Sex-specific environmental influences on the development of autoimmune diseases

Eleni Tiniakou, Karen H. Costenbader, Martin A. Kriegel

Research output: Contribution to journalReview articlepeer-review

32 Scopus citations


Sex differences in autoimmune diseases are evolutionarily tied to the fact that the female immune system is confronted with intense alterations during menstrual cycles, pregnancy and childbirth. These events may be associated with breaches in the mucosal epithelial layers that are shielding us from environmental factors. Associations between environmental agents and autoimmune diseases have been described extensively in prior studies. Little evidence, however, exists for sex-specific environmental effects on autoimmune diseases. In this review, we summarize studies involving this often-neglected aspect. We give examples of environmental factors that may influence the sex bias in autoimmunity. We conclude that most studies do not give insight into sex-specific environmental effects due to the influence of gender-selective social, occupational or other exposures. Prospective studies are needed in order to determine true sex-biased environmental influences. Finally, humanized murine models might aid in better understanding the mechanisms involved in sex-specific environmental effects on autoimmune diseases.

Original languageEnglish (US)
Pages (from-to)182-191
Number of pages10
JournalClinical Immunology
Issue number2
StatePublished - Nov 2013
Externally publishedYes


  • Autoimmunity
  • Chemicals
  • Commensal bacteria
  • Infectious agents
  • Microbiota
  • Smoking

ASJC Scopus subject areas

  • Immunology and Allergy
  • Immunology


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