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AUTOIMMUNE DISEASE EXPERTS DISCUSS ENVIRONMENTAL IMPACTS

WASHINGTON, D.C. (October 17, 2012) – Ten specialists from across the country came together last week to discuss a group of diseases that affect 20-50 million Americans: autoimmune disease. The Society for Women’s Health Research (SWHR), the leading non-profit in the study of sex differences, hosted the roundtable discussion: Sex and Gender-Specific Environmental Exposures and Mechanisms in Autoimmune Diseases, on October 5, 2012 at the Hamilton Crowne Plaza in Washington, D.C.

The conference attendees were tasked to examine and explain mechanisms for the disparity in rates of autoimmune disease between men and women and to comment on the role of specific environmental factors that may be involved in the rise in many autoimmune diseases in recent years. Autoimmune disease occurs when the body’s immune system attacks its own organs, cells and tissues. There are more than 90 autoimmune diseases, many of which are more prevalent in women. Lupus, for example, affects nine times more women than men and multiple sclerosis (MS) affects women twice as often as men.

Fred Miller, MD, PhD, from the National Institute of Environmental Health Sciences (NIEHS) at the National Institutes of Health (NIH) opened the meeting with slides on the impact that autoimmune diseases have on public health, the evidence for the role of environmental factors and recent NIEHS expert panel findings on the role of genetics, environmental factors, and possible mechanisms influencing female predominance.

DeLisa Fairweather, PhD, from the Johns Hopkins Bloomberg School of Public Health, discussed how pathology and age are related and how sex differences in the immune response may account for differences in acute vs. chronic disease. She emphasized the need to analyze data by sex, re-analyze previous studies, and re-evaluate conclusions.

Several participants addressed the role of environmental changes and exposures on the different autoimmune diseases. For instance, Glinda Cooper, PhD, of the US Environmental Protection Agency, urged us to examine trends, look at multiple exposures and their additive effects, and find better predictive measures. Expanding on this topic, Christine Parks, PhD, MSPH, from NIEHS, said exposures over the lifespan need to be taken into account, including childhood and non-occupational exposures. Prakash Nagarkatti, PhD, from the University of South Carolina School of Medicine, presented his work on molecular mechanisms that may link specific environmental exposures to the development of autoimmune diseases. Specific environmental exposures were also addressed by Kathleen Gilbert, PhD, from the University of Arkansas for Medical Sciences, who discussed the possible effects of trichloroethylene, a major environmental pollutant, on lupus and other autoimmune diseases. Further, Marc Monestier, MD, PhD, from Temple University discussed how prenatal exposure to mercury differentially affects male and female offspring.

In addition to gender and environmental exposures, genes play a major role in the development of autoimmune disease. Divaker Choubey, PhD, from the University of Cincinnati College of Medicine, presented data suggesting that p200 gene family may play a key role at the interface between sex and immune response in the development of lupus. S. Ansar Ahmed, DVM, PhD, head of the Department of Biomedical Science and Pathobiology at Virginia Tech University, delved further into the role of epigenetics and microRNAs in the development of autoimmune diseases. Bruce Richardson, MD, PhD, from the University of Michigan, elaborated on the role of epigenetics, focusing on how the “unsilencing” of genes on a woman’s extra X chromosome (typically silenced through an epigenetic process called methylation) may lead to the development of autoimmune disease. Richardson discussed men with Klinefelter’s Syndrome (men with an extra X chromosome), who have the same rate of lupus as women.

While each specialist offered a different research perspective, they all agreed that there are many complex and overlapping factors in autoimmune disease and that sex differences exist and matter. The concluding discussions emphasized the need for innovative studies and techniques to elucidate the mechanisms and possible interconnections among sex differences, environmental stimuli, and genetics in the development of autoimmunity.

“The autoimmune roundtable was an important step in understanding why women are more susceptible to autoimmune diagnoses than men,” said Phyllis Greenberger, MSW, president and CEO of SWHR. “By gathering the leading researchers in autoimmunity to help answer some of the whys, we may increase the likelihood for more personalized care for women with autoimmune disease in the future.”

This sentiment resonated with the roundtable professionals who had traveled from around the country. In his talk, Miller commented on the need for coordination between research agencies and nations saying that as individuals, specialists can’t always see the whole picture of a disease. “We [specialists] are all just blind men feeling the elephant.”

Following the roundtable, participant Glinda Cooper said, “The roundtable held by SWHR on the broader topic of sex and gender differences and environmental influences is the kind of exchange that is needed to foster ground-breaking research in this area. The discussions by people from different backgrounds provided cross-fertilization of ideas, and the questions forced you to think about things from different perspectives.”

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For more information on the Society for Women’s Health Research please contact Rachel Griffith at 202-496-5001 or Rachel@swhr.org.

The Society for Women’s Health Research (SWHR), a national non-profit organization based in Washington D.C., is widely recognized as the thought leader in women’s health research, particularly how sex differences impact health. SWHR’s mission is to improve the health of all women through advocacy, education and research. Visit SWHR’s website at www.swhr.org for more information.

 

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