Sunday 13 December 2009, 23:20

Sjogren’s syndrome: a widespread underestimated disease

An overview on Sjogren’s autoimmune syndrome

Sjogren’s syndrome: a widespread underestimated disease

Sjogren’s syndrome is a relatively common and serious autoimmune disease, affecting the musculoskeletal system and glandular tissue.


Since the first case report in 1882, there have been many cases reported worldwide. The National Institute of Health estimates that between 1 million and 4 million Americans are affected with Sjogren’s syndrome in the United States. Most people are over 40 at the time of diagnosis and women are 9 times more likely to be affected than men.


Sjogren’s syndrome can exist as a primary condition or can develop secondary to other autoimmune diseases, such as systemic lupus erythematosus and rheumatoid arthritis. The most distinctive symptoms of the disease result from lack of saliva (dry mouth) and lack of tears (dry eyes). They include itching and redness in the eyes, an increased sensitivity to light, difficulty in swallowing, chewing and speaking and the development of severe dental caries. Due to these distinctive symptoms, Sjogren’s disease has also been termed “sicca syndrome”.


Other less specific symptoms result from the chronic inflammatory nature of the disease: chronic and severe fatigue, joint pain and depression are common and often disabling, although they are too aspecific to define the disease.


The pathogenesis of Sjogren’s syndrome is autoimmune, characterized by the production of antibodies and the activation of T lymphocytes against proteins or protein-nucleic acid complexes that are normal constituents of cells. Although the specific target protein in Sjogren’s syndrome has not been yet identified, there are sufficient markers to define Sjogren’s syndrome as an autoimmune disease. Serum from patients with Sjogren’s contains circulating antibodies against two protein-RNA complexes (called Ro/SSA and La/SSB), which are also commonly present in the serum of patients affected with systemic lupus erythematosus. This finding is sufficient to support the concept that Sjogren’s syndrome is an autoimmune disease.


At present, there is no specific treatment for Sjogren’s syndrome. The only currently available treatment is supportive and symptomatic. Symptoms of dryness may be relieved by moisture replacement therapy. Corticosteroids and immunosuppressive drugs may be prescribed for patients with severe complications.


Since the availability of effective diagnostic and therapeutic techniques is limited, the clinical research is now focusing on increasing the knowledge of the syndrome, improving diagnostic techniques and finding ways to treat and prevent the disease.


By Chiara De Carli

Category: Medical

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