{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,6]],"date-time":"2026-11-06T19:56:49Z","timestamp":1793995009475,"version":"4.8.0"},"reference-count":261,"publisher":"MDPI AG","issue":"15","license":[{"start":{"date-parts":[[2025,7,23]],"date-time":"2025-07-23T00:00:00Z","timestamp":1753228800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"National Research Foundation of Korea (NRF) with grants given to I.K. and Y.J.J. from the Korean government (MIST)","award":["NRF-2018R1A6A1A03025124"],"award-info":[{"award-number":["NRF-2018R1A6A1A03025124"]}]},{"name":"National Research Foundation of Korea (NRF) with grants given to I.K. and Y.J.J. from the Korean government (MIST)","award":["2023R1A2C2002522"],"award-info":[{"award-number":["2023R1A2C2002522"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJMS"],"abstract":"<jats:p>Autoimmune diseases such as systemic lupus erythematosus and Sj\u00f6gren\u2019s syndrome show pronounced sex disparities in prevalence, severity, and clinical outcomes, with females disproportionately affected. Emerging evidence highlights sex-based differences in immune and inflammatory responses as key contributors to this bias. Genetic factors\u2014including sex chromosomes, skewed X chromosome inactivation, and sex-biased microRNAs\u2014as well as sex hormones and pregnancy modulate gene expression and immune cell function in a sex-specific manner. Additionally, sex hormone-dependent epigenetic modifications influence the transcription of critical immune regulators. These genetic and hormonal factors collectively shape the activation, differentiation, and effector functions of diverse immune cell types. Environmental factors\u2014including infections, gut microbiota, environmental chemicals and pollutants, and lifestyle behaviors such as diet, smoking, UV exposure, alcohol and caffeine intake, physical activity, and circadian rhythms\u2014further modulate immune function and autoimmune disease pathogenesis in a sex-dependent manner. Together, these mechanisms contribute to the heightened risk and distinct clinical features of autoimmunity in females. A deeper understanding of sex-biased immune regulation will facilitate the identification of novel biomarkers, enable patient stratification, and inform the development of sex-specific diagnostic and therapeutic strategies for autoimmune diseases.<\/jats:p>","DOI":"10.3390\/ijms26157101","type":"journal-article","created":{"date-parts":[[2025,7,23]],"date-time":"2025-07-23T14:22:44Z","timestamp":1753280564000},"page":"7101","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":30,"title":["Understanding Sex Differences in Autoimmune Diseases: Immunologic Mechanisms"],"prefix":"10.3390","volume":"26","author":[{"given":"Yu Rin","family":"Kim","sequence":"first","affiliation":[{"name":"Department of Biomedical Sciences, Graduate School, Kyung Hee University, Seoul 02447, Republic of Korea"},{"name":"Biomedical Science Institute, Kyung Hee University, Seoul 02447, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1574-696X","authenticated-orcid":false,"given":"YunJae","family":"Jung","sequence":"additional","affiliation":[{"name":"Department of Microbiology, College of Medicine, Lee Gil Ya Cancer and Diabetes Institute, Gachon University, Incheon 21999, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7117-1008","authenticated-orcid":false,"given":"Insug","family":"Kang","sequence":"additional","affiliation":[{"name":"Department of Biomedical Sciences, Graduate School, Kyung Hee University, Seoul 02447, Republic of Korea"},{"name":"Biomedical Science Institute, Kyung Hee University, Seoul 02447, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eui-Ju","family":"Yeo","sequence":"additional","affiliation":[{"name":"Department of Biochemistry, College of Medicine, Gachon University, Incheon 21999, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,7,23]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"102","DOI":"10.1038\/s41392-025-02168-0","article-title":"Systemic lupus erythematosus: Updated insights on the pathogenesis, diagnosis, prevention and therapeutics","volume":"10","author":"Dai","year":"2025","journal-title":"Signal Transduct. 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