Novel aspects of Sjögren’s syndrome in 2012

Abstract

Sjögren’s syndrome (SS) is a systemic progressive autoimmune disease characterized by a complex pathogenesis requiring a predisposing genetic background and involving immune cell activation and autoantibody production. The immune response is directed to the exocrine glands, causing the typical ‘sicca syndrome’, but major organ involvement is also often seen. The etiology of the disease is unknown. Infections could play a pivotal role: compared to normal subjects, patients with SS displayed higher titers of anti-Epstein-Barr virus (EBV) early antigens, but lower titers of other infectious agent antibodies such as rubella and cytomegalovirus (CMV) suggest that some infections may have a protective role against the development of autoimmune disease. Recent findings seem to show that low vitamin D levels in patients with SS could be associated with severe complications such as lymphoma and peripheral neuropathy. This could open new insights into the disease etiology. The current treatments for SS range from symptomatic therapies to systemic immunosuppressive drugs, especially B cell-targeted drugs in cases of organ involvement. Vitamin D supplementation may be an additional tool for optimization of SS treatment.

Effects of periodontal treatment on primary sjȫgren’s syndrome symptoms

“…According to Tincani et al, 33 pSS patients present a progressive impairment of the salivary glands, with consequent decrease in salivary flow. In the present study, there was an improvement in the salivary flow of pSS patients at 30 and 90 days after periodontal treatment.…”

The Potential Role for Early Biomarker Testing as Part of a Modern, Multidisciplinary Approach to Sjögren’s Syndrome Diagnosis

“…SS is the second most common autoimmune rheumatic disease [2], with a prevalence of approximately 1% (range 0.1-4.8%) [2,4] and an incidence of about 7 per 100,000 person-years at risk [5,6]. In total, up to 4 million Americans have SS [7][8][9].…”

“…A large study of 327 patients presenting with clinically significant aqueous-deficient dry eye (ADDE) in the US found 11.6% of the patients to have SS [3]. Salivary gland dysfunction leads to dry mouth and associated problems such as trouble swallowing dry food, dental caries, and even oral candidiasis [2].…”

“…Sjögren's syndrome (SS) is a chronic, progressive, multisystem autoimmune disease that involves primarily the lacrimal and salivary glands [1,2]. The disease may also have widespread systemic manifestations, generally appearing years after the initial ocular and oral symptoms, and which can have major adverse effects on patient quality of life and survival.…”

The association of vitamin D deficiency with tear break-up time and Schirmer testing in non-Sjögren dry eye

“…1,2 It has also been found that environmental and hormonal factors, the fatsoluble vitamins such as vitamin D, may have a role in the pathogenic immunoregulatory process of primary Sjögren's syndrome (Pss). [4][5][6] The vitamin D supplementation is suggested for chronic autoimmune diseases. 4 Low levels of vitamin D may be related with low-complement components and the presence of cryoglobulins in predicting eventual development of lymphoma in patients with Ss.…”