Association between comorbidities and extraglandular manifestations in primary Sjögren’s syndrome: a multicenter cross-sectional study

Zhang, Yuying; Li, Mengtao; Zhang, Liyun; Li, Qin; Yang, Pinting; Kong, Xiaodan; Duan, Xinwang; Zhang, Miaojia; Li, Xiaomei; Wang, Yongfu; Xu, Jian; Wang, Yanhong; Hsieh, Evelyn; Xu, Dong; Zhao, Yan; Zeng, Xiaofeng

doi:10.1007/s10067-020-04992-x

Cited by 13 publications

(9 citation statements)

References 42 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Previous studies have confirmed that pSS is a strong risk factor for hematological malignancies, but its association with solid tumors is still uncertain (3). A crosssectional study showed that the most common solid cancer in pSS patients is breast cancer, which involved 0.2% of pSS patients (4).…”

Section: Introductionmentioning

confidence: 99%

Risk, Incidence, and Mortality of Breast Cancer in Primary Sjögren’s Syndrome: A Systematic Review and Meta-Analysis

et al. 2022

View full text Add to dashboard Cite

BackgroundPrimary Sjögren’s syndrome (pSS) and breast cancer are a highly prevalent autoimmune disease and malignancy, respectively, both occurring predominantly in females. Whether there is a link between these two diseases is uncertain. We conducted a systematic review and meta-analysis to investigate the risk, incidence, and mortality of breast cancer in patients with pSS.MethodsWe systematically searched Embase, PubMed, and Web of Science on January 31, 2022 to identify the study that assessed risk, incidence, or mortality of breast cancer in pSS. The fixed or random-effects models were applied to pool the effect estimates based on heterogeneity measured by Cochran’s Q-test and Higgins’ I2.ResultsTen studies involving 725,805 participants and 64,836 pSS patients were included in our analysis. The pooled result showed that, overall, pSS was not associated with the risk (SIR=0.92, 95%CI: 0.66-1.29, P=0.646) and mortality (HR = 0.78, 95%CI: 0.26-2.34, P = 0.664) of breast cancer; however, when stratified by geographic region, we found that patients with pSS in Asian countries (SIR=1.32, 95%CI: 1.10-1.58, P=0.003) and Argentina (SIR=3.76, 95%CI: 1.04-9.45, P=0.019) had an elevated risk of breast cancer, while pSS in Europe was associated with a reduced risk (SIR=0.61, 95%CI: 0.51-0.73, P<0.001). The pooled result from 28,635 female pSS patients indicated that the incidence of breast cancer was 2.15 (95% CI: 1.33-3.50) per 1000 person/years.ConclusionThis study suggests that there may be geographical differences in the association between pSS and breast cancer risk; patients with pSS in European countries are associated with a lower risk of breast cancer, while Asia and Argentina are the opposite. Future research is needed to further characterize the effect of pSS on breast cancer risk and the pathophysiological mechanisms underlying this association to unravel the complex relationship between the two.

show abstract

Section: Introductionmentioning

confidence: 99%

Risk, Incidence, and Mortality of Breast Cancer in Primary Sjögren’s Syndrome: A Systematic Review and Meta-Analysis

et al. 2022

View full text Add to dashboard Cite

show abstract

“…As our focus was on the impact of autoantibody on patient profiles, we enrolled only EGM negative and non-medicated patients, whereas in some of the other studies a portion of the patients were medicated and suffered from a variety of EGMs. EGMs have been associated with increased comorbidities and increased mortality in pSS patients compared to the general population ( 47 , 48 ). Therefore, absence of EGM in our cohort may indicate a less severe form of the disease in our patients, contributing to differences with earlier observations.…”

Section: Discussionmentioning

confidence: 99%

Aberrant signaling of immune cells in Sjögren’s syndrome patient subgroups upon interferon stimulation

