# Sex Matters: Hormonal and Chromosomal Determinants of Autoimmunity and Anti‐Cancer Immunity Across the Lifespan

**Authors:** Christian G. Bustillos, Esther M. Peluso, Sophia L. Cha, Melissa G. Lechner, Maureen A. Su

PMC · DOI: 10.1111/imr.70096 · Immunological Reviews · 2026-01-24

## TL;DR

This review explores how sex-related factors like hormones and chromosomes influence cancer immunity and autoimmunity throughout life.

## Contribution

The paper highlights recent insights into how hormonal and chromosomal changes across the lifespan affect immune responses.

## Key findings

- Sex differences in hormone levels and chromosome complement influence anti-cancer and autoimmune responses.
- Changes in hormone levels during life stages like menopause impact immune function.
- Accumulation of chromosomal alterations, such as loss of Y chromosome, affects immunity over time.

## Abstract

Sex plays a key role in shaping both anti‐cancer immunity and autoimmunity. Biological factors underlying sexual dimorphism have now been identified in multiple aspects of anti‐cancer immunity and autoimmunity. These factors include sex differences in hormone levels, chromosome complement, and expression of the long non‐coding RNA XIST. In this review, we discuss recent advances delineating how these differences alter immune responses against cancer and autoimmune responses against healthy tissues. Moreover, we now understand that hormone levels change (e.g., in mini‐puberty, menopause, and andropause) and that somatic alterations in chromosomal complement accumulate (e.g., loss of Y [LOY] chromosome) across the lifespan. We also include here a discussion of how these changes affect anti‐cancer immunity and autoimmunity across a lifetime. These recent advances will set the stage for identifying immunotherapeutic approaches that optimize anti‐cancer immunity while controlling the autoimmune responses.

## Linked entities

- **Diseases:** cancer (MONDO:0004992)

