Report on Sex-Based Immunological Differences and Implications for Sustainable Development Goals

Executive Summary: Aligning Immunological Research with Global Health Objectives

A recent review by scientists at the La Jolla Institute for Immunology (LJI) highlights significant sex-based differences in immune system function and disease susceptibility. This research provides a critical framework for advancing several United Nations Sustainable Development Goals (SDGs), particularly SDG 3 (Good Health and Well-being), SDG 5 (Gender Equality), and SDG 10 (Reduced Inequalities). By investigating the genetic, hormonal, and environmental factors that differentiate male and female immune responses, this work paves the way for precision medicine and more equitable health outcomes for all.

Advancing SDG 3: Good Health and Well-being Through Targeted Research

Achieving SDG 3 requires addressing the specific health needs of all populations. The observed disparities in disease prevalence between sexes represent a significant challenge to this goal. Understanding these differences is the first step toward developing more effective prevention and treatment strategies for non-communicable diseases.

• Asthma: Tends to affect males more in early life, but becomes more prevalent in females later in life.
• Neurological Disorders: Parkinson’s disease is more common in men, whereas Alzheimer’s disease is more common in women.
• Autoimmune Diseases: Women are disproportionately affected, being approximately 2.5 times more likely to develop multiple sclerosis and 9 times more likely to develop lupus.

Research into these areas directly supports SDG Target 3.4, which aims to reduce premature mortality from non-communicable diseases through prevention and treatment.

Core Drivers of Sex-Based Immune Variation

The LJI review identifies three primary drivers shaping the distinct immune profiles of males and females. A comprehensive understanding of these factors is essential for creating health systems that are both inclusive and effective.

1. Genetic Programming: The presence of XX chromosomes in females versus XY in males is a foundational difference. The X chromosome contains a high concentration of immune-related genes.
2. Hormonal Influence: Sex hormones such as estrogen and testosterone are sensed by immune cells, directly regulating gene expression and cellular function. This means genetically similar cells can behave differently depending on the hormonal environment.
3. Environmental and Microbiome Factors: External influences, including nutrition, chemical exposures, and distinct gut and skin microbiomes, contribute to the complex interplay that defines an individual’s immune response.

Implications for Gender Equality and Reduced Inequalities (SDG 5 & SDG 10)

The findings strongly advocate for moving beyond a “one-size-fits-all” approach in medicine, a critical step toward achieving both gender equality in health (SDG 5) and reducing health-related inequalities (SDG 10).

• Chromosomal Advantage and Disadvantage: Females possess two X chromosomes, creating a “mosaic” of immune cells with greater variety, which may enhance defense against pathogens like SARS-CoV-2. However, this increased X chromosome “dosage” is also linked to a higher predisposition for autoimmune disorders.
• Precision Medicine: Recognizing these biological differences is fundamental to the development of precision medicine. In fields like cancer immunotherapy, understanding how an individual’s sex-specific immune system responds is key to tailoring effective treatments.
• Equitable Outcomes: By designing therapies that account for sex-based biological differences, the medical community can work to close the gap in health outcomes, ensuring that treatments are effective for everyone and directly contributing to the mission of SDG 10.

Fostering Partnerships for the Goals (SDG 17)

The translation of these foundational scientific discoveries into tangible medical advances requires robust collaboration. As noted by the researchers, “It takes a team to translate these findings.” This principle is the cornerstone of SDG 17, which calls for strengthening global partnerships to support the achievement of sustainable development. The ongoing work between LJI and its collaborators exemplifies the multi-stakeholder approach needed to build a healthier and more equitable future for all.

SDGs Addressed in the Article

1. SDG 3: Good Health and Well-being

   • The article’s central theme is health, focusing on why diseases like asthma, Parkinson’s, Alzheimer’s, multiple sclerosis, and lupus affect men and women differently. It directly addresses the need to understand the biological underpinnings of diseases to improve health outcomes for everyone. The research discussed aims to pave the way for medical advances and “precision medicine.”

