Lecture

Importance of early diagnosis of Sjögren syndrome

  • FAN Kaijian ,
  • LIU Jinyu ,
  • ZHAO Futao
Expand
  • 1. Department of Rheumatology and Immunology, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200011, China
    2. Department of Pharmacy, Mental Health Center, Chongming District, Shanghai 202150, China

Received date: 2024-10-15

  Online published: 2025-03-11

Abstract

There are several challenges in the early diagnosis of Sjögren syndrome (SS), such as prominent glandular dysfunction in patients to make long diagnostic delays. These challenges are mainly attributed to the lack of adequate understanding of the early-stage characteristic of SS. Clinical and experimental studies have shown that early diagnosis and intervention in SS can help delay disease progression and reduce the risk of complications. To achieve early diagnosis and treatment of SS, it’s necessary to identify more useful biomarkers for the early stages of SS, and to identify high-risk people for SS through appropriate screening.

Cite this article

FAN Kaijian , LIU Jinyu , ZHAO Futao . Importance of early diagnosis of Sjögren syndrome[J]. Journal of Internal Medicine Concepts & Practice, 2024 , 19(06) : 417 -421 . DOI: 10.16138/j.1673-6087.2024.06.12

References

[1] Vasaitis L, Nordmark G, Theander E, et al. Population-based study of patients with primary Sj?gren’s syndrome and lymphoma: lymphoma subtypes, clinical characteristics, and gender differences[J]. Scand J Rheumatol, 2020, 49(3):225-232.
[2] Mariette X, Criswell LA. Primary Sj?gren’s syndrome[J]. N Engl J Med, 2018, 378(10):931-939.
[3] Brito-Zerón P, Acar-Denizli N, Ng WF, et al. Epidemiological profile and north-south gradient driving baseline systemic involvement of primary Sj?gren’s syndrome[J]. Rheumatology (Oxford), 2020, 59(9):2350-2359.
[4] Shiboski CH, Shiboski SC, Seror R, et al. 2016 American College of Rheumatology/European League Against Rheumatism classification criteria for primary Sj?gren’s syndrome[J]. Arthritis Rheumatol, 2017, 69(1):35-45.
[5] Mofors J, Arkema EV, Bj?rk A, et al. Infections increase the risk of developing Sj?gren’s syndrome[J]. J Intern Med, 2019, 85(6):670-680.
[6] Beydon M, McCoy S, Nguyen Y, et al. Epidemiology of Sj?gren syndrome[J]. Nat Rev Rheumatol, 2024, 20(3):158-169.
[7] Chen H, McCann P, Lien T, et al. Prevalence of dry eye and Meibomian gland dysfunction in Central and South America: a systematic review and meta-analysis[J]. BMC Ophthalmol, 2024, 24(1):50.
[8] Stapleton F, Alves M, Bunya VY, et al. TFOS DEWS Ⅱ epidemiology report[J]. Ocul Surf, 2017, 15(3):334-365.
[9] Retamozo S, Acar-Denizli N, Horváth IF, et al. Influence of the age at diagnosis in the disease expression of primary Sj?gren syndrome[J]. Clin Exp Rheumatol, 2021, 39 Suppl 133(6):166-174.
[10] Wu R, Chen Z, Yu J, et al. A graph-learning based model for automatic diagnosis of Sj?gren’s syndrome on digital pathological images: a multicentre cohort study[J]. J Transl Med, 2024, 22(1):748.
[11] Brito-Zerón P, Acar-Denizli N, Zeher M, et al. Influence of geolocation and ethnicity on the phenotypic expression of primary Sj?gren’s syndrome at diagnosis in 8310 patients[J]. Ann Rheum Dis, 2017, 76(6):1042-1050.
[12] Flament T, Bigot A, Chaigne B, et al. Pulmonary manifestations of Sj?gren’s syndrome[J]. Eur Respir Rev, 2016, 25(140):110-123.
[13] Ramírez Sepúlveda JI, Kvarnstr?m M, Brauner S, et al. Difference in clinical presentation between women and men in incident primary Sj?gren’s syndrome[J]. Biol Sex Differ, 2017, 8:16.
