title: Sex-Based Differences in Multiple Sclerosis (Part I): Biology of Disease Incidence.
abstract: Multiple sclerosis (MS) is a chronic autoimmune demyelinating disease that leads to neuron damage and progressive disability. One major feature of multiple sclerosis (MS) is that it affects women three times more often than men. In this chapter, we overview the evidence that the autoimmune component of MS, which predominates in the early stages of this disease, is more robust in women than in men and undergoes a sharp increase with the onset of puberty. In addition, we discuss the common rodent models of MS that have been used to study the sex-based differences in the development of central nervous system (CNS) autoimmunity. We then address the biological underpinnings of this enhanced MS risk in women by first reviewing the autoimmune mechanisms that are thought to lead to the initiation of this disease and then honing in on how these mechanisms differ between the sexes. Finally, we review what is known about the hormonal and genetic basis of these sex differences in CNS autoimmunity.
authors.affiliation: Toronto General Research Institute, University Health Network, Toronto, ON, Canada. sdunn@uhnresearch.ca.|Women's College Research Institute, Toronto, ON, Canada. sdunn@uhnresearch.ca.|Department of Immunology, University of Toronto, Toronto, ON, Canada. sdunn@uhnresearch.ca.
authors.forename: Shannon E
authors.initials: SE
authors.lastname: Dunn
authors.affiliation: Montreal Neurological Institute, McGill University, Montreal, QC, Canada.
authors.forename: Hyunwoo
authors.initials: H
authors.lastname: Lee
authors.affiliation: Department of Immunology, University of Toronto, Toronto, ON, Canada.
authors.forename: Farzan Rusi
authors.initials: FR
authors.lastname: Pavri
authors.affiliation: Department of Immunology, University of Toronto, Toronto, ON, Canada.
authors.forename: Monan Angela
authors.initials: MA
authors.lastname: Zhang
mesh_terms: D000818:Animals; D015551:Autoimmunity / Q000502:physiology; D005260:Female; D012739:Gonadal Steroid Hormones / Q000502:physiology; D006801:Humans; D015994:Incidence; D008297:Male; D051379:Mice; D009103:Multiple Sclerosis / Q000453:epidemiology* / Q000276:immunology / Q000473:pathology*; D012727:Sex Characteristics
chemical_list: D012739:Gonadal Steroid Hormones
keywords: Antigen-presenting cells; B cells; Blood–brain barrier; CNS autoimmunity; Experimental autoimmune encephalomyelitis; Gonadotrophins; Incidence; Magnetic resonance imaging; Microglia; Multiple sclerosis; Prolactin; Sex chromosomes; Sex difference; Sex hormones; T helper cells