scholarly journals The Immune Factors Involved in the Pathogenesis, Diagnosis, and Treatment of Sjogren's Syndrome

2013 ◽  
Vol 2013 ◽  
pp. 1-6 ◽  
Author(s):  
Yi-fan Huang ◽  
Qian Cheng ◽  
Chun-miao Jiang ◽  
Shu An ◽  
Lan Xiao ◽  
...  
Keyword(s):  
Immune System ◽  
Sjögren’S Syndrome ◽  
Sjögren's Syndrome ◽  
Autoimmune Disorder ◽  
Sjogren’S Syndrome ◽  
Sjogren's Syndrome ◽  
Diagnosis And Treatment ◽  
Open Label ◽  
T Lymphocyte Subsets ◽  
Sjögren‘S Syndrome

Sjogren's syndrome (SS) is a systemic, autoimmune disorder characterized by salivary insufficiency and lymphocytic infiltration of the exocrine glands. Even though the mechanism of its pathology and progression has been researched ever since its discovery, the roles of different parts of immune system remain inconclusive. There is no straightforward and simple theory for the pathogenesis and diagnosis of Sjogren’s syndrome because of the multiple kinds and functions of autoantibodies, changing proportion of different T-lymphocyte subsets with the progression of disease, unsuspected abilities of B lymphocytes discovered recently, crosstalk between cytokines connecting the factors mentioned previously, and genetic predisposition that contributes to the initiation of this disease. On the other hand, the number of significant reports and open-label studies of B-cell depletion therapy showing clinical efficacy in sjogren’s syndrome has continued to accumulate, which provides a promising future for the patients. In a word, further elucidation of the role of different components of the immune system will open avenues for better diagnosis and treatment of SS, whose current management is still mainly supportive.

scholarly journals Efficacy and safety of abatacept in active primary Sjögren’s syndrome: results of a phase III, randomised, placebo-controlled trial

2020 ◽  
pp. annrheumdis-2020-218599
Author(s):  
Alan N Baer ◽  
Jacques-Eric Gottenberg ◽  
E William St Clair ◽  
Takayuki Sumida ◽  
Tsutomu Takeuchi ◽  
...  
Keyword(s):  
Sjögren’S Syndrome ◽  
Sjögren's Syndrome ◽  
Controlled Trial ◽  
Sjogren’S Syndrome ◽  
Sjogren's Syndrome ◽  
Phase Iii ◽  
Open Label ◽  
Double Blind ◽  
Patient Reported ◽  
Sjögren‘S Syndrome

ObjectivesTo evaluate efficacy and safety of abatacept in adults with active primary Sjögren’s syndrome (pSS) in a phase III, randomised, double-blind, placebo-controlled trial.MethodsEligible patients (moderate-to-severe pSS [2016 ACR/European League Against Rheumatism (EULAR) criteria], EULAR Sjögren’s Syndrome Disease Activity Index [ESSDAI] ≥5, anti-SS-related antigen A/anti-Ro antibody positive) received weekly subcutaneous abatacept 125 mg or placebo for 169 days followed by an open-label extension to day 365. Primary endpoint was mean change from baseline in ESSDAI at day 169. Key secondary endpoints were mean change from baseline in EULAR Sjögren’s Syndrome Patient Reported Index (ESSPRI) and stimulated whole salivary flow (SWSF) at day 169. Other secondary clinical endpoints included glandular functions and patient-reported outcomes. Selected biomarkers and immune cell phenotypes were examined. Safety was monitored.ResultsOf 187 patients randomised, 168 completed double-blind period and 165 continued into open-label period. Mean (SD) baseline ESSDAI and ESSPRI total scores were 9.4 (4.3) and 6.5 (2.0), respectively. Statistical significance was not reached for primary (ESSDAI −3.2 abatacept vs −3.7 placebo, p=0.442) or key secondary endpoints (ESSPRI, p=0.337; SWSF, p=0.584). No clinical benefit of abatacept over placebo at day 169 was seen with other clinical and PRO endpoints. Relative to baseline, abatacept was associated with significant differences vs placebo in some disease-relevant biomarkers (including IgG, IgA, IgM-rheumatoid factor) and pathogenic cell subpopulations (post hoc analyses). No new safety signals were identified.ConclusionsAbatacept treatment did not result in significant clinical efficacy compared with placebo in patients with moderate-to-severe pSS, despite evidence of biological activity.

