Gastrointestinal and Hepatic Disease in Sjogren Syndrome

Popov, Yevgeniy; Salomon-Escoto, Karen

doi:10.1016/j.rdc.2017.09.010

Cited by 32 publications

(32 citation statements)

References 42 publications

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“…Dysphagia is a frequent complaint in pSS patients generally related to inadequate lubrication of the upper aerodigestive tract and food bolus resulting from hyposalivation. Oesophageal dysmobility is also mentioned in certain cases, explaining the lack of correlation between xerostomia and dysphagia [ 226 , 227 ]. Dyspepsia is frequent, occurring in 23% of pSS patients, and often linked to chronic atrophic gastritis where inflammatory infiltrates similar to those of the SG are found following tissue histological examination.…”

Section: Clinical Manifestationsmentioning

confidence: 99%

“…Dyspepsia is frequent, occurring in 23% of pSS patients, and often linked to chronic atrophic gastritis where inflammatory infiltrates similar to those of the SG are found following tissue histological examination. Antibodies against parietal cells or intrinsic factor can be found, but pernicious anaemia remains rare [ 226 ]. Manifestations such as diffuse abdominal pain, diarrhoea or malabsorption can occur as part of a protein losing enteropathy or in case of overlap with Celiac disease [ 226 , 227 ].…”

Section: Clinical Manifestationsmentioning

confidence: 99%

“…Antibodies against parietal cells or intrinsic factor can be found, but pernicious anaemia remains rare [ 226 ]. Manifestations such as diffuse abdominal pain, diarrhoea or malabsorption can occur as part of a protein losing enteropathy or in case of overlap with Celiac disease [ 226 , 227 ]. Interestingly, pSS patients with Primary Biliary Cirrhosis overlap (PBC) are at higher risk of developing duodenal ulcers (85% of cases) [ 226 ].…”

Section: Clinical Manifestationsmentioning

confidence: 99%

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Current State of Knowledge on Primary Sjögren’s Syndrome, an Autoimmune Exocrinopathy

Parisis

Chivasso

Perret

et al. 2020

JCM

106

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Primary Sjögren’s syndrome (pSS) is a chronic systemic autoimmune rheumatic disease characterized by lymphoplasmacytic infiltration of the salivary and lacrimal glands, whereby sicca syndrome and/or systemic manifestations are the clinical hallmarks, associated with a particular autoantibody profile. pSS is the most frequent connective tissue disease after rheumatoid arthritis, affecting 0.3–3% of the population. Women are more prone to develop pSS than men, with a sex ratio of 9:1. Considered in the past as innocent collateral passive victims of autoimmunity, the epithelial cells of the salivary glands are now known to play an active role in the pathogenesis of the disease. The aetiology of the “autoimmune epithelitis” still remains unknown, but certainly involves genetic, environmental and hormonal factors. Later during the disease evolution, the subsequent chronic activation of B cells can lead to the development of systemic manifestations or non-Hodgkin’s lymphoma. The aim of the present comprehensive review is to provide the current state of knowledge on pSS. The review addresses the clinical manifestations and complications of the disease, the diagnostic workup, the pathogenic mechanisms and the therapeutic approaches.

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Section: Clinical Manifestationsmentioning

confidence: 99%

Section: Clinical Manifestationsmentioning

confidence: 99%

Section: Clinical Manifestationsmentioning

confidence: 99%

See 1 more Smart Citation

Current State of Knowledge on Primary Sjögren’s Syndrome, an Autoimmune Exocrinopathy

Parisis

Chivasso

Perret

et al. 2020

JCM

106

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“…This suggests that dysphagia is present in all IIM subtypes and it may be present also in the early phases of the disease . Only one patient had a concomitant diagnosis of Sjögren's syndrome, which by itself may associate with dysphagia, but no significant differences were identified. Moreover, in early patients, after six months the OPES parameters were correlated more closely to clinical symptoms compared to the symptoms at baseline.…”

Section: Discussionmentioning

confidence: 93%

Assessment of swallowing function with oro‐pharyngeal‐esophageal scintigraphy in patients with idiopathic inflammatory myopathies

