Is Sjögren's syndrome a retroviral disease?

Abstract

Circumstantial evidence suggests that retroviruses play a role in the pathogenesis of Sjögren's syndrome. Such evidence, derived from studies of patients with Sjögren's syndrome, includes the following: the presence of serum antibodies cross-reactive with retroviral Gag proteins; the occurrence of reverse transcriptase activity in salivary glands; the detection of retroviral antigens, retrovirus-like particles, or novel retroviral sequences in salivary glands; the occurrence of Sjögren's syndrome-like illnesses in patients having confirmed systematic infections with retroviruses such as human immunodeficiency virus-1 (HIV-1) and human T lymphotropic virus type 1; and the beneficial effect of anti-retroviral treatment on the occurrence of HIV-1-associated sicca syndrome. Additional evidence is provided by animal models.

Evaluation of tear film function, ocular surface and tear film in HIV-seropositive patients

“…The etiology of keratoconjunctivitis sicca related to HIV infection is not well established yet. Evidence derived from studies of patients with Sjögren's syndrome shows the presence of a cross-sectional reaction of serum antibodies with retroviral proteins, and the occurrence of reverse transcriptase activity in the salivary glands (18) . Furthermore, the detection of retroviral antigens, retrovirus-like particles or retroviral sequences in the salivary glands of patients with systemic retrovirus infection (EBV, HIV and HTLV) corroborate the theory that the infection could represent the trigger for the development of manifestations caused by underactivity of the exocrine glands, although to date no study has evidenced that these findings present in the salivary glands are reproduces in the lacrimal ones, but clinical evidence suggest that the pathogenic mechanism is similar (24) .…”

“…Present in 0.85 to 3% of HIVpositive patients, the DILS is characterized by lymphocytic infiltration in various organs and peripheral lymphocytosis at CD8+ costs, clinically manifested as sicca syndrome and increased parotid, thus simulating a condition similar to Sjogren's syndrome ( Sjogrenlike). Tear reduction may be associated with this lymphocytic infiltration and eventual destruction of acinar and ducts of the lacrimal gland (18) . In SJ lymphocytic infiltration is by CD4+ and serological tests (anti-RO and anti-LA) are positive (19,20) .…”

“…The prevalence of dry eye in HIVinfected patients in previous studies ranged from 7.79% to 38.8%, and the symptoms of dry eye have an important impact on the quality of life of these patients (13)(14)(15)(16)(17) . Early in the HIV epidemic, SJ cases were reported as secondary to the infection (18) . However, a few years later, the sicca syndrome associated with HIV was defined as a clinical entity that was called diffuse infiltrative lymphocytosis syndrome (DILS).…”

Dry eye disease caused by viral infection: review

“…There are several known and suspected virus associated to DED (1)(2)(3) . The pathogenic mechanisms and therapeutic approach for virus-related DED are reviewed herein.…”

“…It is a chronic disease affecting exocrine glands, mainly lacrimal and salivary ones, but also organs and systems can be involved. It is characterized by an aggressive lymphocytic infiltration and circulating autoantibodies that lead to damage and dysfunction of glands and target organs (1) . Although the pathogenesis of Sjögren Syndrome is considered a multifactorial process, it has been postulated that some viral infection could play a significant role on initiating and/or perpetrating the autoimmune response (10) .…”