How Are Autoimmune Diseases in Women Different Than in Men?

Women account for 80 percent of patients with autoimmune diseases such as lupus and rheumatoid arthritis.

Why Do Women Suffer More Than Men?

Physicians smiling Women account for 80 percent of patients with autoimmune diseases such as lupus and rheumatoid arthritis. Researchers at National Jewish Health have discovered an immune cell that accumulates in females and those prone to autoimmune diseases. Understanding why and how these “Age-associated B Cells” arise could lead to new therapies for autoimmune diseases, which currently have no cure.

Autoimmune Disease – Self-Defense Gone Wrong

Autoimmune disease occurs when a person’s immune system malfunctions and starts attacking its own body instead of defending it. Autoimmune diseases such as rheumatoid arthritis, lupus and multiple sclerosis afflict more than 23 million mostly older adults in the United States. Women account for about 80 percent of patients with autoimmune disease.

Philippa Marrack, PhD, explains more:

All of us have immune systems in our bodies whose job it is to get rid of infections.

For example, influenza virus. It does a very efficient job in most people.

Unfortunately, occasionally, the immune response makes a mistake and it decides that a part of your body is an infection and sets off to destroy, or at least inactivate, that part of your body that it thinks by mistake is actually influenza virus.

And in so doing, while it's doing that, it damages that part of the body.

For example, in a disease like rheumatoid arthritis, the immune system decides, oh, these bits of joint look like something invading organism that we need to get rid of.

And they start attacking the joints because of the inflammation that that creates. You end up with the symptoms of rheumatoid arthritis.

COVID and Autoimmune Disease FAQs

This information reviewed by Philippa Marrack, PhD (September 2021).

Are those with autoimmune conditions at higher risk of COVID-19 infection and hospitalization?

Recent data suggest that some patients with autoimmune disease may be more likely to be hospitalized if they are infected with SARS0CoV-2.

Why might this happen?

If the patients is not vaccinated, the autoimmune disease itself, or the immunosuppressive drugs the patient is taking may suppress the ability of the patient's immune system to respond to, and get rid of, the virus. Along similar lines the autoimmune disease and, more likely, the immunosuppressive drugs the patient is taking may lower the response of the patient to the vaccine, resulting in a low titer of anti-COVID antibodies, for example.

Are those with autoimmune conditions NOT at higher risk of COVID-19 infection and hospitalization due to the ABC's?

We don't know whether ABCs are useful, or neutral, or harmful in patients with COVID.

Are those on immunosuppressants at increased risk of COVID-19?

This may depend on the immunosuppressants given. For example, one study shows that prednisone doesn't lower antibody production against the vaccine much, by comparison with patients without an autoimmune disease, but methotrexate may reduce the amount of anti-SARS-antibody a bit and anti-CD20 (Retuxan) certainly lowers the antibody response.

Contact your doctor with questions about how your medications may be affected by the response to the vaccine.

New Cells in Suspicious Neighborhoods

Researchers discovered a unique set of cells in older female mice, which they called Age-associated B Cells, or ABCs. They found those same ABCs in mice prone to autoimmune disease and in women with autoimmune disease. At the time, what ABCs do was unclear.

Kira Rubtsova, PhD, explains more in this YouTube video.

Cost of a Better Defense?

The National Jewish Health researchers discovered thajeat ABCs are part of a healthy immune response. Women are better than men at fighting viral infections, in part because they have more ABCs. That stronger viral defense, however, makes women more susceptible to autoimmune disease, when ABCs malfunction.

Kira Rubtsova, PhD, explains more in this YouTube video.

Therapeutic Promise

diagram Today, there is no prevention or complete cure for autoimmune diseases, although there are medications that inhibit the symptoms. When National Jewish Health researchers removed ABCs from mice with autoimmune disease, the mice got better. It is a long way from mice to the clinic, but ABCs hold promise for a new approach to autoimmune diseases such as lupus, rheumatoid arthritis and multiple sclerosis, which strike women more often than men.

Anatoly Rubtsov, PhD, explains more in this YouTube video.

Clinical Trials

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