Immunoendocrinology or the study of the effects of sex steroids and sex chromatin on immune diseases was pioneered by Henry G. Kunkel. In the disease lupus (SLE) the prevalence of female disease is high; the sex ratio is 10 females to every male after puberty. Since Kunkel's death the influences of triggering epitopes like viruses, histocompatibility, the hypothalamic pituitary-adrenocortical axis, nervous system and the effect of sex steroids are all recognized as contributing factors to pathogenesis. It is too simple to say that sex and genetics are the final reason for the female predominance of SLE. Today the likely cause of the disease involves the epigenetics of sex chromatin and the factors detailed above.
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