The Use of Whole Saliva in the Differential Diagnosis of Sjögren's Syndrome

1996 ◽  
Vol 10 (1) ◽  
pp. 17-24 ◽  
Author(s):  
L.M. Sreebny ◽  
W.X. Zhu
Keyword(s):  
Salivary Glands ◽  
Sjögren’S Syndrome ◽  
Sjögren's Syndrome ◽  
Autoimmune Disorder ◽  
Sjogren’S Syndrome ◽  
Sjogren's Syndrome ◽  
Screening Tests ◽  
Whole Saliva ◽  
Sjögren‘S Syndrome ◽  
Immunologic Test

Sjögren's Syndrome (SS) is a chronic, multisystem. autoimmune disorder. It is characterized by (1) generalized exocrine gland dysfunction, (2) serologic abnormalities, and (3) organ-system changes. Oral changes are a prominent feature of this disease. Among these are xerostomia and hypofunction of the salivary glands. Given the intimate relationship between SS and the salivary glands, it is reasonable to postulate that whole saliva (WS) contains the stigmata associated with the presence of this disease. But few studies have been conducted on this secretion. Indeed, WS has largely been neglected and ignored by physicians, dentists, and scientists. Objections to its use have included the fact that it is "impure", that it does not adequately represent what is present in the salivary glands, that no standards have been established for its rate of flow, and that findings based on it lack specificity. Yet, it is this secretion which coats and protects the hard and soft oral tissues, enables us to prepare our food for digestion, and assists our speech. This review will demonstrate that there is a uniqueness and constancy to whole saliva and that it may be used to diagnose the presence of SS. "Screening tests", which include several simple-to-perform sialometric, chemical, and microbiologic procedures, may be conducted in doctors' offices to establish the "profile" of an SS patient. Electrophoretic studies may be used to study the nature of the salivary proteins, and an immunologic test, which is performed on WS and utilizes Western Blot Autoantibody Strips (ImmunoVision. Springdale, AR). may be used to establish the definitive diagnosis of SS.

scholarly journals Current Concepts of Autoimmune Exocrinopathy: Immunologic Mechanisms in the Salivary Pathology of Sjögren's Syndrome

1996 ◽  
Vol 7 (2) ◽  
pp. 144-158 ◽  
Author(s):  
P.C. Fox ◽  
P.M. Speight
Keyword(s):  
Sjögren’S Syndrome ◽  
Sjögren's Syndrome ◽  
Autoimmune Disorder ◽  
Sjogren’S Syndrome ◽  
Sjogren's Syndrome ◽  
Immune Mediators ◽  
Normal Salivary Gland ◽  
Subsequent Loss ◽  
Autoimmune Exocrinopathy ◽  
Sjögren‘S Syndrome

Sjogren's syndrome is a systemic autoimmune disorder characterized by symptoms of oral and ocular dryness and a chronic, progressive loss of salivary and lacrimal function. The exocrine involvement is the result of a focal, peri-ductal mononuclear cell infiltrate and the subsequent loss of secretory epithelial cells. The mechanisms of this autoimmune exocrinopathy are not understood fully. Many recent investigations have described alterations in a number of immune mediators within the salivary glands. These studies provide new insights into the immune regulation of normal salivary gland functions and the mechanisms of gland damage in Sjogren's syndrome.

scholarly journals MANAGEMENT OF SJOGREN'S SYNDROME THROUGH AYURVEDA : A CASE STUDY

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Dr Raja Singla ◽  
Dr Harish Kumar
Keyword(s):  
Sjögren’S Syndrome ◽  
Sjögren's Syndrome ◽  
Autoimmune Disorder ◽  
Lymphocytic Infiltration ◽  
Sjogren’S Syndrome ◽  
Sjogren's Syndrome ◽  
Exocrine Glands ◽  
Dry Eyes ◽  
Sjögren‘S Syndrome

Sjögren's syndrome is a chronic, slowly progressing autoimmune disorder characterised by lymphocytic infiltration of exocrine glands resulting in xerostomia and dry eyes (conjunctivitis). 1) The disease can present as an entity alone or in association with other auto-immune diseases like Scleroderma, RA, SLE & auto-immune thyroid disease. 2) In this article, attempt is made to understand the Sjögren's syndrome & its treatment in ayurveda by considering the concept of udakvaha srotodushti, vyadhikshamatva and vatadhikya vatrakta. Keywords:Auto-immune, Vatadhikya Vatrakta, Sjögren's syndrome, Udakvaha srotodushti

