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The biological basis for sex differences in autoimmune diseases
- raphlinus 5y agoMore commentary on this topic from Derek Lowe: https://blogs.sciencemag.org/pipeline/archives/2021/07/14/why-are-women-and-men-so-different-in-autoimmune-disease https://blogs.sciencemag.org/pipeline/archives/2021/07/14/wh...
- tiahura 5y agoIsn’t there some thought that male homosexuality and related conditions may in part be caused by a maternal immune response to a protein important in male fetal brain development?
- shdh 5y agoIt’s interesting how the male:female ratio of Fibromyalgia is so heavily skewed in the direction of female.
- boardwaalk 5y agoRe: the article title: Isn't "autoimmunity" alone the good thing? -- it's what your body does to fight things off. "Why autoimmune diseases are more..." seems like better title. Maybe I'm just not aware of the common verbiage in medical circles but it seems a little sloppy for Nature.
- lthornberry 5y agoMy rule of thumb: if the choices are A) "maybe I'm just not aware of the common verbiage in [technical] circles" that I'm not a part of or B) "a little sloppy for" the multiple layers of experts involved in choosing and approving a title in a flagship science journal, it's very very likely to be A.
- swatkat 5y agohttps://en.m.wikipedia.org/wiki/Autoimmunity https://en.m.wikipedia.org/wiki/Autoimmunity ” Autoimmunity is the system of immune responses of an organism against its own healthy cells, tissues and other body normal constituents.”
- bArray 5y agoAutoimmune diseases/disorders are abnormal immune systems, either being overactive or underactive [1]. It's not generally a good thing and often leads to bad consequences. [1] https://www.webmd.com/a-to-z-guides/autoimmune-diseases https://www.webmd.com/a-to-z-guides/autoimmune-diseases
- adw 5y agoType 1 diabetes, rheumatoid arthritis, Crohn's disease, ulcerative colitis, lupus, multiple sclerosis; a whole grab-bag of fun. These are also difficult diseases to treat – often involving biologics (large molecules administered by injection or IV). T1D is insulin, obviously, but the first big blockbuster medications in the space were Humira and Remicade, monoclonal antibodies, which are powerful immune-system suppressants but more selective (and therefore, relatively speaking, safer long-term) than systemic steroids like prednisone.
- jhgb 5y ago> it's what your body does to fight things off That's just immunity. Auto-immunity is "what your body does to fight itself off". You generally don't want to be fighting yourself off.
- coldtea 5y ago>- it's what your body does to fight things off. That's immunity. Auto in auto-immunity is not the "auto" from "automatic" but the ancient Greek "auto-" meaning "self-". So, auto-immunity is like self-fighting (fighting yourself). You don't want that.
- murderfs 5y ago> Auto in auto-immunity is not the "auto" from "automatic" (which is also from the Greek auto meaning self)
- folli 5y agoIt's sloppy of Nature to use the correct nomenclature?
- ademup 5y agoI confess I was thrown off by "autoimmunity" as I thought it would be a GOOD thing, my reasoning being that an "Autoimmune Disorder" is a bad thing. But I was wrong! I am happy to have learned this new thing today, which is: "Autoimmunity is the system of immune responses of an organism against its own healthy cells, tissues and other body normal constituents."
- treeman79 5y agoOver time you learn what “triggers” your immune system. Often this is called a flare. Or simply inflammation. A few hours In the sun? Destroy all the organs! Eat some carbs? A real shame if those nerve sheaths got eaten... Avoiding triggers becomes your life.
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- playpause 5y agoI’ve never heard the sun thing, interesting - any idea why that might be? Avoiding carbs/sugars seems to help me a bit, I think. Do you have any good links for common triggers, how to spot them, etc? I never seem to ‘learn’ mine because there’s always so many possibilities of what could have triggered a flare.
