Autoimmune Disease in Women: Endocrine Transition and Risk Across the Lifespan

Conclusion
Autoimmune disease states show strong associations with endocrinological changes in human and animal studies. There is clear evidence for the role of sex steroids in the immune disturbances that result in autoimmune diseases (Figure 2). The majority of women who pass through the different endocrinological transition states do not succumb to autoimmune diseases.

FIGURE 2

Figure 2. Factors that contribute to increased incidence and prevalence of autoimmunity in women. In women (46XX) with genetic susceptibility to autoimmune states, external environmental stimuli affect modifying factors as well as endocrine transitions via epigenetic mechanisms. Additionally, there are interactions between estrogens, androgens, leptin and prolactin on one hand and the interplay between Th1 and Th2 immune responses on the other. Both (endocrine and immune response) these phenomena are influenced in varying ways during the female transition states depending on the circulating concentrations of different hormones and immune cytokines, which in turn may be determined by epigenetics. Thus, hormonal fluctuation, immune polarization and transition states together drive susceptible women over the autoimmune “tipping point” leading to manifestation of overt clinical disease.

However, a small percentage of women emerge with an increased risk of developing autoimmune diseases due to sustained hormonal changes during the endocrinological transitions coupled wit...

Source: Frontiers in Endocrinology - April 28, 2019 Category: Endocrinology Source Type: research