The gut microbiome in autoimmunity: Sex matters

Clin Immunol. 2015 Aug;159(2):154-62. doi: 10.1016/j.clim.2015.04.016. Epub 2015 May 6.


Autoimmune diseases like rheumatoid arthritis are multifactorial in nature, requiring both genetic and environmental factors for onset. Increased predisposition of females to a wide range of autoimmune diseases points to a gender bias in the multifactorial etiology of these disorders. However, the existing evidence to date has not provided any conclusive mechanism of gender-bias beyond the role of hormones and sex chromosomes. The gut microbiome, which impacts the innate and adaptive branches of immunity, not only influences the development of autoimmune disorders but may interact with sex-hormones to modulate disease progression and sex-bias. Here, we review the current information on gender bias in autoimmunity and discuss the potential of microbiome-derived biomarkers to help unravel the complex interplay between genes, environment and hormones in rheumatoid arthritis.

Keywords: Autoimmunity; Gender-bias; Microbiome; Sex-hormones.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Arthritis, Rheumatoid / immunology*
  • Arthritis, Rheumatoid / metabolism
  • Arthritis, Rheumatoid / microbiology
  • Autoimmune Diseases / immunology
  • Autoimmune Diseases / metabolism
  • Autoimmune Diseases / microbiology
  • Autoimmunity / immunology*
  • Female
  • Gastrointestinal Microbiome / immunology*
  • Gene-Environment Interaction
  • Gonadal Steroid Hormones / immunology*
  • Gonadal Steroid Hormones / metabolism
  • Humans
  • Male
  • Sex Factors


  • Gonadal Steroid Hormones