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Science  01 Mar 2013:
Vol. 339, Issue 6123, pp. 1044-1045
DOI: 10.1126/science.1236226

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The gender bias observed in numerous diseases has long been understood as an entirely host-intrinsic factor. It is one of the many puzzling features of some autoimmune conditions (inappropriate immune responses that attack self antigens and destroy host tissue) including type 1 diabetes mellitus, in which sex hormones affect disease susceptibility and severity (1, 2). On page 1084 of this issue, Markle et al. (3) introduce an astonishing twist to this view, suggesting that gender bias may be exercised and/or reinforced by the commensal microbiota of the host. This extrinsic, albeit commensal, factor appears to regulate sex hormone levels and arguably the gender bias observed in type 1 diabetes mellitus. The finding contributes to an expanding field of translational research aiming to convert our growing knowledge of the host-microbiota relationship into therapeutic approaches.