[14] Wei L, Zhifei X, Xiaoran N, et al. Patients with early-onset primary Sj?gren’s syndrome have distinctive clinical manifestations and circulating lymphocyte profiles[J]. Rheumatology (Oxford), 2022, 61(2):597-605.
[15] Goules AV, Argyropoulou OD, Pezoulas VC, et al. Primary Sj?gren’s syndrome of early and late onset: distinct clinical phenotypes and lymphoma development[J]. Front Immunol, 2020, 11:594096.
[16] Beydon M, Seror R, Le Guern V, et al. Impact of patient ancestry on heterogeneity of Sj?gren’s disease[J]. RMD Open, 2023, 9(1):e002955.
[17] Singh AG, Singh S, Matteson EL. Rate, risk factors and causes of mortality in patients with Sj?gren’s syndrome[J]. Rheumatology (Oxford), 2016, 55(3):450-60.
[18] Kim HJ, Kim KH, Hann HJ, et al. Incidence, mortality, and causes of death in physician-diagnosed primary Sj?gren’s syndrome in Korea[J]. Semin Arthritis Rheum, 2017, 47(2):222-227.
[19] Jin L, Dai M, Li C, et al. Risk factors for primary Sj?gren’s syndrome: a systematic review and meta-analysis[J]. Clin Rheumatol, 2023, 42(2):327-338.
[20] Mofors J, Bj?rk A, Richardsdotter Andersson E, et al. Cigarette smoking patterns preceding primary Sj?gren’s syndrome[J]. RMD Open, 2020, 6(3):e001402.
[21] Ben-Eli H, Aframian DJ, Ben-Chetrit E, et al. Shared medical and environmental risk factors in dry eye syndrome, Sjogren’s syndrome, and B-cell non-Hodgkin lymphoma: a case-control study[J]. J Immunol Res, 2019, 2019:9060842.
[22] Olsson P, Turesson C, Mandl T, et al. Cigarette smoking and the risk of primary Sj?gren’s syndrome: a nested case control study[J]. Arthritis Res Ther, 2017, 19(1):50.
[23] Mccoy SS, Sampene E, Baer AN. Association of Sj?gren’s syndrome with reduced lifetime sex hormone exposure: a case-control study[J]. Arthritis Care Res (Hoboken), 2020, 72(9):1315-1322.
[24] Machowicz A, Hall I, De Pablo P, et al. Mediterranean diet and risk of Sj?gren’s syndrome[J]. Clin Exp Rheumatol, 2020, 38 Suppl 126(4):216-221.
[25] Brito-Zerón P, Baldini C, Bootsma H, et al. Sj?gren syndrome[J]. Nat Rev Dis Primers, 2016, 2:16047.
[26] Auteri S, Alberti ML, Fernández ME, et al. Occult primary Sj?gren Syndrome in patients with interstitial pneumonia with autoimmune features[J]. Respir Med, 2021, 182:106405.
[27] M?land E, Miyamoto ST, Hammenfors D, et al. Understanding fatigue in Sj?gren’s syndrome: outcome measures, biomarkers and possible interventions[J]. Front Immunol, 2021, 12:703079.
[28] Unger J, Mattsson M, Dr?goi RG et al. The experiences of functioning and health of patients with primary Sj?gren’s syndrome[J]. Front Med (Lausanne), 2021, 8:770422.
[29] McCoy SS, Bartels CM, Saldanha IJ, et al. National Sj?gren’s foundation survey: burden of oral and systemic involvement on quality of life[J]. J Rheumatol, 2021, 48(7):1029-1036.
[30] Tarn J, Lendrem D, McMeekin P, et al. Primary Sj?gren’s syndrome: longitudinal real-world, observational data on health-related quality of life[J]. J Intern Med, 2022, 291(6):849-855.
[31] Wicheta S, van der Groen T, Faquin WC, et al. Discrepancies in interpretation of the minor salivary gland biopsy in the diagnosis of Sj?gren syndrome[J]. J Oral Maxillofac Surg, 2019, 77(8):1628-1635.
[32] Fisher BA, Jonsson R, Daniels T, et al. Standardisation of labial salivary gland histopathology in clinical trials in primary Sj?gren’s syndrome[J]. Ann Rheum Dis, 2017, 76(7):1161-1168.
[33] Wicheta S, van der Groen T, Faquin WC, et al. Minor Salivary gland biopsy-an important contributor to the diagnosis of Sj?gren syndrome[J]. J Oral Maxillofac Surg, 2017, 5(12):2573-2578.
[34] Kroese FGM, Haacke EA, Bombardieri M. The role of salivary gland histopathology in primary Sj?gren’s syndrome: promises and pitfalls[J]. Clin Exp Rheumatol, 2018, 36 Suppl 112(3):222-233.
