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Predisposing factors to autoimmune disease
1Saint Lukes/Roosevelt Medical Center, Columbia University College of Physicians and Surgeons, New York, New York, USA.
Abstract:
There are many factors that predispose women to autoimmune disease. The protective effect of testosterone during development prevents most males from getting autoimmune disease, although in some instances this protective effect can be bypassed by either genetic anomalies or endocrinopathies. Autoimmunity is defined as the development of symptoms and antibodies referable to one or another autoimmune disease. Some of the factors that predispose young women to autoimmunity also directly involve the endocrine system and indirectly, disorders of gonadal development. Altered sex steroid metabolism is one endogenous factor that predisposes a young woman to autoimmunity. The metabolism of estrone which can be directed to either the 16-or the 2-metabolites by diet, thyroid function, or certain drugs has a major influence on immune function and possibly gonadal pathology. Attempts to shift the metabolism of estrone to the 2-compounds with a variety of agents actually decreases the predisposition to autoimmunity. Other pre-disposing factors are all related to hormone metabolism and include hyperprolactinemia, the use of exogenous estrogenic agents, or compounds that change basic steroid metabolism. Most of these conditions are reversible.