Week 10 ~ Autoimmune Disease in Women

Autoimmunity was named a major women's health issue by the Office of Research on Women's Health at the National Institutes of Health (NIH). This condition appears to be the underlying cause of more than 100 serious, chronic illnesses. According to the American Autoimmune Related Diseases Association (AARDA), autoimmune disease (AD) affects about 50 million Americans, and more than 75% of these individuals are women. There are more than 80 known types of autoimmune diseases, and in each one of "these ADs, the underlying problem is 'autoimmunity' - the body's immune system becomes misdirected and attacks the very organs it was designed to protect" (AARDA, 2014). When the body is unable to tell the difference between self and nonself, it produces autoantibodies that end up attacking normal cells by mistake.

There has been practically no general focus on autoimmunity as the underlying cause of many diseases. This is due to the fact that autoimmune diseases cross over many different medical specialties (e.g., rheumatology, neurology, and cardiology), and these specialties tend to focus only on singular diseases within their particular category. The AARDA states that autoimmune diseases "have been cited in the top ten leading causes of all deaths among U.S. women age 65 and younger. Moreover, these diseases represent the fourth largest cause of disability among women in the United States" (2014). The top five autoimmune diseases that affect women much more frequently than men are Hashimoto's thyroiditis (10:1 ratio), systemic lupus erythematosus (9:1), Sjogren's syndrome (9:1), antiphospholipid syndrome-secondary (9:1), and primary biliary cirrhosis (9:1).

Just like women are more susceptible than men, different ethnic groups are more susceptible to certain autoimmune diseases as well. For example, African-American, Hispanic, Asian, and Native American women are two to three times more likely to develop systemic lupus erythematosus (SLE or lupus) than Caucasian women. In 2013, two different epidemiological studies confirmed that lupus disproportionately affects young African-American women, and it was discovered that the incidence rate is much greater than previously thought. The studies also showed that these women tend to develop lupus at a younger age than white females.

Estrogen may play a role in the cause of many autoimmune diseases. Using lupus as an example again, women tend to experience worsening of symptoms during pregnancy and also during their menstrual periods. If estrogen does indeed play a part, this would explain why the majority of autoimmune disease sufferers are women. More research still needs to be done, though, in order to learn more about the role estrogen could possibly play in autoimmunity. If researchers end up discovering this theory is correct, this could significantly improve prevention and treatment strategies and hopefully find a cure to many of these diseases.
 
It is believed that several autoimmune diseases are passed down from parents to their children. The National Institute of Aging (NIA) researchers have discovered "five of 89 independent variations in human genetics that are believed to be responsible for autoimmune conditions, from celiac disease to multiple sclerosis" (Krans, 2013). It was found that these gene variations are linked to how the body produces immune system cells, and they have a crucial effect on how many of these cells the body produces. More research on this topic could lead to determining exactly how autoimmunity and genetics are connected, which could definitely aid in the development of more preventative measures as well as possible solutions to a cure.



References 
1. American Autoimmune Related Diseases Association. (2014). Autoimmune disease in women. Retrieved from http://www.aarda.org/autoimmune-information/autoimmune-disease-in-women/
2. Office on Women's Health. (2012). Autoimmune diseases fact sheet. Retrieved from http://www.womenshealth.gov/publications/our-publications/fact-sheet/autoimmune-diseases.html
3. Herndon, J. (2014). System lupus erythematosus. Healthline. Retrieved from http://www.healthline.com/health/systemic-lupus-erythematosus
4. Krans, B. (2013). More genetic clues to autoimmune disorders discovered. Healthline. Retrieved from http://www.healthline.com/health-news/ms-inherited-genes-affect-autoimmune-disease-risk-092713
5. Photo (top): http://blog.23andme.com/wp-content/uploads/2012/05/Autoimmune1.jpg
6. Photo (middle): http://graphics8.nytimes.com/images/2007/08/01/health/adam/17134.jpg
7. Photo (bottom): http://ashpauls.files.wordpress.com/2010/04/autoimmune.jpg