From Molecular Mechanism to the Etiology of Sjogren Syndrome

2019 ◽  
Vol 24 (35) ◽  
pp. 4177-4185 ◽  
Author(s):  
Wei Wei ◽  
Syed Sayeed Ahmad ◽  
Shuang Chi ◽  
Yu Xie ◽  
Mohammad Amjad Kamal ◽  
...  
Keyword(s):  
Immune System ◽  
Molecular Mechanism ◽  
Sjögren’S Syndrome ◽  
Sjögren's Syndrome ◽  
Progressive Systemic Sclerosis ◽  
Sjogren’S Syndrome ◽  
Sjogren's Syndrome ◽  
Whole Body ◽  
The Relationship ◽  
Sjögren‘S Syndrome

Sjogren's Syndrome (SS) is a chronic, female overwhelming fundamental issue of an immune system rheumatic sickness that influences the whole body. It is described by lymphocytic invasion of the exocrine viz. salivary and lacrimal glands and by surprising B-cell hyperactivity. Keratoconjunctivitis sicca (dry eye) and Stomatitis sicca (oral dryness) are the primary visual appearances of SS. The primary SS is recognized from secondary SS which happens as a piece of other immune system maladies. The secondary SS exists together particularly with fundamental lupus erythematosus (15- 36%), rheumatoid joint inflammation (20- 32%) and also restricted and progressive systemic sclerosis (11- 24%), less as often as possible with different sclerosis and immune system hepatitis and thyreoiditis. We assess changes in salivary epidermal growth factor (EGF) intensity and estimate the relationship between salivary EGF levels and the seriousness of intraoral symptoms in SS individuals. The outcomes demonstrated that the salivary EGF levels diminished with the movement of SS, and this crumbling in salivation quality and additionally, hyposalivation could imagine a vital constituent in the pathogenesis of refractory intraoral indication in SS suffering patients. A strong relationship between particular alleles of the MHC and SS improvement has been recommended. The primary hereditary examination on SS revealed a relationship amongst SS and HLA-DR3 in SS population. Subsequent reports featured the relationship amongst SS and the HLA-D locus, with a diverse distribution between primary SS and secondary SS. The motivation behind this manuscript is to give a concise survey on the molecular mechanism, effects of infectious agents and genetic factors in the etiology of Sjogren’s Syndrome. Such effects are discussed independently.

B cells in Sjögren's syndrome: From pathophysiology to diagnosis and treatment

2012 ◽  
Vol 39 (3) ◽  
pp. 161-167 ◽  
Author(s):  
Divi Cornec ◽  
Valérie Devauchelle-Pensec ◽  
Gabriel J. Tobón ◽  
Jacques-Olivier Pers ◽  
Sandrine Jousse-Joulin ◽  
...  
Keyword(s):  
B Cells ◽  
Sjögren’S Syndrome ◽  
Sjögren's Syndrome ◽  
Sjogren’S Syndrome ◽  
Sjogren's Syndrome ◽  
Diagnosis And Treatment ◽  
Sjögren‘S Syndrome

scholarly journals Immune Monitoring upon Treatment with Biologics in Sjögren’s Syndrome: The What, Where, When, and How

Biomolecules ◽  
2021 ◽  
Vol 11 (1) ◽  
pp. 116
Author(s):  
Joyce J.B.C. van Beers ◽  
Jan G.M.C. Damoiseaux
Keyword(s):  
Immune System ◽  
Sjögren’S Syndrome ◽  
Sjögren's Syndrome ◽  
Sjogren’S Syndrome ◽  
Sjogren's Syndrome ◽  
Immune Monitoring ◽  
Soluble Factor ◽  
Adverse Side Effects ◽  
A Cell ◽  
Sjögren‘S Syndrome

Over the years, a wide variety of therapeutic antibodies has been successfully introduced in the auto-immunology clinic, and many more are on the way. Many of these treatments address either a pathogenic circulating molecule or a cell-bound molecule. Whereas addressing the former target results in neutralization of the soluble factor and binding to the latter target either inhibits cellular function or induces selective cell death. If this targeted molecule or cell is part of the immune system, this therapy evokes a state of immunodeficiency with infections as a possible consequence. Therefore, immune monitoring is needed to prevent such adverse side effects of immunotherapy. In this paper, different immunotherapies used in Sjögren’s syndrome, as well as different approaches to monitoring the immune system, are discussed.

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