The prevalence of autoimmune diseases is rising, particularly among women, with winter conditions and high pollution levels further aggravating symptoms, an expert from the All India Institute of Medical Sciences (AIIMS), Delhi, said on Wednesday.
Dr Uma Kumar, professor and head of the Department of Rheumatology at AIIMS, explained that autoimmune diseases develop through complex mechanisms and may affect a single organ or multiple organs across the body.
Limited autoimmune conditions involve one organ, such as the pancreas, while systemic diseases affect several organs. These include rheumatoid arthritis, systemic lupus erythematosus, scleroderma, Sjögren’s syndrome, IgG4-related diseases and many others. Nearly 60 such systemic autoimmune diseases are known, and most are more common in women.
“These diseases can occur at any age but are more prevalent among women of reproductive age. Female hormones and immune-related genes on the X chromosome play an important role. The female-to-male ratio is very high at younger ages and becomes almost equal after menopause,” Dr Kumar said.
She noted that the ratio may be as high as 9:1 during adolescence and early adulthood, gradually evening out to 1:1 after the age of 60 or 70.
Dr Kumar also highlighted that women often face neglect due to social misconceptions that autoimmune diseases are hereditary or contagious, which is untrue. “Many women suffer in silence, leading to significant mental health challenges,” she said.
Symptoms tend to worsen during winter due to cold temperatures, reduced atmospheric pressure, increased joint stiffness, limited sunlight exposure, vitamin D deficiency, weight gain, low mood, pollution and a higher incidence of viral infections, she added.
Air pollution is a major trigger. Studies have shown higher inflammatory markers, oxidative stress and even the presence of autoantibodies in healthy individuals exposed to heavy pollution, especially those living near busy roads, indicating a strong link between pollution and autoimmune disease risk.
Chronic mental stress and poor sleep further increase inflammation and disease activity, with night-shift workers facing a higher risk. Post-COVID, doctors have also observed a noticeable rise in autoimmune and inflammatory conditions, underlining the impact of environmental and lifestyle factors.
Unhealthy diets, smoking, tobacco use and obesity were cited as additional contributors. Obesity, in particular, is a chronic inflammatory state that increases susceptibility to autoimmune diseases.
Improved diagnostic facilities and greater awareness among doctors and the public have also led to higher detection rates. Since awareness campaigns began over a decade ago, recognition of these conditions has steadily improved.
Dr Kumar emphasised that while autoimmune diseases are treatable, they usually require lifelong management, similar to diabetes or hypertension. “There is no single symptom or test to diagnose these conditions. Symptoms can range from fatigue, fever and joint pain to skin rashes, hair loss, dryness of eyes or mouth, kidney or neurological involvement and recurrent pregnancy loss,” she said.
She cautioned against the unsupervised use of steroids and painkillers, noting that they are not required for all autoimmune conditions and can be harmful if misused.
“Lifestyle modification is crucial. Adequate sleep, stress management, regular physical activity, quitting smoking and maintaining a healthy weight can help prevent disease flares,” Dr Kumar said, adding that yoga has been shown to reduce inflammation and improve sleep among patients with autoimmune diseases.