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X Chromosome Dose and Sex Bias in Autoimmune Diseases
University of Cincinnati, OH USA; Cincinnati Childrens Hospital Medical Centre, OH 45229 USA.
University of Oklahoma, OK 73190 USA; Oklahoma City VA Medical Centre, OK USA.
Cincinnati Childrens Hospital Medical Centre, OH 45229 USA.
Cincinnati Childrens Hospital Medical Centre, OH 45229 USA; Cincinnati VA Medical Centre, OH USA.
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2016 (English)In: Arthritis & Rheumatology, ISSN 2326-5191, E-ISSN 2326-5205, Vol. 68, no 5, 1290-1300 p.Article in journal (Refereed) PublishedText
Abstract [en]

Objective. More than 80% of autoimmune disease predominantly affects females, but the mechanism for this female bias is poorly understood. We suspected that an X chromosome dose effect accounts for this, and we undertook this study to test our hypothesis that trisomy X (47, XXX; occurring in similar to 1 in 1,000 live female births) would be increased in patients with female-predominant diseases (systemic lupus erythematosus [SLE], primary Sjogrens syndrome [SS], primary biliary cirrhosis, and rheumatoid arthritis [RA]) compared to patients with diseases without female predominance (sarcoidosis) and compared to controls. Methods. All subjects in this study were female. We identified subjects with 47, XXX using aggregate data from single-nucleotide polymorphism arrays, and, when possible, we confirmed the presence of 47, XXX using fluorescence in situ hybridization or quantitative polymerase chain reaction. Results. We found 47, XXX in 7 of 2,826 SLE patients and in 3 of 1,033 SS patients, but in only 2 of 7,074 controls (odds ratio in the SLE and primary SS groups 8.78 [95% confidence interval 1.67-86.79], P = 0.003 and odds ratio 10.29 [95% confidence interval 1.18-123.47], P = 0.02, respectively). One in 404 women with SLE and 1 in 344 women with SS had 47, XXX. There was an excess of 47, XXX among SLE and SS patients. Conclusion. The estimated prevalence of SLE and SS in women with 47, XXX was similar to 2.5 and similar to 2.9 times higher, respectively, than that in women with 46, XX and similar to 25 and similar to 41 times higher, respectively, than that in men with 46, XY. No statistically significant increase of 47, XXX was observed in other female-biased diseases (primary biliary cirrhosis or RA), supporting the idea of multiple pathways to sex bias in autoimmunity.

Place, publisher, year, edition, pages
WILEY-BLACKWELL , 2016. Vol. 68, no 5, 1290-1300 p.
National Category
Clinical Medicine
URN: urn:nbn:se:liu:diva-128940DOI: 10.1002/art.39560ISI: 000375551600030PubMedID: 26713507OAI: diva2:934958

Funding Agencies|NIH [AR-062755, AI-024717, AI-031584, AI-062629, AI-063274, AI-082714, AI-083194, AI-101934]; NIH (National Institute of Dental and Craniofacial Research Intramural Research Program); University of Oklahoma Health Sciences Center (Clinical and Translational Science OCTSI Summer Scholar Program); US Department of Veterans Affairs [IMMA9]; US Department of Defense [PR094002]; Alliance for Lupus Research; Kirkland Scholar Program; Strategic Research Program at Helse Bergen; Western Norway Regional Health Authority; Broegelmann Foundation; French Ministry of Health (EvASSESS Programme Hospitalier de Recherche Clinique); Swedish Rheumatism Foundation; Arthritis Australia; Research to Prevent Blindness; Medical Research Council, UK [G0800629]; DFG [KFO 250 WI 1031/6-1]; Canadian Institutes of Health Research [MOP89955, MOP74621]; Ontario Research Fund [RE05-075]; Canada Research Chair Program; Instituto de Salud Carlos III (ISCIII through FEDER) [02558]; Allergan; Lilly; UCB; The NIH [AR-042460, AR-048204, AR-048940, AR-049084, AR-052125, AR-053483, AR-053734, AR-056360, AR-058959, AR-062277, AR-043814, AR-065626, DE-015223, DE-018209, RR-020143, GM-103510, GM-104938, HG-008667, TR-001475, HG-006828]

Available from: 2016-06-09 Created: 2016-06-07 Last updated: 2016-06-09

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Eriksson, Per
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Division of Neuro and Inflammation ScienceDepartment of RheumatologyFaculty of Medicine and Health Sciences
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