The goal of this article was to use a uniquely informative model system to determine whether sex chromosome complement may contribute to the gender difference in susceptibility to EAE and lupus. Our data have indicated that the XX sex chromosome complement is disease promoting compared with the XY
− complement. Has the possibility been ruled out that long-term effects of developmental hormones may have had an influence in our system? Regarding a potential effect of hormonal differences present before gonadectomy at 4 wk, the comparisons made in our manuscript are between XX versus XY
− femice, with both groups having had ovaries during development. Analogously, comparisons between XX
Sry versus XY
−Sry male mice are between groups that have both had testes during development. Moreover, our laboratory (
7) and another (
22) have assessed testosterone levels in 6–8-wk-old XX
Sry versus XY
−Sry male mice, as well as in XX versus XY
− female mice, and have found no difference between groups. Although it is impossible to state that hormones were equivalently secreted from XX
Sry versus XY
−Sry testes, or from XX versus XY
− ovaries, at every day of development, when phenotypic measures in the CNS that are known to undergo organizational effects mediated by gonadal hormones were previously compared between XX
Sry and XY
−Sry males, as well as between XX and XY
− females, no differences were found (
23). Together, these previously published results provide strong evidence against a gonadal hormone difference between our comparisons of mice that differ in sex chromosome complement although they have the same gonadal type. Finally, the fact that differences similar to those observed when comparing XX
Sry versus XY
−Sry in autoimmune disease outcomes in this article were observed when comparing XX versus XY
−suggests that this difference in autoimmune disease outcomes did not require a particular history of a difference in ovarian or testicular secretions. Thus, we conclude that the female sex chromosome complement, as compared with the male sex chromosome complement, has a direct effect on promoting susceptibility to two distinct autoimmune diseases, which is unlikely to be mediated by indirect effects of differences in gonadal hormones.
In addressing what immune mechanisms might underlie the disease-promoting effect of the XX as compared with the XY
− sex chromosome complement, we found clear differences in Th2 cytokine production, with higher levels from cells derived from XY
− mice. These Th2 cytokines (IL-13, -4, and -10) have been previously associated with protection from disease in EAE (
24–
28). Therefore, increased Th2 cytokine production in XY
− mice compared with that in XX mice could underlie the decreased EAE disease severity in XY
− mice compared with XX mice. Further, although late stages of murine lupus characterized by renal fibrosis have been considered a Th2-mediated disease (
29), initiation of events in the early phase of disease have been reduced by treatment with Th2 cytokines such as IL-4 and -10 (
30–
33). Consistently, in vivo blockade of IL-4 has been shown to result in increases in serum IgG anti-DNA antibody levels (
29). Therefore, as in EAE, relatively higher levels of Th2 cytokines early during disease induction in XY
− as compared with XX mice could underlie the decreased severity of pristane-induced lupus in XY
− mice.
Our finding of increased IL-13Rα2 expression in spleen cells derived from XX mice, as compared with XY
−, was particularly interesting because the IL-13Rα2 gene is on the X chromosome (
17) and because not all X genes undergo X inactivation (
34,
35). Thus, increased expression of IL-13Rα2 could be caused by an X dosage effect in XX as compared with XY
−. Relatively higher expression of IL-13Rα2 in XX could in turn act as a decoy receptor to limit Th2 responses in the XX (
18–
21), which is consistent with lower levels of Th2 cytokines in XX as compared with XY
−. Alternatively, cytokine differences could be the cause, not the effect, of differences in IL-13Rα2. This is however less likely because cytokines such as IL-13 and -10, which up-regulate IL-13Rα2 expression, were not increased in XX. Furthermore, expression of another IL-13 receptor, IL-13Rα1, was no different between XX and XY
− mice. Such a selective increase in IL-13Rα2, but not IL-13Rα1, has been described in other models of immunoinflammatory diseases, such as in oxazolone-induced colitis and bleomycin-induced inflammatory disease (
36–
38). Ongoing experiments will further investigate the contribution of IL-13Rα2 in mediating the enhanced susceptibility of XX mice to increased autoimmune diseases in females.
Our data demonstrating an increase in IL-13Rα2 expression in cells derived from XX mice do not preclude the possibility of increased expression of other candidate genes on X. These other candidate genes are numerous and include CD40 ligand, FoxP3, and Toll-like receptor 7, to name a few. Consistent with a potential X dosage effect in our lupus model, XXY men and XX women have a similarly high risk of developing lupus, whereas the incidence of lupus in XO females is very low (
39). Because these sex chromosome differences in humans are confounded by differences in sex hormones during both development and adulthood, one may never be able to distinguish between a sex chromosome effect versus a sex hormone effect in humans. In contrast, our experimental murine system offers distinct advantages for investigating direct effects of X and Y genes. Future studies using XO mice will determine whether the XX versus XY
− differences observed in this study are caused by an X dosage effect or an effect of a gene on the Y chromosome.
Previous descriptions of an effect of a gene on a sex chromosome on lupus exist, but our findings are distinct from those results. It is well known that the BXSB strain develops lupus with a reversed sex bias, with males having accelerated disease. This was reported to be caused by a gene duplication event, whereby the
Yaa region containing Toll-like receptor 7 was duplicated on the Y chromosome (
40). Although this was an elegant demonstration of how gene duplication can localize to a sex chromosome to affect autoimmunity, our results are unique. Specifically, the previous study described a gene duplication event in the pseudoautosomal region, whereas our comparisons between XX versus XY
− revealed effects from differences in the nonpseudoautosomal region because mice compared in this study had the same pseudoautosomal region (
4). Second, lupus disease acceleration caused by
Yaa on the Y chromosome in the BXSB strain is opposite from the known enhanced susceptibility of females to lupus in humans, whereas our finding of enhanced susceptibility in XX mice are consistent with the known female bias. Lastly,
Yaa is disease accelerating in lupus, whereas it is protective in EAE (
41). Thus, the
Yaa effect is disease specific. In contrast, our finding of enhanced susceptibility in XX exists in both EAE and lupus. Thus, our data are the first to describe a sex chromosome effect that is consistent with the known female sex bias and is present across immunopathologically distinct autoimmune diseases.