Barsotti

Puccini²,

Tripoli

et al. 2019

Neurogastroenterology Motil

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Background: Swallowing impairment is frequently present in patients with idiopathic inflammatory myopathies (IIMs), and it represents an important cause of morbidity, dramatically reducing the quality of life of patients. Moreover, dysphagia is associated to a worst prognosis. Unfortunately, no standardized instrumental techniques for the assessment of the upper gastrointestinal tract in IIM patients are available. In this study, we explored the characteristics of the alterations in the upper gastrointestinal tract using oro-pharyngeal-esophageal scintigraphy (OPES) in a cohort of IIM patients and we correlated the alterations with clinical parameters. Methods: A total of 51 IIM patients were examined with OPES, both with liquids and semisolids, and the data acquired were examined to compute the transit time and the percentage of retention at oral, pharyngeal, and esophageal level. Patient-reported outcome data (PRO) on dysphagia, disease activity, and clinical parameters were collected.Key results: Oro-pharyngeal-esophageal scintigraphy identified at least one alteration in all patients, particularly with the semisolid test and oral and pharyngeal levels presented a higher frequency of involvement compared to the esophageal tract (P < 0.05). A very good correlation between dysphagia severity assessed by PRO and many OPES results was identified. In patients with a shorter disease duration, there was a higher prevalence of alterations at the oral and pharyngeal level and they were correlated to higher swallowing difficulties and higher disease activity parameters. Conclusions & inferences:Our results showed that OPES may represent a novel reproducible tool to assess dysphagia in IIM patients, thus opening new possibilities to evaluate dysphagia in these patients. K E Y W O R D Sdeglutition, disease activity, dysphagia, idiopathic inflammatory myopathies, scintigraphy

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“…Inflammation is fueled by the pro-inflammatory cytokines produced by CD4 + T lymphocytes that generate IL-1, IL-2, and interferon (IFN)-gamma that cause lumen stenosis, and damage to the glandular secretory ducts [ 21 ]. The mucosa and submucosa of the gastrointestinal tract are atrophic, with the infiltration of active plasma cells, and other immune cells [ 22 ].…”

Section: Introductionmentioning

confidence: 99%

Advances in Mast Cell Activation by IL-1 and IL-33 in Sjögren’s Syndrome: Promising Inhibitory Effect of IL-37

Conti

Stellin

Caraffa

et al. 2020

IJMS

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Sjögren’s syndrome (SS) is a chronic autoimmune inflammatory disease that affects primarily older women and is characterized by irreversible damage of the exocrine glands, including tear (xerophthalmia) and salivary glands (xerostomia). Secretory glands lose their functionality due to the infiltration of immune cells, which produce cytokines and cause inflammation. Primary SS is characterized by dry syndrome with or without systemic commitment in the absence of other pathologies. Secondary SS is accompanied by other autoimmune diseases with high activation of B lymphocytes and the production of autoantibodies, including the rheumatoid factor. Other cells, such as CD4+ T cells and mast cells (MCs), participate in SS inflammation. MCs are ubiquitous, but are primarily located close to blood vessels and nerves and can be activated early in autoimmune diseases to express a wide variety of cytokines and chemokines. In the SS acute phase, MCs react by generating chemical mediators of inflammation, tumor necrosis factor (TNF), and other pro-inflammatory cytokines such as interleukin (IL)-1 and IL-33. IL-33 is the specific ligand for ST2 capable of inducing some adaptive immunity TH2 cytokines but also has pro-inflammatory properties. IL-33 causes impressive pathological changes and inflammatory cell infiltration. IL-1 family members can have paracrine and autocrine effects by exacerbating autoimmune inflammation. IL-37 is an IL-1 family cytokine that binds IL-18Rα receptor and/or Toll-like Receptor (TLR)4, exerting an anti-inflammatory action. IL-37 is a natural inhibitor of innate and acquired immunity, and the level is abnormal in patients with autoimmune disorders. After TLR ligand activation, IL-37 mRNA is generated in the cytoplasm, with the production of pro-IL-37 and later mature IL-37 caspase-1 mediated; both precursor and mature IL-37 are biologically active. Here, we discuss, for the first time, the current knowledge of IL-37 in autoimmune disease SS and propose a new therapeutic role.

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Gastrointestinal and Hepatic Disease in Sjogren Syndrome

Cited by 32 publications

References 42 publications

Current State of Knowledge on Primary Sjögren’s Syndrome, an Autoimmune Exocrinopathy

Current State of Knowledge on Primary Sjögren’s Syndrome, an Autoimmune Exocrinopathy

Assessment of swallowing function with oro‐pharyngeal‐esophageal scintigraphy in patients with idiopathic inflammatory myopathies

Advances in Mast Cell Activation by IL-1 and IL-33 in Sjögren’s Syndrome: Promising Inhibitory Effect of IL-37

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