[35] Shiboski CH, Baer AN, Shiboski SC, et al. Natural history and predictors of progression to Sj?gren’s syndrome among participants of the Sj?gren’s International Collaborative Clinical Alliance Registry[J]. Arthritis Care Res (Hoboken), 2018, 70(2):284-294.
[36] Costa S, Quintin-Roué I, Lesourd A, et al. Reliability of histopathological salivary gland biopsy assessment in Sj?gren’s syndrome: a multicentre cohort study[J]. Rheumatology (Oxford), 2015, 54(6):1056-64.
[37] Panchovska M. Questions from patients and doctors on negative minor salivary gland biopsy in Sj?gren syndrome[J]. J Rheumatol, 2021, 48(1):149.
[38] Blokland SLM, Hillen MR, Kruize AA, et al. Increased CCL25 and T helper cells expressing CCR9 in the salivary glands of patients with primary Sj?gren’s syndrome: potential new axis in lymphoid neogenesis[J]. Arthritis Rheumatol, 2017, 69(10):2038-2051.
[39] Janga SR, Shah M, Ju Y, et al. Longitudinal analysis of tear cathepsin S activity levels in male non-obese diabetic mice suggests its potential as an early stage biomarker of Sj?gren’s Syndrome[J]. Biomarkers, 2019, 24(1):91-102.
[40] Berry JS, Tarn J, Casement J, et al. Examining the biological pathways underlying clinical heterogeneity in Sjogren’s syndrome: proteomic and network analysis[J]. Ann Rheum Dis, 2024, 83(1):88-95.
[41] Delli K, Haacke EA, Kroese FG, et al. Towards personalised treatment in primary Sj?gren’s syndrome: baseline parotid histopathology predicts responsiveness to rituximab treatment[J]. Ann Rheum Dis, 2016, 75(11):1933-1938.
[42] Chen CT, Tseng YC, Yang CW, et al. Increased risks of spontaneous acterial peritonitis and interstitial lung disease in primary biliary cirrhosis patients with concomitant Sj?gren syndrome[J]. Medicine (Baltimore), 2016, 95(2):e2537.
[43] Huang Y, Qiu Y, Xie Z, et al. Risk factors and prognosis of interstitial lung disease for primary Sj?gren syndrome patients: a retrospective case-control study[J]. Clin Rheumatol, 2023, 42(11):3033-3041.
[44] Al Qassimi S, Namas R. Advanced cystic lung disease secondary to Sj?gren syndrome[J]. J Clin Rheumatol, 2024, 30(6):e155.
[45] Martín-Nares E, Hernández-Molina G. Novel autoantibodies in Sj?gren’s syndrome: a comprehensive review[J]. Autoimmun Rev, 2019, 18(2):192-198.
[46] Jin Y, Li J, Chen J, et al. Tissue-specific autoantibodies improve diagnosis of primary Sj?gren’s syndrome in the early stage and indicate localized aalivary injury[J]. J Immunol Res, 2019, 2019:3642937.
[47] He J, Jiang J, Baumgart K. Candidate autoantibodies for primary Sj?gren’s syndrome: where are they now?[J]. Clin Exp Rheumatol, 2022, 40(12):2387-2394.
[48] Longobardi S, Lopez-Davis C, Khatri B, et al. Autoantibodies identify primary Sj?gren’s syndrome in patients lacking serum IgG specific for Ro/SS-A and La/SS-B[J]. Ann Rheum Dis, 2023, 82(9):1181-1190.
[49] 杨玉淑, 齐晅, 丁萌, 等. 抗唾液腺蛋白1抗体联合抗腮腺分泌蛋白抗体对干燥综合征的诊断价值[J]. 北京大学学报(医学版), 2024, 56(5):845-852.
[50] Tan PH, Ji J, Hsing CH, et al. Emerging roles of Type-I interferons in neuroinflammation, neurological diseases, and long-haul COVID[J]. Int J Mol Sci, 2022, 23(22):14394.
[51] Xu D, Fang J, Zhang S, et al. Efficacy and safety of telitacicept in primary Sj?gren’s syndrome: a randomized, double-blind, placebo-controlled, phase 2 trial[J]. Rheumatology (Oxford), 2024, 63(3):698-705.
[52] Huang H. A study of CD19/BCMA chimeric antigen receptor T cells therapy for patients with refractory Sjogren’s syndrome[EB/OL]. 2021. https://clinicaltrials.gov/ct2/show/NCT05085431
Outlines

/