The novel antibodies salivary gland protein 1 (SP-1), carbonic anhydrase 6 (CA VI) and parotid secretory protein (PSP) have shown to be present in animal models for Sjogren's syndrome (SS) and patients with the disease. The antibodies SP-1, CA VI and PSP occurred earlier in the course of the disease than antibodies to Ro or La. These antibodies were found in 45% of patients meeting the criteria for SS who lacked antibodies to Ro or La. Furthermore, in patients with idiopathic xerostomia and xerophthalmia for less than 2 years, 76% had antibodies to SP-1 and/or CA VI while only 31% had antibodies to Ro or La. Antibodies to SP-1, CA VI and PSP may be useful markers for identifying patients with SS at early stages of the disease or those that lack antibodies to either Ro or La. The presence of the antibodies to SP-1, CA VI and PSP should be correlated with clinical (dry mouth, dry eyes), serological (Ro, La,
ANA, RF) and histological (positive lymphocytic focus scores) findings in establishing a definitive diagnosis for SS.
- Shen, L. et al. (2010). A role of lymphotoxin in primary sjogren's syndrome. J Immunol; 185: 6355-6363. [L]
- Shen, L. et al. (2012). Novel autoantibodies in Sjogren's syndrome. Clinical Immunology; 145, 251-255. [L]
Sjögren’s can be challenging to recognize or diagnose because symptoms of Sjögren’s may mimic those of menopause, drug side effects, or medical conditions such as lupus, rheumatoid arthritis, fibromyalgia, chronic fatigue syndrome, and multiple sclerosis and thus makes receiving a prompt diagnosis difficult.
The diagnosis of Sjögren’s syndrome requires demonstration of an autoimmune disease that is adversely affecting the function of the glands that produce tears and saliva. Dry eyes and dry mouth are the most common symptoms. Assessments by a rheumatologist, ophthalmologist, and a dentist or oral medicine specialist are usually needed to search for key elements of the disease. Key elements may include an inadequate tear film, decreased saliva production, salivary gland inflammation, and an underlying autoimmune process. A careful evaluation is needed to exclude other potential causes of dryness of the eyes and of the mouth.
Although there is no cure for Sjögren syndrome, many treatments are available to minimize symptoms and reduce the risk of complications. Pharmacological treatments include lubricating eye drops, autologous serum eye drops and other prescription agents, punctal plugs, lubricating mouthwashes, mouth rinses to help remineralize damaged teeth, pilocarpine, cevimeline, and hydroxychloroquine. In more severe cases, immune-modulating treatments such as high-dose steroids, intravenous immunoglobulin, mycophenolate, or rituximab may be used. Treatment is highly individualized, and most pharmacological therapies are not FDA approved specifically for Sjögren syndrome. Lifestyle measures like using humidifiers and consuming an anti-inflammatory diet also play an important role in the management of the syndrome.
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