Rapid decrease in salivary epidermal growth factor levels in patients with Sjögren's syndrome: A 3-year follow-up study

Azuma, Naoto; Katada, Yoshinori; Kitano, S; Sekiguchi, Mutsuo; Kitano, Masayasu; Nishioka, Aki; Hashimoto, Naoaki; Iwasaki, Tsuyoshi; Sano, Hajime

doi:10.3109/14397595.2015.1034941

Cited by 11 publications

(10 citation statements)

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“…Oral health is an integral part of general well-being, and activities such as conversing, smiling, and eating are important determinants of daily QoL 66 . Oral health-related quality of life has been studied in patients with pSS 27,[67][68][69] and other systemic disorders [70][71][72] . Not surprisingly, using the OHIP-49 questionnaire, Lopez-Jornet et al found that patients with pSS had lower OHRQoL compared to patients with secondary SS (24.15 ± 24.34 vs 10.27 ± 14.65) 27 .…”

Section: General Health-related Quality Of Life Patients With Medicamentioning

confidence: 99%

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Patients with non-Sjögren’s sicca report poorer general and oral health-related quality of life than patients with Sjögren’s syndrome: a cross-sectional study

Tashbayev

Garen

Palm

et al. 2020

Sci Rep

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Understanding the impact of the disease on quality of life is crucial in patient management. in this cross-sectional study, general and oral health-related quality of life questionnaires, and thorough examinations of oral and ocular dryness were performed in age-and sex-matched patients with primary Sjögren's syndrome (pSS group), non-Sjögren's syndrome sicca (non-SS group) and healthy controls. General and oral health-related quality of life were investigated with the 36-Item Short Form Health Survey and the 14-Item Oral Health Impact Profile questionnaires, respectively. Subjective symptoms of xerostomia and ocular dryness were recorded using the Summated Xerostomia inventory and ocular Surface Disease index, respectively. clinical examinations included evaluation of clinical oral dryness scores, candida counts, unstimulated and stimulated saliva secretory rates, tear osmolarity, tear film break-up time, Schirmer I test and ocular surface staining. Both patient groups had pronounced signs and symptoms of xerostomia and ocular dryness. even though the non-SS patients had less severe clinical signs than the pSS patients, they demonstrated much poorer general and oral health-related quality of life. in conclusion, non-SS patients require more attention in order to improve their quality of life. Sjögren's syndrome (SS) is a systemic, autoimmune connective tissue disease presenting a wide range of sicca symptoms, mainly dry mouth and dry eyes that result from permanently impaired salivary and lacrimal gland function 1. Sjögren's syndrome is also associated with extraglandular renal, pulmonary, and neurological manifestations in about 30% of patients 2. Around 5% of patients may develop lymphoma which is the most severe complication 2,3. Sjögren's syndrome is defined as primary SS (pSS) when occurring in the absence of an underlying rheumatic disorder, and as secondary SS (sSS) when associated with another connective tissue disorder 4,5. The large and diverse group of patients that have sicca symptoms consists of patients with various disorders who receive medical treatments that cause hypofunction of salivary and/or lacrimal glands. However, some patients have sicca symptoms in the absence of known diseases or medication, but without the distinctive features of pSS, namely Ro/SSA and/or La/SSB autoantibodies and lymphocyte infiltration in their minor salivary glands 6. In the present paper, this diverse group of patients was named the non-SS group, in order to highlight the fact that although they present with SS-like symptomatology they do not fulfil the diagnostic criteria for SS 7-20. The oral manifestations of SS can include subjective symptoms of dry mouth (xerostomia), burning sensation on the tongue, reduced sense of taste, and difficulties in swallowing food 21. Clinical findings of dry mouth include dry and fissured tongue, lack of saliva pool and bubbly saliva, tooth decay, and candidiasis 22. The subjective symptoms of dry eyes in SS can manifest as reduced vision, ocular discomfort, scratchiness, and pai...

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Section: General Health-related Quality Of Life Patients With Medicamentioning

confidence: 99%

“…Similar findings were reported by McMillan and co-workers 67 . It has been established in several studies that patients with both pSS and sSS suffer from significantly reduced OHR QoL 27,30,[67][68][69]73 . However, research on OHRQoL in patients with non-SS sicca has been very limited.…”

Section: General Health-related Quality Of Life Patients With Medicamentioning

confidence: 99%

Patients with non-Sjögren’s sicca report poorer general and oral health-related quality of life than patients with Sjögren’s syndrome: a cross-sectional study

Tashbayev

Garen

Palm

et al. 2020

Sci Rep

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“…EGF, which combines with EGF receptor (EGFR) to control cell development and proliferation, is secreted from salivary glands. The clinical importance of EGF in both salivary and lacrimal glands in SS has also been discussed, as a relationship between the EGF concentration and exocrine function was demonstrated [128,129,130,131]. …”

