Viruses may act as autoimmune triggers.

Treatment and future innovations

While most autoimmune diseases have no cure, treatments help manage symptoms and slow progression. Common approaches include:

• Anti-inflammatory medications
• Corticosteroids
• Immunosuppressants
• Pain management
• Physical therapy
• Surgery (for severe cases)

Looking ahead, precision therapies such as CAR-T cell therapy and CRISPR-based gene editing are emerging as potential treatments, offering hope for the future.

Conclusion

As research advances, understanding triggers, risk factors, and novel therapies will be crucial in combating autoimmune diseases.

This is part four of a series about disparities and a call for equity in healthcare. In future installments, we will explore inequities in treatment access across other high risk diseases, the impact of socioeconomic factors, and emerging advocacy efforts aimed at closing these healthcare gaps.

Read more

• Women and migraines: Understanding the impact, triggers, and treatment
• Social Determinants of Health (SDOH) and Their Impact on Breast Cancer Medication Adherence
• Pharmacy deserts: A growing problem in the U.S.
• Understanding the disparities: Why Black Americans suffer from higher rates of diabetes
• What is sickle cell disease?

References

• Autoimmune Diseases. National Institute of Environmental Health Sciences: https://www.niehs.nih.gov/health/topics/conditions/autoimmune
• Autoimmune Awareness Month. Autoimmune Association: https://autoimmune.org/autoimmune-awareness-month/
• Understanding sex differences in autoimmune disease. National Institutes of Health. February 13, 2024: https://www.nih.gov/news-events/nih-research-matters/understanding-sex-differences-autoimmune-disease#:~:text=Four%20of%20every%20five%20people,easily%20triggered%20in %20the%20other.
• Autoimmune disorders. MedlinePlus: https://medlineplus.gov/ency/article/000816.htm#:~:text=A%20person%20may%20have%20more,Type%20I%20diabetes
• Murray, Molly. Guest Blog: A Major Health Crisis: The Alarming Rise of Autoimmune Disease. National Health Council. March 28, 2024: https://nationalhealthcouncil.org/blog/a-major-health-crisis-the-alarming-rise-of-autoimmune-disease/
• Miller, Frederick W. The Increasing Prevalence of Autoimmunity and Autoimmune Disease: An Urgent Call to Action for Improved Understanding, Diagnosis, Treatment and Prevention. Current Opinion in Immunology. Volume 80. February 2023: https://pmc.ncbi.nlm.nih.gov/articles/PMC9918670/#:~:text=Multiple%20lines%20of%20evidence%20suggest,psychosocial%20stress%2C%20and%20climate%20change.
• Goldman, Bruce. Stanford Medicine- led study shows why women are at greater risk of autoimmune disease. Stanford Medicine. February 1, 2024: https://med.stanford.edu/news/all-news/2024/02/women-autoimmune.html
• Stress & Autoimmune Disease: Navigating the Complex Relationship. Global Autoimmune Institute. June 3, 2024: https://www.autoimmuneinstitute.org/articles/stress-autoimmune-disease-navigating-the-complex-relationship/
• Ray, Carly and Ming, Xue. Climate Change and Human Health: A Review of Allergies, Autoimmunity and the Microbiome. International Journal of Environmental Research and Public Health. July 2020:
  https://pmc.ncbi.nlm.nih.gov/articles/PMC7369820/#:~:text=4.,possible%20vector%20of%20this%20dysbiosis.
• Casey, Olivia. Guest blog: Climate Change and its Impact on Autoimmune Disease. National Health Council. October 24, 2024: https://nationalhealthcouncil.org/blog/guest-blog-climate-change-and-its-impact-on-autoimmune-disease/#:~:text=A%20key%20driver%20in%20some,linked%20to%20 ultraviolet%20radiation%20exposure.
• Zhao, Chan-Na, Xu, Zhiwei, Wu, Guo-Cui, Mao, Yan-Mei et al. Emerging role of air pollution in autoimmune diseases. Autoimmunity Review. June 2019:
  https://pubmed.ncbi.nlm.nih.gov/30959217/#:~:text=Mechanisms%20linking%20air%20pollution%20exposures,Autoimmunity;%20Citrullination;%20Particulate%20matter.
• Sundaresan, Bhargavi, Shirafkhan, Fatemah, Ripperger, Kevin, and Rattay, Kristin. The Role of Viral Infections in the Onset of Autoimmune Diseases. Viruses. March 2023: https://pmc.ncbi.nlm.nih.gov/articles/PMC10051805/
• Autoimmune disorders. BetterHealth Channel. Victoria State Government. Department of Health:
  https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/autoimmune-disorders
• Parry, Wynne. The Immunotherapy Revolution for Autoimmune Diseases. August 12, 2023:
  https://www.pennmedicine.org/news/publications-and-special-projects/penn-medicine-magazine/immune-health/the-immunotherapy-revolution-for-autoimmune-diseases
• De Pasquale, Sue. Precision Therapies for Autoimmune Diseases. Johns Hopkins Medicine. February 7, 2024: https://www.hopkinsmedicine.org/news/articles/2024/02/precision-therapies-for-autoimmune-diseases

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