- smichel17 5y agoI don't have an autoimmune disease. But a friend of mine had lyme disease => stomach bleeding => allergies to all the foods (when undigested food gets into your bloodstream, your body reacts to it much the same way as it would a virus). Both then and now, as some of her allergies are starting to fade, the trick was limited experimentation. Get to a known good state. Spend a week exposing yourself to small, then medium amounts of whatever you want to test. Observe your reaction. Repeat for something different the next week. You can test removing stuff from your diet this way too, but it's hard to identify false negatives: "I didn't get better -- does that mean I'm not allergic to this food, or that there are more triggers I still need to remove?" It's basically the scientific method: form a hypothesis, establish a control, make a modification, observe results. It takes a lot of patience, but if your condition has a big enough impact on your life, is probably worth it. The hardest part is probably getting to a known good state. My friend was able to take an allergy test and err on the side of eliminating foods, to help her get there faster. I don't know what might help you; I'd recommend making a plan with your doctor.
- sonicggg 5y agoThat's why we are seeing a much higher rate of Long Covid cases in women, rather then men.
- KMag 5y agoThe TLDR for the article is that it appears to be a combination of chromosomal and hormonal differences that are responsible for observed sex differences in autoimmunity. Are you asserting that a combination of chromosomal and hormonal differences are also responsible for the observed sex differences in incidence of long COVID? Or are you asserting that autoimmunity is directly involved in long COVID? Or, are you saying something else? It's an honest question. It's ambiguous what you're saying. Maybe you're saying something interesting, but it's difficult to tell without specifics.
- Miner49er 5y agoI'm not OP, but I wouldn't be at all surprised if long COVID is an autoimmune reaction or just people that developed autoimmune diseases from having COVID.
- da_big_ghey 5y agoI am not in posession of any specific knowings on Corona but virus is known cause of acquiring autoimmunity: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6723519/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6723519/
- pjc50 5y agoInteresting that they describe very well how .. adversarial pregnancy is. But also that the placenta might have a benefit to the host.
- DoreenMichele 5y agoIts' not a bad article. I had long ago heard about the hypothesis that women have a more complex immune system so they can carry a pregnancy to term and not reject the baby immediately as something invasive. (And that's a hypothesis that makes sense to me.) But I would add that we already know that female menstruation impacts certain specific disease processes, such as heart disease. Men get advised to donate blood to lower their risk of heart disease. Women who are still menstruating don't need to do that. Covid is known to impact the blood significantly. Blood differences between men and women could play a role in difference in outcomes between men and women for this condition. Women who have been pregnant become chimeras. They get cells from the baby that stay in their system. They also share a blood supply with the baby. I have a serious and incurable congenital disorder. I'm convinced my two pregnancies were hugely beneficial to my long-term health for a long list of reasons, possibly including having cells still in me from one child who did not inherit the disorder. So I'm interested in this topic for personal reasons and I've read a bit about such things over the years and I think it's probably hugely more complicated than this article suggests.
- erispoe 5y ago> Men get advised to donate blood to lower their risk of heart disease. I had never heard of that and did not find any article supporting that from a quick search. I found observational studies concluding that men who donate blood are less at risk for heart attacks, but did not control for selection bias (men who choose to or can donate blood are healthier) or for causes associated with the blood donation (e.g. you might discover you have high blood pressure while donating and seek treatment afterwards).
- DoreenMichele 5y agoQuick and dirty search gets me a piece titled Health benefits of blood donation which says (in part): Studies have shown that, in general, Americans tend to consume more iron on a daily basis than is necessary for good health. Ingestion of quantities of iron beyond a certain quantity can promote formation of free radicals in the body. Free radicals have justly earned their reputation for causing cellular changes which can disrupt normal cell function and increase the risk of certain chronic diseases such as heart disease and cancer. This is more likely to be a problem for men and post menopausal women... https://medicalwesthospital.org/january-is-blood-donor-month.php https://medicalwesthospital.org/january-is-blood-donor-month... I'm American. If you aren't, that might be a factor.
- stared 5y agoIt seems that in general female immune system is stronger. While "man flu" is a popular term for men getting excuses to complain and play on a computer during a minor infection - it might have a grain of truth. For example, COVID male death rates are higher than female (for the same age). See https://www.nature.com/articles/s41467-020-19741-6 https://www.nature.com/articles/s41467-020-19741-6 and https://www.thelancet.com/journals/langlo/article/PIIS2214-109X(20)30464-2/fulltext https://www.thelancet.com/journals/langlo/article/PIIS2214-1.... Of course, a stronger immune system is NOT a universal advantage, as it can backfire. (There is a similar phenomena in other systems, e.g. military.)
