Male/Female Differences in Autoimmune Diseases of the CNS

A group of physicians from Germany have recently published an article in Seminars in Immunopathology, noting significant differences in the incidence of autoimmune diseases of the central nervous system in males versus females. They stated diseases such as multiple sclerosis, neuromyelitis optica and autoimmune encephalitis are more likely to be found in females.

Some examples of the differences in incidence are 3:1 female to male ratio for relapsing-remitting MS and 9-10:1 female to male ratio in neuromyelitis optica (seropositive). Autoimmune encephalitis differs according to the subtype involved, with anti-NMDA much more prevalent in women of a certain age group (particularly 12-45 years). However, there are subtypes that are more prevalent in men: anti-LGI1 and CASPR2 AE, and others with a slightly female preponderance or more equal ratios.

Although “it is not clear what triggers the pronounced inflammatory response in women,” possible explanations the authors offer for these discrepancies are hormonal differences, genetic influences, and epigenetic factors (other biological mechanisms that turn genes on or off).

The authors also stated there exists the possibility that males and females may respond differently to treatment and therefore more personalized approaches may be beneficial. They noted additional research needs to be done in this area. The abstract can be read here.