Sex-based Differences Continue to Mount

Editor's Note: This is the fourth article in a series on sex-based differences in the biology of males and females. Future articles in the series will cover sex-based differences in drug metabolism and in life expectancy. Lisa Damiani In the 1970s, medical textbooks noted that lupus patients should not get pregnant because it could kill them, recalls physician Michael Lockshin. "I was challenged by a medical student, who had lupus, to show the data to prove that. But it didn't exist and it was a

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The encounter led him to a new research path. "What it amounted to was a career that I hadn't considered," says Lockshin, who is also a professor of medicine at the Weill College of Medicine of Cornell University, New York, and a member of the Institute of Medicine's study panel on sex differences.1

Today, though scientists understand autoimmune diseases such as systemic lupus erythematosus (LSE) better than they did 30 years ago, this group of ailments is still mystery-laden, especially regarding mechanism and cause. In autoimmunity, immune-response cells direct themselves against self-antigens instead of foreign microbes. Most common autoimmune diseases (e.g., rheumatoid arthritis) occur more frequently in women than men. But a few are not predominant in either sex, and others are more prevalent in men. Some, like LSE, are more severe in men than women, although not more widespread. What's more, there is a mix of genetic, environmental, and ...

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