- marcellus23 5y ago> While "man flu" is a popular term for men getting excuses to complain and play on a computer during a minor infection I always find it funny how we're supposed to be in an age of fighting sexism but the rise of bizarre gendered stereotypes like this — to the point where articles are getting written about them as if they're real phenomenon! — is baffling. Imagine articles about "woman flu" for the (also stereotypically common) phenomenon of women constantly being sick.
- hnbad 5y agoWhat if I told you that this is literally what feminists mean when they talk about "toxic masculinity" and that pop feminism (i.e. what sells ads/clicks) has barely anything to do with actual feminism? Toxic masculinity refers to the idea that masculinity is narrowly defined around a number of traits and social expectations that are harmful both towards men and to others. E.g. "man flu" is a thing because it's generally not socially acceptable for men to show vulnerability but men often see illness as an exception to that and thus some men use seemingly minor illnesses as an "excuse" to be vulnerable and dependent. Likewise emotions other than anger are often difficult to express for men but sports (football in the US, the other kind of football in Europe) is an "excuse" to express sadness and emotional proximity between (straight) men. The point here is that these gendered expectations and behaviors aren't innate but they're upheld by society. Women's liberation was able to overcome a lot of stereotypical expectations for women (though certainly not even most of them) but it wasn't followed by a "men's liberation" doing the same for men, except as a direct response where women's liberation challenged male gender roles. E.g. with women no longer being expected to take care of the home by themselves, household chores like laundry and cooking have become socially acceptable for men. Pop feminism individualizes these problems by ridiculing men, but the problem isn't individual men, nor men in general really. It's a social problem and much like women's liberation it requires a mass movement to solve. Except most men still aren't aware there's a problem and those who are often don't think it's fixable (much like women who rejected the suffragettes or the later waves of feminism).
- k__ 5y agoMy friend, who is a study nurse, told me medical studies are often just done on men and then women are treated as small men when it comes to treatment later.
- PragmaticPulp 5y agoI can’t recall seeing a study where only men were allowed to participate, with the exception of male-specific health studies (erectile dysfunction, testosterone replacement therapy, and so on). In fact, any study that arbitrarily excluded women without good reason would almost certainly be flagged by review boards before being allowed to proceed, and it would struggle to get accepted into journals. Maybe this was true many decades ago, but it’s certainly not true in recent history.
- s1artibartfast 5y agoin my experience, it is still pretty common, depending on the development stage and drug indication. It is not done without good reason. As mentioned elsewhere, there are pleanty of practical reason. The challenge with single sex studies isn't about Journals or IRBs, neither of which care, it is about FDA approval for marketing
- jonlucc 5y agoNot to discount your friend's experience, but I haven't seen a recent study for which this is true. Selection criteria aren't secret; they're on clinicaltrials.gov and published in the eventual data used for FDA approval and publication.
- k__ 5y agoYes, things are certainly getting better. But there is much historical baggage that are still hurting women today without most of them even noticing.
- depressedpanda 5y agoDuring college, I participated in medical trials at AstraZeneca as an easy way to make money. They almost exclusively asked for male test subjects. One of my female friends also wanted to earn money that way, and called them asking why. Their response was essentially that medical trials are very expensive, and men are a cheaper resource. I.e., women have ovaries and a set amount of eggs, and therefore would potentially be more adversely affected by complications from the experimental drugs, so the insurance was a lot more expensive.
- TazeTSchnitzel 5y agoIt's good when the reasons behind apparent sex differences are investigated. When they are simply taken for given in e.g. provision of healthcare, it can be harmful to people who don't fit the average “male person” or “female person” profile. For instance, people who for whatever reason have hormone levels not typical for the chromosomes they have, people with unusual chromosome configurations, or people with social circumstances unusual for their sex.
- omgwtfbbq 5y agoInb4 sex is a cultural construct /s