## Full-text entities

- **Genes:** GNRH1 (gonadotropin releasing hormone 1) [NCBI Gene 2796] {aka GNRH, GRH, LHRH, LNRH}, Hbb-y (hemoglobin Y, beta-like embryonic chain) [NCBI Gene 15135] {aka Ey, Hby}, IL1A (interleukin 1 alpha) [NCBI Gene 3552] {aka IL-1 alpha, IL-1A, IL1, IL1-ALPHA, IL1F1}, Bcl2 (B cell leukemia/lymphoma 2) [NCBI Gene 12043] {aka Bcl-2, C430015F12Rik, D630044D05Rik, D830018M01Rik}, Cd4 (CD4 antigen) [NCBI Gene 12504] {aka L3T4, Ly-4}, Prl8a2 (prolactin family 8, subfamily a, member 2) [NCBI Gene 13529] {aka D/tPRP, DPRP, Dtprp, Ghd11, mdPRP}, Slurp1 (secreted Ly6/Plaur domain containing 1) [NCBI Gene 57277] {aka 1110021N19Rik, ARS, ArsB, Slurp-1}, TNF (tumor necrosis factor) [NCBI Gene 7124] {aka DIF, IMD127, TNF-alpha, TNFA, TNFSF2, TNLG1F}, ESR1 (estrogen receptor 1) [NCBI Gene 2099] {aka ER, ESR, ESRA, ESTRR, Era, NR3A1}, Ifng (interferon gamma) [NCBI Gene 15978] {aka IFN-g, If2f, Ifg}, Tnf (tumor necrosis factor) [NCBI Gene 21926] {aka DIF, TNF-a, TNF-alpha, TNFSF2, TNFalpha, Tnfa}, Il21 (interleukin 21) [NCBI Gene 60505] {aka IL-21}, Tcrb (T cell receptor beta chain) [NCBI Gene 21577] {aka TCRbeta, Tib}, NR1I2 (nuclear receptor subfamily 1 group I member 2) [NCBI Gene 8856] {aka BXR, ONR1, PAR, PAR1, PAR2, PARq}, EPHB2 (EPH receptor B2) [NCBI Gene 2048] {aka BDPLT22, CAPB, DRT, EK5, EPHT3, ERK}, Foxp3 (forkhead box P3) [NCBI Gene 20371] {aka JM2, scurfin, sf}, Hspa5 (heat shock protein family A (Hsp70) member 5) [NCBI Gene 14828] {aka Bip, D2Wsu141e, D2Wsu17e, Grp78, Hsce70, SEZ-7}, Uty (ubiquitously transcribed tetratricopeptide repeat containing, Y-linked) [NCBI Gene 22290] {aka Hydb, mKIAA4057}, Ssb (small RNA binding exonuclease protection factor La) [NCBI Gene 20823] {aka SS-B}, Kdm5c (lysine demethylase 5C) [NCBI Gene 20591] {aka D930009K15Rik, Jarid1c, Smcx, mKIAA0234}, Havcr2 (hepatitis A virus cellular receptor 2) [NCBI Gene 171285] {aka TIM-3, Tim3, Timd3}, PDCD1 (programmed cell death 1) [NCBI Gene 5133] {aka ADMIO4, AIMTBS, CD279, PD-1, PD1, SLEB2}, Kdm6a (lysine (K)-specific demethylase 6A) [NCBI Gene 22289] {aka Utx}, Trav6-3 (T cell receptor alpha variable 6-3) [NCBI Gene 328483] {aka Gm13948, Gm193, Gm4, TCR}, Il1b (interleukin 1 beta) [NCBI Gene 16176] {aka IL-1beta, Il-1b}, Kdm6b (KDM1 lysine (K)-specific demethylase 6B) [NCBI Gene 216850] {aka 1700064E03Rik, Jmjd3}, Il2rg (interleukin 2 receptor, gamma chain) [NCBI Gene 16186] {aka CD132, [g]c, gamma(c), gc, p64}, Tox (thymocyte selection-associated high mobility group box) [NCBI Gene 252838] {aka 1700007F02Rik}, SP1 (Sp1 transcription factor) [NCBI Gene 6667], Il2ra (interleukin 2 receptor, alpha chain) [NCBI Gene 16184] {aka CD25, Il2r, Ly-43}, Tcf7 (transcription factor 7, T cell specific) [NCBI Gene 21414] {aka TCF-1, Tcf1}, CD4 (CD4 molecule) [NCBI Gene 920] {aka CD4mut, IMD79, Leu-3, OKT4D, T4}, Prc1 (protein regulator of cytokinesis 1) [NCBI Gene 233406] {aka D7Ertd348e}, Ptpn6 (protein tyrosine phosphatase, non-receptor type 6) [NCBI Gene 15170] {aka 70Z-SHP, Hcph, PTPTY-42, Ptp1C, SH-PTP1, SHP-1}, Il4 (interleukin 4) [NCBI Gene 16189] {aka BSF-1, Il-4}, Gzmb (granzyme B) [NCBI Gene 14939] {aka CCP-1/C11, CCP1, Ctla-1, Ctla1, GZB}, Rag2 (recombination activating gene 2) [NCBI Gene 19374] {aka Rag-2}, Fdxr (ferredoxin reductase) [NCBI Gene 14149] {aka AR}, Esr2 (estrogen receptor 2 (beta)) [NCBI Gene 13983] {aka ER[b], ERbeta, Estrb}, Nr3c1 (nuclear receptor subfamily 3, group C, member 1) [NCBI Gene 14815] {aka GR, Grl-1, Grl1}, CD8A (CD8 subunit alpha) [NCBI Gene 925] {aka CD8, CD8alpha, IMD116, Leu2, p32}, NFKB1 (nuclear factor kappa B subunit 1) [NCBI Gene 4790] {aka CVID12, EBP-1, KBF1, NF-kB, NF-kB1, NF-kappa-B1}, TNFSF13B (TNF superfamily member 13b) [NCBI Gene 10673] {aka BAFF, BLYS, CD257, TALL-1, TALL1, THANK}, Il17a (interleukin 17A) [NCBI Gene 16171] {aka Ctla-8, Ctla8, IL-17, IL-17A, Il17}, Ar (androgen receptor) [NCBI Gene 11835] {aka Tfm}, Spen (spen family transcription repressor) [NCBI Gene 56381] {aka Mint, mKIAA0929}, IL6 (interleukin 6) [NCBI Gene 3569] {aka BSF-2, BSF2, CDF, HGF, HSF, IFN-beta-2}, Cd247 (CD247 antigen) [NCBI Gene 12503] {aka 4930549J05Rik, A430104F18Rik, Cd3, Cd3-eta, Cd3-zeta, Cd3h}, Ftx (Ftx transcript, Xist regulator, non-protein coding) [NCBI Gene 78878] {aka B230206F22Rik, NCRNA00182, Thcytx}, AKT1 (AKT serine/threonine kinase 1) [NCBI Gene 207] {aka AKT, PKB, PKB-ALPHA, PRKBA, RAC, RAC-ALPHA}, Ccl25 (C-C motif chemokine ligand 25) [NCBI Gene 20300] {aka A130072A22Rik, CKb15, Scya25, TECK}, S100A6 (S100 calcium binding protein A6) [NCBI Gene 6277] {aka 2A9, 5B10, CABP, CACY, PRA, S10A6}, NR4A1 (nuclear receptor subfamily 4 group A member 1) [NCBI Gene 3164] {aka GFRP1, HMR, N10, NAK-1, NGFIB, NP10}, Dll4 (delta like canonical Notch ligand 4) [NCBI Gene 54485] {aka Delta4}, Cd44 (CD44 antigen) [NCBI Gene 12505] {aka HERMES, Ly-24, Pgp-1}, ESR2 (estrogen receptor 2) [NCBI Gene 2100] {aka ER-BETA, ESR-BETA, ESRB, ESTRB, Erb, NR3A2}, Pgr (progesterone receptor) [NCBI Gene 18667] {aka 9930019P03Rik, NR3C3, PR, PR-A, PR-B}, Itgax (integrin alpha X) [NCBI Gene 16411] {aka Cd11c, Cr4, N418}, Manf (mesencephalic astrocyte-derived neurotrophic factor) [NCBI Gene 74840] {aka 3230402M22Rik, Armet, D18Mgi17}, Tlr7 (toll-like receptor 7) [NCBI Gene 170743]
- **Diseases:** breast and ovarian cancer (MESH:D061325), Fetal anomalies (MESH:D000013), pancreatic ductal adenocarcinoma tumor (MESH:D021441), MS (MESH:D009103), CRC (MESH:D015179), TECs (MESH:D013945), CAH (MESH:D000312), allergic airway inflammation (MESH:D007249), Sjogren's syndrome (MESH:D012859), vitiligo (MESH:D014820), Xist deficiency (MESH:D007153), Juvenile dermatomyositis (MESH:D003882), triple negative breast cancer (MESH:D064726), sex hormone excess (MESH:D058533), breast cancer (MESH:D001943), metastases (MESH:D009362), Tolerance (MESH:D018149), hypogonadism (MESH:D007006), T1D (MESH:D003922), Sex Chromosomes in Cancer (MESH:D025064), prostate and bladder cancers (MESH:D011471), LOY (MESH:C536297), Chron's disease (MESH:D004194), death (MESH:D003643), autoimmune uveitis (MESH:D014605), ulcerative colitis (MESH:D003093), Hashimoto's thyroiditis (MESH:D050031), cardiac fibrosis (MESH:D005355), liver cancer (MESH:D006528), ovarian cancer (MESH:D010051), idiopathic (MESH:D002311), Cancer (MESH:D009369), melanoma (MESH:D008545), RA (MESH:D001172), inflammatory bowel disease (MESH:D015212), EAE (MESH:D004660), testicular cancer (MESH:D013736), autoimmune side effects (MESH:D064420), Grave's disease (MESH:D006111), myocarditis (MESH:D009205), Klinefelter syndrome (MESH:D007713), SLE (MESH:D008180), bladder cancer (MESH:D001749), asthma (MESH:D001249), scleroderma (MESH:D012595), hypothalamic hypogonadism (MESH:D007027), autoimmune experimental encephalitis (MESH:D020274), Autoimmune diseases (MESH:D001327), premature ovarian insufficiency (MESH:D016649), JIA (MESH:D001171), glioblastoma (MESH:D005909), autoimmune colitis (MESH:D003092), AIT (MESH:D013967), Myasthenia Gravis (MESH:D009157)
- **Chemicals:** I (MESH:D007455), estriol (MESH:D004964), Progesterone (MESH:D011374), estrone (MESH:D004970), DHEA (MESH:D003687), testosterone (MESH:D013739), DHT (MESH:D013196), GSKJ4 (MESH:C000593030), steroid (MESH:D013256), glutamine (MESH:D005973), nitric oxide (MESH:D009569), ADT (-), estradiol (MESH:D004958), fulvestrant (MESH:D000077267), R848 (MESH:C402365)
- **Species:** Homo sapiens (human, species) [taxon 9606], Ovis aries (domestic sheep, species) [taxon 9940], Mus musculus (house mouse, species) [taxon 10090]
- **Cell lines:** 4T1 breast — Homo sapiens (Human), Anaplastic large cell lymphoma, ALK-negative, Cancer cell line (CVCL_A1FA), SJL/J — Mus musculus (Mouse), Finite cell line (CVCL_5897), LOY — Homo sapiens (Human), Primary cutaneous T-cell non-Hodgkin lymphoma, Cancer cell line (CVCL_2633), MC38 — Mus musculus (Mouse), Mouse colon adenocarcinoma, Cancer cell line (CVCL_B288), CT26 — Mus musculus (Mouse), Mouse colon adenocarcinoma, Cancer cell line (CVCL_7254)

## Full text

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## Figures

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## References

145 references — full list in the complete paper: https://tomesphere.com/paper/PMC12831719/full.md

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Source: https://tomesphere.com/paper/PMC12831719