Study Sheds Light on the Role of X Chromosome Inactivation in Lupus 

31st July 2024 – by Aaruthy Suthahar

Researchers at TwinsUK have conducted a study examining the role of the X chromosome in systemic lupus erythematosus (lupus), an autoimmune disease that predominantly affects females. The study, involving nearly 1,000 female participants, found significant differences in X Chromosome Inactivation (XCI) between lupus patients and healthy controls. 

Lupus is a condition where the immune system attacks the body’s tissues, leading to inflammation and damage. Despite extensive research, the reasons why 90% of lupus patients are female remain unclear. One theory suggests that the sex chromosomes, particularly the X chromosome, may play a role. 

In females, one of the two X chromosomes is randomly inactivated in each cell, a process known as XCI. This study measured changes in XCI in immune cells and discovered that only 7% of lupus patients showed changes in XCI, compared to 30% typically seen in healthy females. Moreover, among those with more severe lupus, only 3% exhibited changes in XCI. 

To further validate these findings, researchers studied twin pairs from TwinsUK where one twin had lupus, and the other did not. The results were consistent: twins with lupus had fewer changes in XCI than their healthy counterparts. 

Interestingly, these findings differ from previous research on other autoimmune diseases such as thyroid disease and rheumatoid arthritis, indicating distinct mechanisms underlying different autoimmune conditions. Instead of a broad pattern of XCI changes, the study found a correlation between XCI and the “interferon signature,” a marker of lupus disease activity. 

These insights suggest that the role of XCI in lupus is unique and may not follow the patterns observed in other autoimmune diseases. More research is needed to understand how these changes in XCI affect immune function and their implications for infection defence, especially as individuals age. 

First author Dr. Amy Roberts explained:   

“Thanks to the TwinsUK volunteers, we were able to demonstrate differences in X chromosome inactivation between healthy controls and people with lupus. Not only does this research help us understand lupus but also how our immune system changes with age – an area we are actively researching further.” 

This study represents a significant step forward in understanding the complex biology of lupus and underscores the importance of examining sex-specific factors in autoimmune diseases. 

Why do more women develop lupus than men?

15th May 2019 – by Paz Garcia

Photograph of Selena Gomez
Singer and actor Selena Gomez has spoken publicly about living with lupus

King’s College London researchers have identified a new gene which may explain why so many more women develop lupus than men.

Systemic lupus erythematosus – known as SLE or lupus – is an autoimmune condition where the immune system mistakenly attacks the joints, skin and other organs, leading to inflammation.

It’s thought to affect about 65,000 people in the UK. 9 out of every 10 people with the condition are female.

The team included Dr Amy Roberts and Dr Kerrin Small from the Department of Twin Research and Genetic Epidemiology.

The paper was published today in Nature Communications.

Why did they do this research?

Previous research suggests that the X chromosome plays a role in lupus.

Chromosomes are lengths of DNA that contain certain genes on them.

Males have both an X and a Y chromosome, and females have two X chromosomes (XX). Humans only need one dose of the genes on the X chromosome however, so in females one of the X chromosomes in every cell is “switched off” so they don’t get double the dose.

Evidence suggests however that some genes on the switched off X chromosome escape this inactivation.

The team therefore decided to investigate suspect genes on X chromosomes, to see if there were any links with lupus.

What did they find?

The team analysed genetic information and cells collected as part of a number of existing research programmes, including from TwinsUK.

The researchers identified a gene on the X chromosome called CXorf21 as the likely culprit.

They found that the gene was closely linked to another gene known to play a role in lupus which also escapes inactivation in switched off X chromosomes.

The team also found that activity in this gene could be increased in a number of different ways. These included when the gene was not inactivated in switched off X chromosomes and when exposed to immune system molecule interferon – both classic hallmarks of lupus.

What does this mean?

We now have a better understanding of the genetics behind lupus, and why it affects so many more women than men. This could help us develop new screening strategies to pick up new diagnoses sooner, and ultimately help us develop treatments for the condition.

Dr Amy Roberts, who co-led the research, explained:

“It is not understood why females are more at risk than males for developing lupus, or indeed most other autoimmune diseases. Historically this has been attributed to hormonal differences.

However, genes encoded on the X chromosome are good candidates because these are the only chromosomes that are different between the sexes. We examined once such gene, CXorf21, which creates a protein of unknown function. We found that females have more of the CXorf21 protein than males.

Our study supports the idea that males and females have different risks for autoimmune conditions due to genetics. More work is now needed to fully understand the function of this protein, which ultimately could lead to both a better understanding of the disease and potential for improved treatments.”

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