ROBINSON LABSex & gender
Why does lupus affect so many more girls and women?
The short, jargon-free version
Questions, methods and key papers
In plain words
Lupus affects many more females than males: around 9 in 10 adults with lupus are women. Something about being female makes the immune system more likely to attack the body, but we do not yet fully understand what.
One likely part of the answer is sex hormones, such as oestrogen and testosterone, which change how immune cells and the fats in our blood behave.
By studying volunteers including transgender people taking hormone therapy, we can see what happens to the immune system and to blood fats when hormone levels change. This helps explain why lupus develops, and why it often changes around puberty.
The science
Female predominance is one of the strongest risk factors for SLE. We study how sex hormones shape immune and metabolic pathways relevant to autoimmunity, including in cisgender and transgender cohorts.
Key questions
- How do oestrogen and testosterone regulate regulatory T cells?
- How do sex hormones remodel lipoprotein metabolism and cardiovascular risk?
- How do sex differences intersect with IFN-I biology in autoimmunity?
Approach
Immunophenotyping, transcriptomics and metabolomics in cisgender and transgender volunteers and in patients with autoimmune rheumatic disease, as part of the UCL REINVENT FOCIS Centre of Excellence.
Key papers
- Robinson GA, et al. Investigating sex differences in T regulatory cells from cisgender and transgender healthy individuals and patients with autoimmune inflammatory disease: a cross-sectional study. Lancet Rheumatol 2022. doi.org/10.1016/S2665-9913(22)00198-9 Journal cover
- Robinson GA, et al. Sex hormones drive changes in lipoprotein metabolism. iScience 2021. doi.org/10.1016/j.isci.2021.103257
- Robinson GA, et al. Sex differences in lipid metabolism: implications for systemic lupus erythematosus and cardiovascular disease risk. Front Med 2022. doi.org/10.3389/fmed.2022.914016