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In 2017, pop star Selena Gomez underwent a kidney transplant after suffering complications from lupus, a rare autoimmune disease.
As it happens, lupus is notoriously difficult to diagnose. It is also 8 times more common in women than in men.
This can happen if your immune system goes into overdrive, or gets confused between your body's own cells and foreign bodies.
While there is no official data in India, according to the US National Stem Cell Foundation, more than 4 percent of the world's population has an autoimmune disease.
But, that's not all.
In fact, so strong is the gender bias of autoimmune diseases that women are twice as likely to develop them as men.
This conclusion, though, is mostly observational, and the why of is still one of the biggest medical mysteries. One reason for this is that we aren't quite sure why autoimmune diseases happen in the first place.
There have been different theories, of course, from genes to the placenta, a number of different scientific inquiries have thrown up different answers.
Considering autoimmune diseases generally present themselves during reproductive ages between 15 and 55 in women, some researchers think the female reproductive system may have an answer.
In 2019, a study conducted by researchers at the School of Life Sciences in Arizona State University in the US put forth the interesting theory of 'pregnancy compensation hypothesis' (PCH).
Basically, the study authors suggested that a female's immune system became dormant during pregnancy, so it doesn't attack and destroy the fetus. So in some sense the placenta provided a pushback to the immune system which tended to ramp up as a result.
This isn't the first time someone has looked to the 'lady parts' for answers to illnesses dominant in women. In Ancient Greece, Hippocrates—considered the father of modern medicine—also believed women's illnesses stemmed from the uterus.
Dr Vineeta Bal, an Immunologist, and researcher at the Indian Institute of Science Education and Research (IISER Pune) doesn't fully buy into this theory.
Speaking to FIT, she says, "even women who have never been pregnant are somewhat more susceptible to autoimmune diseases. Thus, placenta alone may not explain this association."
However, she doesn't deny that the placenta could have some role to play.
Dr Bal goes on to explain, "The development of full-fledged placenta and growing of a foetus which has 50 percent mismatch with the mother's transplantation antigens (called HLA), may imply that the immunosuppression exercised locally by the placenta during pregnancy, suppressive cytokines and other immune components such as regulatory T cells (Tregs) may make women more prone to the break in autoimmune pathology in the long run."
"Women do generally tend to have a higher risk of autoimmune diseases. It could be caused by multiple factors including genetic reasons," Dr Satish Koul, Director of Internal medicine, Fortis Memorial Research Institute, Gurugram tells FIT.
Many researchers in the past have considered this. In fact, genetics and hormonal changes are two of the strongest contenders as far as theories for the causes of autoimmune diseases go.
According to some researchers, the X chromosome has codes for more immune related and immune regulatory genes, and having a larger number of these could increase the chances of a larger number of mutations occurring.
"While female hormones are one obvious candidate to explain the difference there is no concrete evidence that estrogen/progesterone are actively contributing to the pathology," says Dr Vineeta Bal.
According to Dr Koul, the root cause is more likely a combination of reasons wherein a family history of autoimmune diseases, and other environmental factors could also up the risk of these conditions in some women.
Instead of more granulated data for diseases and drugs, this discrepancy between female and male illnesses has further led to the exclusion of female variables from scientific studies.
An article published in the Guardian brings to lights how male mice are preferred for animal trials of medical research, even when studying women's conditions. The reason? Inconvenient hormonal fluctuations.
Even though women are more likely to develop autoimmune diseases, they also struggle to get a diagnosis and medical aid due to the gaping gender gap in medicine.
Understanding and decoding autoimmune diseases and its impact on women becomes more important now than ever with the world seeing an unexplained yet consistent rise in cases of autoimmune diseases.
(At The Quint, we question everything. Play an active role in shaping our journalism by becoming a member today.)
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