et al. 2022

View full text Add to dashboard Cite

BackgroundPrimary Sjögren’s syndrome (pSS) is a systemic autoimmune disease, characterized by mononuclear cell infiltrates in the salivary and lacrimal glands, leading to glandular atrophy and dryness. Patient heterogeneity and lack of knowledge regarding its pathogenesis makes pSS a difficult disease to manage.MethodsAn exploratory analysis using mass cytometry was conducted of MAPK/ERK and JAK/STAT signaling pathways in peripheral blood mononuclear cells (PBMC) from 16 female medication free pSS patients (8 anti-Sjögren’s syndrome-related antigen A negative/SSA- and 8 SSA+) and 8 female age-matched healthy donors after stimulation with interferons (IFNs).ResultsWe found significant differences in the frequencies of memory B cells, CD8+ T central and effector memory cells and terminally differentiated CD4+ T cells among the healthy donors and patient subgroups. In addition, we observed an upregulation of HLA-DR and CD38 in many cell subsets in the patients. Upon IFNα2b stimulation, slightly increased signaling through pSTAT1 Y701 was observed in most cell types in pSS patients compared to controls, while phosphorylation of STAT3 Y705 and STAT5 Y694 were slightly reduced. IFNγ stimulation resulted in significantly increased pSTAT1 Y701 induction in conventional dendritic cells (cDCs) and classical and non-classical monocytes in the patients. Most of the observed differences were more prominent in the SSA+ subgroup, indicating greater disease severity in them.ConclusionsAugmented activation status of certain cell types along with potentiated pSTAT1 Y701 signaling and reduced pSTAT3 Y705 and pSTAT5 Y694 induction may predispose pSS patients, especially the SSA+ subgroup, to upregulated expression of IFN-induced genes and production of autoantibodies. These patients may benefit from therapies targeting these pathways.

show abstract

“…Second, in addition to traditional cardiovascular risk factors, microinflammation and immune system dysregulation could also have an impact on IHD in pSS: extraglandular organ inflammation may be an independent risk factor for the onset of CVEs [8,28,37], and especially of IHD [8], and the presence of pSS autoantibodies (anti-SSa/SSb) has been associated with the onset of stroke [20]. Nevertheless, the different subtypes of Sjögren's disease could not be integrated into our analysis: patients with high disease activity, such as low complement consumption or lymph node enlargement, might show a different risk of cardiovascular issues and should be studied distinctly from other "low disease activity" patients in further studies.…”

Section: Discussionmentioning

confidence: 99%

Cardiovascular Events, Sleep Apnoea, and Pulmonary Hypertension in Primary Sjögren’s Syndrome: Data from the French Health Insurance Database

Goulabchand

Roubille

Montani

et al. 2021

JCM

View full text Add to dashboard Cite

Primary Sjögren’s syndrome (pSS) is an autoimmune disease, associated with a high risk of lymphoma. Mounting evidence suggests that cardiovascular morbidity and mortality are higher in patients with pSS, although data are heterogeneous. The aim of this study was to assess whether pSS patients are at higher risk of hospitalisation for cardiovascular events (CVEs), venous thromboembolic events (VTEs), pulmonary hypertension (PH), and sleep apnoea syndrome (SAS). Through a nationwide population-based retrospective study using the French health insurance database, we selected new-onset pSS in-patients hospitalised between 2011 and 2018. We compared the incidence of CVEs (ischemic heart diseases (IHDs), strokes, and heart failure), SAS, VTEs, and PH with an age- and sex-matched (1:10) hospitalised control group. The calculations of adjusted hazard ratios (aHR) included available confounding factors. We studied 25,661 patients hospitalised for pSS compared with 252,543 matched patients. The incidence of hospitalisation for IHD, SAS, and PH was significantly higher in pSS patients (aHR: 1.20 (1.06–1.34); p = 0.003, aHR: 1.97 (1.70–2.28); p < 0.001, and aHR: 3.32 (2.10–5.25); p < 0.001, respectively), whereas the incidence of stroke, heart failure, and VTE was the same between groups. Further prospective studies are needed to confirm these results and to explore the pathophysiological mechanisms involved.

show abstract

Association between comorbidities and extraglandular manifestations in primary Sjögren’s syndrome: a multicenter cross-sectional study

Cited by 13 publications

References 42 publications

Risk, Incidence, and Mortality of Breast Cancer in Primary Sjögren’s Syndrome: A Systematic Review and Meta-Analysis

Risk, Incidence, and Mortality of Breast Cancer in Primary Sjögren’s Syndrome: A Systematic Review and Meta-Analysis

Aberrant signaling of immune cells in Sjögren’s syndrome patient subgroups upon interferon stimulation

Cardiovascular Events, Sleep Apnoea, and Pulmonary Hypertension in Primary Sjögren’s Syndrome: Data from the French Health Insurance Database

Contact Info

Product

Resources

About