Gender Differences in Autoimmune Diseases (Multiple Sclerosis and Systemic Lupus Erythematous)

INTRODUCTION

Autoimmune diseases (ADs) are conditions that results from the body’s immune system inability to distinguish a healthy antigen, cell, or tissue from unhealthy and damaging ones, which results in a self-destruction attack. This is because the body’s immune response is supposed and responsible in fighting against invading antibodies, but in the case of autoimmune diseases the attack is on itself which produces various reactions in the host system, these reactions can be from minimal to severe and fatal disorders. The appearance of various autoimmune disorders varies as well as the age at which they first manifest. (Angum et al., 2020).

The origin of autoimmune diseases is a disruption of immune tolerance which is also recognized as the failure of the immune system to tolerate its own cells and tissues and leads to abnormal immune responds by the antibodies, and eventually leads to dysfunction of specific or multiple targeted organs, tissue or cell. The term auto is from a Greek word which means self, implies that autoimmune diseases are considered injury to self. autoimmune diseases can be systemic in that the immune system can attack its own antigens in multiple organs in a generalized manner or it can also be specific when it is focused, on a particular organ. Some types of autoimmune diseases are Psoriasis, Rheumatoid Arthritis, Multiple Sclerosis, Graves Diseases, Polyarteritis Nodosa, Pemicious Anemia, Systemic Lupus Erythematosus etc.

Autoimmune diseases (ADs) are approximated to about 80 distinct conditions that affects 3-5% of the world’s population. it is widely accepted and believed that a disease is regarded autoimmune, if an immune response to self-antigen induces the diseases pathology. Autoimmune disease has a wide range of targeted tissues with both cellular and humoral immune responses which contributes to the tissue damage. Autoimmune diseases have the tendency of affecting any part of the human body, heart, brain, nervous system, muscles, skin, joint, the eyes, the kidney, pancreas, digestive system and circulatory system. Most autoimmune diseases are considered multifactorial having both genetic and environmental role in the disease origin. (Kochi,2016). Certain standard or criteria such as identification of target antigen, specific antibodies, T cells in target organs and transfer of disease by cell or antibodies has been used to classify a disease as autoimmune. (Ngo et al., 2014).

The onset of most autoimmune diseases varies with age, Sjogren’s syndrome manifest around the age of 40-60, Systemic Lupus  Erythematosus can be observed at the ages of 15-55 years, Systemic Sclerosis can be diagnosed from the age of 20 to 50, the diagnoses of rheumatoid arthritis can be from the age of 30 to 60, and 15 to 35 years for psoriasis. (Angum et al., 2020).

Autoimmune diseases are often disabling with immune system failure which leads to its inability to tolerate a loss inborn antigen due to high level of self-antibodies, prolonged inflammation, intervening cells and chronic inflammation. Autoimmune disease has a similar yet complex mechanism and patients usually have lifelong debilitating symptoms, organ function loss, decreased work productivity and excessive medical
cost and because many autoimmune diseases manifest in women during their reproductive years, they have impact fetal and maternal outcome such as pregnancy loss in women living with systemic lupus erythematosus, vasculitis and type 1 diabetes and also infertility in women living with rheumatoid arthritis. Autoimmune diseases are widespread and affect 5% to 9% of the population which have a significant personal and public health impact. Gender and ethnicity are considered as the reason for high occurrence. (Ramos et al., 2015).

Autoimmune diseases are complex diseases that involves genetic, epigenetic and environmental components. The occurrence of autoimmune diseases has been on the increase in the last 10 years which cannot only be explained genetically. Changes in lifestyles such as food, hygiene and exposure to pollutant have been proposed as risk factors for autoimmune diseases. Autoimmune diseases are linked to intestinal barrier
defects; however, diet is not only a factor. Psychological stress is also an environmental factor that contributes to autoimmune disorders. (Ilchmann-Diounou Hanna and Menard Sandrine, 2020).

Genetic factors contribute for 80% in autoimmune diseases while environmental factors account for 20% variables in the uprising of the disease. Environmental factors like diet, iodine, highly active antiretroviral therapy, pathogenic organisms, cigarette smoking, and external and internal radiation such as sunlight are associated with autoimmune diseases. Due to structural similarity, antibodies produced in responds to certain infectious agents and organisms such as yersinia enterocolitica reacts with human cell protein. Sex steroids and stress or trauma are also triggers and predisposing variables to autoimmune diseases. (Ojo et al., 2019).

Discoveries has shown that being exposed to ionizing radiation has a strong influence on immune system response, which in effect leads to change in the immune responds. The changes caused by ironizing radiation are considered factors the for different disorders found in persons exposed to radiation. These discoveries therefore suggest that treatment by radiation or radiation by accident could cause severe and chronic
inflammatory diseases. Inflammation responds are presumed to be a cause of 25% and 50% of all forms of cancer due to highly reactive radiation. Severe kidney damage in diabetes patients is as a result of the increase of insulin stimulation and increased nicotinamide adenine dinucleotide phosphate (NADPH) activity. Organ specific diseases, like pancreatitis, ulcerative colitis, Rheumatoid Arthritis Crohn’s disease are affected by exposure to radiation. Inflammatory diseases and exposure to ironizing radiation are strongly linked. Ironizing radiation can influence immune system functionality in the targeted organ and tissues and also promote increase in the number of macrophages, cytokines, lymphocytes T(t-cells), interferon gamma radiation tumor necrosis factor (TNF-α), transforming growth factor beta (TGF-β) due to secretion of inflammation mediator. (Yahyapour et al., 2018).

The ability to regulate gene transcription, stability, inheritable alteration in gene expressions, which relate the environment without changes in respect to DNA bases is known as epigenetic mechanism. For the past decade, intensive Investigations have been carried out which linked epigenetic modification and influence in autoimmune diseases by regulating immune cell function, epigenetic dysregulation has directly
affected the development of autoimmune diseases. Mechanism such as DNA methylation, chromatin remodeling and non-coding RNAs are identified as important cellular immune regulator as they modulate gene expression and transcription in targeted cells and tissues. (Mazzone et al., 2019).

The global prevalence of autoimmune diseases is increasing, for instance severe diseases such as systemic lupus erythematosus (SLE), multiple sclerosis (MS), rheumatoid arthritis (RA) and type 1 diabetes (T1d) prevalence level has reached 0.5% to 5% in various region of the world. Autoimmune diseases which are promoted by B and T lymphocytes causes tissue damage are marked by periods of strong autoimmune
attack which is followed by decreased inflammation and partial recovery of the damaged tissue. Inflammatory cytokines like interleukin and interferons, endoplasmic reticulum stress, reactive oxygen is common tissue damage in these autoimmune diseases. (Szymeczak et al., 2021).

…. FULL INTRODUCTION IN SEMINAR WORK, BUY IT