Men and women are not equal in the face of disease, including arthritis.
The creation of every human being begins microscopically — with the fertilized egg in a woman’s womb. This fertilized egg gives life to each cell in our bodies, eventually dividing into 10 trillion cells with different functions and places.
Within each of these trillions of cells in a human’s body are the same 23 pairs of chromosomes, which contain all of the DNA that makes our bodies operate. Between males and females, 22 of the 23 pairs of chromosomes are exactly the same. The only difference is in number 23, the sex chromosome, explained David Page, MD, professor of biology at the Massachusetts Institute of Technology and the director of the Whitehead Institute.
In his 2013 Ted Talk speech, addressing an audience of scientists and laypeople alike, he delved into a subject that many, even professionals in the science research world, tend to ignore: the relationship between gender and disease.
“We have been operating with a unisex vision of the human genome,” Page said, citing the widespread belief that the Y chromosome exclusive to males only functions in the reproductive organs. In scientific practice, there is a belief that the genomes of men and women are equivalent except for in reproduction. Men have the XY chromosome and women have the XX chromosome.
Most have adopted the theory that humans are all 99.9% identical genetically, but that is only true if you are comparing the genomes of men to men or women to women. Page illustrated that, in fact, men and women are merely 98.5% genetically identical. Therefore, he put somewhat comically, a human man is as genetically related to a human woman as he is to a male chimpanzee.
Because of this contrast in our genetics, men and women experience disease differently and are more susceptible to different ailments.
“Men and women aren’t equal in the face of disease,” Page stated. Men are more prone to developing certain mental disorders, including autism spectrum disorder. Page asserted that for every 1 girl with autism, there are 5 boys with the condition.
Women are much more vulnerable to a wide spectrum of autoimmune diseases. For every 1 man with rheumatoid arthritis, there are 2 to 3 women with the disease, and for every 1 man with lupus, there are 6 women suffering from it.
Disorders can also be more or less severe in one sex than the other, Page explained. This assertion is backed by many studies, including a recent study out of Australia that found that women with type 1 diabetes have a 40% greater risk of death than men.
These different susceptibilities are not by chance, or even by environmental factors, Page contended, but are due to distinctions in the very genetic makeup between the sexes.
Page argued that many scientists he communicates with around the world don’t understand the importance of the fundamental differences between the XX and XY chromosome. Most believe that all differences, including vulnerability to disease, must stem from differences in the sex hormones, produced by the reproductive organs. But the research stops there. He said that many of the scientists he visits around the world don’t know if they are studying XX or XY cells when looking at them under the microscope.
Because of this inattention to something he deems vitally essential to disease research, Page is calling for reform to our focus. He asserted that though we have processes for determining disease difference in race, age, and more, “as unbelievable as it may seem, we have no genetic toolkit to ask the question ‘why are men as a group at higher or lower risk of a particular disease than women as a group?’”
Large efforts, funds and energy are spent on understanding diseases, developing treatments and finding possible cures, but Page said this is “failing to account for this most fundamental difference between men and women”: the XX and XY chromosomes.
In his research at a world-renown facility at MIT, Page has discovered that all the cells in your body, including the liver, skin, heart, and more, know at a very base level if they are XX or XY. “XX and XY cells do their business differently,” he said, including making proteins, as Page claimed to have found through his research.
Page is trying to direct of the focus of disease research and healthcare treatment toward considering the XX and XY chromosomes. He argued that researchers and healthcare providers need to take this distinguishable difference into account and develop a more comprehensive knowledge of how this difference places into health. He advocated drug discovery that uses the XX and XY approach instead of the standard unisex, and said we should weave this into all facets of healthcare.
“I believe that if we do this, and I believe that we can, that we will arrive at a fundamentally new paradigm for understanding and treating human disease.”
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