Section: Control Of Apoptosis In Sjögren’s Syndromementioning

confidence: 99%

Modulation of Apoptosis by Cytotoxic Mediators and Cell-Survival Molecules in Sjögren’s Syndrome

Nakamura

Horai

Shimizu

et al. 2018

IJMS

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The pathogenesis of Sjögren’s syndrome (SS) involves multiple factors including genetic background, cell death, and exocrine dysfunction. We here discuss apoptotic control in exocrine glands in SS by showing various pro- and anti-apoptotic pathways. Although the membrane-bound and soluble form of the Fas/Fas ligand system is a leading player with activation of the death domain and caspase 8/3 cleavage, the role of soluble Fas/FasL (including its polymorphism) in apoptosis is controversial. The tumor necrosis factor related apoptosis-inducing ligand (TRAIL)-mediated apoptosis of salivary gland epithelial cells (SGECs) involves a mitochondrial pathway that includes caspase 9 cleavage. The involvement of innate immunity cells such as toll-like receptors (TLRs) has been investigated; TLR2-4 and TLR7-9 are associated with the induction of inflammation in exocrine glands of SS patients. TLR3 has the potential to induce the apoptosis of SS patients’ SGECs. Linkage of epidermal growth factor (EGF) was shown in exocrine glands in SS, and it inhibited the Fas/FasL system with the help of cell-survival factors. TLR3 has dual actions to cause inflammation as well as apoptosis, which are inhibited by EGF. In conclusion, apoptosis in exocrine glands of SS patients is tightly controlled by balance of pro-apoptotic signals and growth factor.

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“…To the best of our knowledge, no study conducted to date has measured salivary EGF levels in patients with SS. Thus, we evaluated changes in salivary EGF levels in patients with SS and assessed the association between salivary EGF levels and the severity of intraoral manifestations in SS [ 16 , 17 ].…”

Section: Introductionmentioning

confidence: 99%

Deterioration in saliva quality in patients with Sjögren’s syndrome: impact of decrease in salivary epidermal growth factor on the severity of intraoral manifestations

2018

Self Cite

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BackgroundSjögren’s syndrome (SS) is a chronic inflammatory autoimmune disease characterized by lymphocytic infiltration of the exocrine glands, especially the salivary and lacrimal glands. As a result of salivary gland dysfunction, most patients with SS have xerostomia related to a reduced salivary flow rate. In addition to the discomfort due to xerostomia, dry mouth can cause various intraoral manifestations such as refractory stomatitis, ulcer, and atrophic changes in the oral mucosa and tongue, and the patient’s quality of life (QoL) is severely impaired. These manifestations are believed to be caused mainly by a decrease in the clearance in the oral cavity owing to hyposalivation. However, because saliva has several beneficial physiological effects on the intraoral environment, qualitative changes in sialochemistry should also be considered a cause of the refractory intraoral manifestations in SS.Main textSalivary epidermal growth factor (EGF) is considered an important cytoprotective factor against injuries. It contributes to wound healing in the oral cavity and to maintenance of mucosal integrity in the oral cavity and gastrointestinal tract. We evaluated changes in salivary EGF levels and assessed the association between salivary EGF levels and the severity of intraoral manifestations in patients with SS. The following novel findings were obtained: (1) salivary EGF levels in SS patients were significantly lower than those in non-SS patients; (2) salivary EGF levels as well as the salivary flow rate decreased with the progression of SS; (3) with prolonged SS disease duration, salivary EGF levels decreased more rapidly than the salivary flow rate; and (4) decreases in salivary EGF levels significantly correlated with exacerbation of the oral health-related QoL in patients with SS.ConclusionsThe deterioration in saliva quality as well as lower intraoral clearance by hyposalivation could play a role in the pathogenesis of refractory intraoral manifestations in patients with SS. Our findings suggest a new target for therapeutic intervention for SS.

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Rapid decrease in salivary epidermal growth factor levels in patients with Sjögren's syndrome: A 3-year follow-up study

Abstract: The rapid decrease in salivary EGF level contributes to the progression of intraoral manifestations of SS.

Cited by 11 publications

References 23 publications

Patients with non-Sjögren’s sicca report poorer general and oral health-related quality of life than patients with Sjögren’s syndrome: a cross-sectional study

Patients with non-Sjögren’s sicca report poorer general and oral health-related quality of life than patients with Sjögren’s syndrome: a cross-sectional study

Modulation of Apoptosis by Cytotoxic Mediators and Cell-Survival Molecules in Sjögren’s Syndrome

Deterioration in saliva quality in patients with Sjögren’s syndrome: impact of decrease in salivary epidermal growth factor on the severity of intraoral manifestations

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