2. SDG 5: Gender Equality

   • The article highlights a significant disparity in health outcomes and disease prevalence based on biological sex. By advocating for research into these differences and promoting “precision medicine” that considers sex, it implicitly addresses the need for equality in health research and treatment. The statement, “one size doesn’t fit everybody,” points to the need to move beyond a male-centric or generalized model of medicine to ensure equitable health outcomes for women, who are disproportionately affected by autoimmune diseases.

3. SDG 9: Industry, Innovation, and Infrastructure

   • The article is fundamentally about scientific research and innovation. It showcases the work of scientists at the La Jolla Institute for Immunology (LJI) who are leading “new research” and have “uncovered a whole new body of information.” This focus on enhancing scientific research to drive medical advances aligns with the goal of fostering innovation.

4. SDG 17: Partnerships for the Goals

   • The article concludes by emphasizing the importance of collaboration. It states that the researchers are “working with collaborators across the country to move this research forward” and quotes Dr. Sharma saying, “It takes a team to translate these findings.” This directly reflects the principle of forming partnerships to achieve scientific and health-related goals.

Specific Targets Identified

1. Target 3.4: Reduce premature mortality from non-communicable diseases

   • The article discusses several non-communicable diseases (NCDs), including asthma, Parkinson’s, Alzheimer’s, multiple sclerosis, lupus, and cancer. The research into sex-based immune differences is presented as a critical step toward developing better treatments and “precision medicine,” which would directly contribute to reducing mortality and suffering from these NCDs.

2. Target 3.d: Strengthen the capacity for early warning, risk reduction and management of national and global health risks

   • By investigating why one sex may be more vulnerable to certain diseases (e.g., women and autoimmune diseases) or pathogens (e.g., men and SARS-CoV-2), the research helps in identifying and managing health risks more effectively for different population segments. This foundational knowledge strengthens the capacity to predict, prevent, and manage disease outbreaks and prevalence.

3. Target 5.c: Adopt and strengthen sound policies and enforceable legislation for the promotion of gender equality

   • While not about legislation, the article’s push for “precision medicine” and recognition of sex-based differences is a call to reform policies and practices within the medical and research fields. It advocates for moving away from a “one-size-fits-all” approach, which has historically disadvantaged women in medical research, toward a more equitable system where treatments are tailored based on factors including biological sex.

4. Target 9.5: Enhance scientific research and encourage innovation

   • The entire article is a testament to this target. It describes new scientific discoveries published in a major journal (*Science*) and highlights the work of a dedicated research center, the “Center for Sex-Based Differences in the Immune System.” The research aims to innovate in fields like cancer immunotherapy by understanding the “complex interplay of chromosomes and sex hormones.”

5. Target 17.6: Enhance regional and international cooperation on and access to science, technology and innovation

   • The article explicitly supports this target in its conclusion by mentioning that the LJI scientists are “working with collaborators across the country” and that “It takes a team to translate these findings,” underscoring the need for partnerships to advance science and technology.

Implied Indicators for Measuring Progress

1. Incidence and prevalence rates of diseases, disaggregated by sex

   • The article opens by citing statistics on how diseases affect sexes differently: “Parkinson’s is more common in men, but Alzheimer’s is more common in women,” and women are “nine times more likely to develop lupus.” Tracking these rates is a direct way to measure the scale of the problem and the impact of new, targeted interventions.

2. Development and application of sex-specific medical treatments

   • The article points toward the goal of creating new treatments, particularly in “cancer immunotherapy” and “precision medicine.” An indicator of progress would be the number of new drugs or therapies developed and approved that account for sex-based biological differences.

3. Integration of sex-based analysis in medical research funding and clinical trials

   • The call to move beyond a “one-size-fits-all” approach implies a need for systemic change in research. Progress could be measured by the percentage of publicly funded medical studies that include analysis of results by sex, or policies requiring such analysis.

4. Number of collaborative research projects and publications

   • The mention of working with “collaborators across the country” and the publication of the research in the journal *Science* suggest that the volume and impact of collaborative research in this specific field can serve as an indicator of progress toward achieving the goals.

SDGs, Targets, and Indicators Analysis

Source: technologynetworks.com