Why autoimmune disorder lupus affect women more than men

Female sex hormone oestrogen and the X chromosome play a significant role in making women more vulnerable to the autoimmune disorder lupus’, said experts on World Lupus Day on Friday.

World Lupus Day is observed every year on May 10 to raise awareness of the life-changing autoimmune disease, in which the body attacks its organs by producing certain substances called antibodies.

Symptoms predominantly include fever, fatigue, malar rashes, multiple large and small joint pains, breathlessness, sometimes difficulty in swallowing, and chest pain.

The condition, also known as Systemic Lupus Erythematosus (SLE), affects millions of individuals worldwide. In India, 3.2 cases of SLE are documented per 100,000 people. However, globally women in the reproductive age range disproportionately account for up to 90 per cent of cases of the SLE.

Despite recent progress in the understanding of lupus, the striking female-to-male ratio of disease incidence remains largely unexplained.

“But some studies point out that sex hormones play a major role in causing genetically predisposed women more vulnerable to lupus; oestrogen specifically is likely to contribute more to the development of lupus,” Dr Anu Daber, Sr Consultant Rheumatology, Paras Health Gurugram, told IANS.

Research also highlights the connection between X chromosomes in women and the development of lupus, meaning in females, having two active X chromosomes would overwhelm the cellular machinery.

“To prevent this, one X chromosome is inactivated in each developing cell. This process, called X-chromosome inactivation, might influence how the immune system learns to identify threats. Variations in how efficiently this inactivation occurs could potentially lead the immune system to mistakenly target the body's own tissues, contributing to autoimmune diseases like lupus,” Dr Anu explained.

Dr. Prasad Kuvalekar, Consultant Physician of Internal Medicine, DPU Super Specialty Hospital, Pimpri, Pune noted that lupus affects the skin, kidney, heart, brain joints, lungs, and blood vessels.

“There are no vaccines available to prevent lupus as it's an autoimmune condition and most of the time it's genetic. There are also no preceding signs to identify its early onset,” Dr Prasad told IANS, noting that malar rashes can, to some extent, be identified as an early sign.

Further, people with lupus are more susceptible to infection, cancer, and bone tissue death, since the disease and its therapies can impair the immune system. Lupus also raises complications in pregnancy problems. Dr. Prasad said that women who have lupus are more likely to miscarry.

“Lupus raises the risk of high blood pressure during pregnancy and premature birth. To lessen the chance of severe consequences, doctors frequently advise deferring pregnancy until your disease has been controlled for at least six months,” he added.

Physical activity may be key to managing the autoimmune disorder, and the associated problems as well as ease mental stress.

“Women can include low-impact exercises in their routine like yoga, tai chi, pilates, walking, and swimming. Regular exercise has been shown to have a positive impact on mental health, reducing the risk of depression and anxiety, which are common comorbidities among individuals with SLE,” Dr Anu said.