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Women and Autoimmune Disease

Women and Autoimmune Disease

Autoimmune diseases are conditions in which the immune system mistakenly attacks and destroys healthy body tissue. More than 80 different types of autoimmune diseases are known to exist, impacting almost every major organ system in the body.1

 

Heredity, genetics, and environmental triggers are thought to lead to autoimmune diseases, and while accurate statistics on the global prevalence of autoimmune diseases in women are difficult to ascertain, they are considered a significant cause of chronic illness and death.2

 

Autoimmune diseases affect women disproportionately. In the U.S. alone, 8% of the population suffers from autoimmune diseases, 78% of whom are women.3 Rheumatoid arthritis is an example of an autoimmune disease that affects women more than men.

  • Several reports have indicated that autoimmune diseases collectively affect 5–10% of the developed world’s population.2
  • Female sex hormones are listed as environmental triggers for autoimmune diseases.2
  • Autoimmune diseases are listed as one of the top-10 causes of death in women 65 years and younger.2
     

Risk Factors

The incidence of rheumatoid arthritis (RA) is typically two to three times higher in women than men. The onset of RA, in both women and men, is highest among those in their sixties.

Genetics

Certain individuals are genetically susceptible to developing autoimmune diseases. This susceptibility is associated with multiple genes and other risk factors. In many autoimmune diseases three main sets of genes are suspected. These genes are related to:4

  • Immunoglobulins
  • T-cell receptors
  • Major histocompatibility complexes (ie Human Leucocyte Antigen (HLA) system)

Although a predisposition to autoimmune disease can run in families, some family members can be affected by different disorders; for example, one person may have diabetes, while another has rheumatoid arthritis.5

Modifiable risk factors

Several modifiable risk factors have been studied in association with RA, including reproductive hormonal exposures, tobacco use, dietary factors, and microbial exposures. 

Smoking

Among all risk factors, the strongest and most consistent evidence is for an association between smoking and RA. A history of smoking is associated with a modest to moderately (1.3—2.4 times) increased risk of RA onset. This relationship between smoking and RA is strongest among people who are ACPA-positive (anti-citrullinated protein/peptide antibodies), a marker of autoimmune activity.

Reproductive and breastfeeding history

Hormones related to reproduction have been studied extensively as potential risk factors for RA.

  1. Oral contraceptives (OC): Early studies found that women who had ever used OCs had a modest to moderately decreased in risk of RA. The decreased risk has not been confirmed in recent studies. The estrogen concentration of contemporary OCs is typically 80—90% less than the first OCs introduced in the 1960s, which may account for the lack of association in recent studies.
  2. Hormone replacement therapy (HRT): There is mixed evidence of an association between HRT and RA onset.
  3. Live birth history: Most studies have found that women who have never had a live birth have a slight to moderately increased risk of RA.
  4. Breastfeeding: Recent population-based studies have found that RA is less common among women who breastfeed.
  5. Menstrual history: At least two studies have observed that women with irregular menses or a truncated menstrual history (e.g. early menopause) have an increased risk of RA.6

Symptoms

Signs and symptoms of rheumatoid arthritis (RA) may include:

  • Tender, warm, swollen joints
  • Morning stiffness that may last for hours
  • Firm bumps of tissue under the skin on your arms (rheumatoid nodules)
  • Fatigue, fever and weight loss

Early RA tends to affect your smaller joints first—particularly the joints that attach fingers to hands and toes to feet.
As the disease progresses, symptoms often spread to the knees, ankles, elbows, hips and shoulders. In most cases, symptoms occur in the same joints on both sides of the body.
RA signs and symptoms may vary in severity and may even come and go. Periods of increased disease activity, called flares, alternate with periods of relative remission, when the swelling and pain fade or disappear. Over time, RA can cause joints to deform and shift out of place.7

Solutions

Reducing the burden of autoimmune disease in women includes:

  • Understanding risk factors
  • Making rapid, accurate diagnoses when symptoms occur
  • Implementing appropriate therapies
  • Monitoring treatment

Laboratory diagnostic testing plays an integral role in caring for women with autoimmune diseases. Siemens' comprehensive solutions follow the complete continuum of care for autoimmune disease, including early detection of rheumatoid arthritis. In addition, our solutions in healthcare IT support the exchange of data for making informed decisions.

Siemens Solutions for Autoimmune Disease Testing

 

Other Siemens Systems

Diagnosis

 

 

 

 

 

 

 

Anti-CCP

 

 

 

 

 

    X

 

Rheumatoid factor

    X

    X

    X*

    X*

    X

 

    X

C reactive protein

    X

    X

    X

    X

    X

    X

    X

AST

    X

    X

    X

    X

    X

 

 

ALT

    X

    X

    X

    X

    X

 

 

ALP

    X

    X

    X

    X

    X

 

 

GGT

    X

    X

    X

    X

    X

 

 

Inflammatory markers

 

 

 

 

 

    X

 

CBC with smear

 

 

 

 

 

 

    X

*open channel assay

Resources:

1
Website [Internet]. Available from: http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0001819/
2
American Autoimmune Related Diseases Association, Inc. [Internet]. [cited 2013 Mar 12] Available from: https://www.aarda.org/press_release_display.php?ID=53
3
Website [Internet]. [cited 2013 Mar 12] Available from: http://wwwnc.cdc.gov/eid/article/10/11/pdfs/04-0367.pdf
4

 http://www.news-medical.net/health/Autoimmunity-Genetic-Factors.aspx

5

http://www.betterhealth.vic.gov.au/bhcv2/bhcarticles.nsf/pages/Autoimmune_disorders

6

CDC. Rheumatoid Arthritis. http://www.cdc.gov/arthritis/basics/rheumatoid.htm

7

Rheumatoid Arthritis http://www.mayoclinic.com/health/rheumatoid-arthritis/DS00020/DSECTION=symptoms

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