Chronic Obstructive Pulmonary Disease Is Common in Never-smoking Patients with Primary Sjögren Syndrome

Nilsson, Anna; Diaz, Sandra; Theander, Elke; Hesselstrand, Roger; Piitulainen, Eeva; Ekberg, Olle; Wollmer, Per; Mandl, Thomas

doi:10.3899/jrheum.140370

Cited by 16 publications

(28 citation statements)

References 25 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Extraglandular manifestations affecting various organs including the lungs are common amongst pSS patients [3–9] and approximately 50% of pSS patients report dry cough [3]. However, involvement of the respiratory system in pSS entails not only dry airways, but also obstructive airway disease [8], including chronic obstructive pulmonary disease (COPD) [5, 6], as well as interstitial lung disease (ILD) [3, 4, 10], all of which can co-exist in the same patient. Furthermore, all types of respiratory involvement can result in respiratory symptoms.…”

Section: Introductionmentioning

confidence: 99%

“…Although pulmonary involvement seems to be subclinical in a substantial fraction of pSS patients [4], concomitant pulmonary involvement in pSS has been shown to be associated with a fourfold increased risk of mortality after 10 years of disease [7]. It has previously been shown that COPD is a common finding in pSS patients, even among never-smoking patients [5, 6]. To the best of our knowledge, no previous study has investigated to what degree COPD contributes to the respiratory symptoms in pSS patients.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Respiratory symptoms are poor predictors of concomitant chronic obstructive pulmonary disease in patients with primary Sjögren’s syndrome

et al. 2017

Self Cite

View full text Add to dashboard Cite

Involvement of the respiratory system, in particular dry airways and chronic obstructive pulmonary disease (COPD), is common in patients with primary Sjögren’s syndrome (pSS). As respiratory symptoms are also common in pSS patients and may have different etiologies, we wanted to evaluate the amount and impact of respiratory symptoms in out-patients with pSS and to assess if such symptoms are related to concomitant COPD. The St George’s Respiratory Questionnaire (SGRQ) was used to assess respiratory symptoms. SGRQ scores were compared between 51 consecutive pSS patients, in an out-patient setting, and 80 population-based controls. The patients were also studied by pulmonary function tests and CT scans of the lungs to assess signs of obstructive airway disease, including COPD, as well as to assess signs of interstitial lung disease (ILD). 41 and 18% of pSS patients were found to have COPD and radiographic signs of ILD, respectively. pSS patients had significantly higher SGRQ scores compared to controls, but no significant differences in SGRQ scores were found between patients with and without COPD. Neither did the small group of pSS patients with ILD significantly differ in SGRQ scores in comparison to patients without ILD. Respiratory symptoms were common in pSS, but were not more common in patients with concomitant COPD. Since pulmonary involvement in pSS is associated with an increased mortality and respiratory symptoms is a poor marker for pulmonary involvement, we suggest that pulmonary function tests should be performed liberally in all pSS patients regardless of symptoms.

show abstract

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Respiratory symptoms are poor predictors of concomitant chronic obstructive pulmonary disease in patients with primary Sjögren’s syndrome

et al. 2017

Self Cite

View full text Add to dashboard Cite

show abstract

“…Primary Sjögren's syndrome (pSS) is a progressive systemic disease, characterized by autoimmune lymphocytic infiltration of exocrine glands and sicca symptoms. Various respiratory symptoms are also commonly encountered in pSS patients (1)(2)(3)(4), and multiple nonexocrine organs, including the lungs and airways, have been described as being affected in the disease (2,3,(5)(6)(7). In addition, a high prevalence of chronic obstructive pulmonary disease (COPD) in pSS has been reported (8,9), even among never-smoking pSS patients (6), strongly indicating that the disease per se is involved in COPD development.…”

mentioning

confidence: 99%

“…Various respiratory symptoms are also commonly encountered in pSS patients (1)(2)(3)(4), and multiple nonexocrine organs, including the lungs and airways, have been described as being affected in the disease (2,3,(5)(6)(7). In addition, a high prevalence of chronic obstructive pulmonary disease (COPD) in pSS has been reported (8,9), even among never-smoking pSS patients (6), strongly indicating that the disease per se is involved in COPD development. Besides COPD and small airway disease (2)(3)(4), interstitial lung disease (4,10,11) and dry airways are also found in a substantial fraction of patients (3).…”

mentioning

confidence: 99%

“…As a reflection of the pSS-associated pulmonary disease spectrum, radiographic findings, e.g. bronchiolitis and bronchial wall thickening, bronchiolar nodules, cysts, and bronchiectasis (3,4,6,8,12), are commonly found. To date, there is only sparse knowledge on the immunological mechanisms behind airway involvement in pSS, despite recent progress in the understanding of the pathogenesis of pSS (13,14).…”

mentioning

confidence: 99%

See 1 more Smart Citation

Increased B-cell activating factor, interleukin-6, and interleukin-8 in induced sputum from primary Sjögren’s syndrome patients

Nilsson

Tufvesson

Hesselstrand

et al. 2018

Scandinavian Journal of Rheumatology

View full text Add to dashboard Cite

Smoking, disease characteristics and serum cytokine levels in patients with primary Sjögren’s syndrome

et al. 2018

Self Cite

View full text Add to dashboard Cite

Smoking affects several disease processes. Epidemiological studies have previously found a negative association between primary Sjögren’s syndrome (pSS) and smoking. The aim of this study was to examine whether markers of disease activity and cytokine expression in pSS patients differ between ever and never smokers. Fifty-one consecutive pSS patients and 33 population controls were included in the study. Clinical and standard laboratory parameters were registered. Serum cytokines (IL-1β, IL-2, IL-3, IL-4, IL-6, IL-8, IL-10, IL-12, IL-17, IL-18, IL-33, IFN-α, IFN-γ, TNF-α, EGF, BAFF, Fas-ligand, RANTES, TGF-β1) were assessed. A positive lip biopsy was less prevalent among ever smoking patients compared to never smokers (81 vs 100%; p = 0.03). However, except for TNF-α, which was higher in ever smokers, no differences in cytokine levels were found when comparing ever and never smoking pSS patients. Furthermore, no significant differences were found between ever and never smoking patients in the ESSDAI total score, IgG levels, or complement levels. However, IL-6, IL-12, IL-17 and IL-18 were significantly increased in pSS patients compared to controls. In this study, a negative association between ever smoking and positive lip biopsy was found, confirming previous reports. Expected differences in cytokine levels compared to controls were noted, but no major differences were found between ever and never smoking pSS patients. Taking into account the negative association between pSS diagnosis and smoking in epidemiological studies, possible explanations include a local effect of smoking on salivary glands rather than systemic effects by cigarette smoke.Electronic supplementary materialThe online version of this article (10.1007/s00296-018-4063-8) contains supplementary material, which is available to authorized users.

show abstract

Chronic Obstructive Pulmonary Disease Is Common in Never-smoking Patients with Primary Sjögren Syndrome

Cited by 16 publications

References 25 publications

Respiratory symptoms are poor predictors of concomitant chronic obstructive pulmonary disease in patients with primary Sjögren’s syndrome

Respiratory symptoms are poor predictors of concomitant chronic obstructive pulmonary disease in patients with primary Sjögren’s syndrome

Increased B-cell activating factor, interleukin-6, and interleukin-8 in induced sputum from primary Sjögren’s syndrome patients

Smoking, disease characteristics and serum cytokine levels in patients with primary Sjögren’s syndrome

Contact Info

Product

Resources

About