Persistent Cytomegalovirus infection—The etiology of Sjogren's Syndrome

Xerostomia due to systemic disease: A review of 20 conditions and mechanisms

“…The destruction of these ducts leads to xerostomia. [50] However, no relationship between xerostomia and anti-CMV antibodies was noted. [51]…”

Does cytomegalovirus play a causative role in the development of various inflammatory diseases and cancer?

“…5) and destruction of these ductal cells would lead to the classical symptoms of SS, i.e. keratoconjuctivitis sicca and xerostomia [249].…”

Ocular Mucosal Immunity

“…Furthermore, in experimental models of this complex disorder, the generation of autoantibodies (Ohashi et al, 1985) and autoreactive T cells to (Tsubata et al, 1996), and the deposition of IgG, IgA, and complement in ductal epithelial cells of (deLuise et al, 1982), lacrimal tissue may accompany the striking glandular inflammation (Jabs et al, 1985;Jabs and Prendergast, 1988;Tsubata et al, 1996;Takahashi et al, 1996;Robinson et al, 1998;van Blokland and Versnel, 2002). The etiology of Sjögren's syndrome may involve the endocrine system (Ansar et al, 1985;Talal and Ahmed, 1985;Nelson and Steinberg, 1987;Ahmed et al, 1989;Homo-Delarche et al, 1991;Homo-Delarche and Durant, 1994;Sullivan, 1994Sullivan, , 1997, but it may also be due to primary infection by, and reactivation of, EpsteinBarr virus, cytomegalovirus, herpes virus-6, hepatitis C, or retroviruses (Burns, 1983;Fox, 1988;Green et al, 1989;Krueger et al, 1990;Mariette et al, 1991Mariette et al, , 1993Fox et al, 1991;Pflugfelder et al, 1993;Pepose et al, 1996;Sipsas et al, 2011). These viruses have been identified in the lacrimal and/or salivary tissues of Sjögren's patients (Burns, 1983;Fox et al, 1986;Fox, 1988;Krueger et al, 1990;Garry et al, 1990;Mariette et al, 1991;Pflugfelder et al, 1993;Tsubota ...…”

“…The etiology of Sjögren's syndrome may involve the endocrine system (Ansar et al, 1985;Talal and Ahmed, 1985;Nelson and Steinberg, 1987;Ahmed et al, 1989;Homo-Delarche et al, 1991;Homo-Delarche and Durant, 1994;Sullivan, 1994Sullivan, , 1997, but it may also be due to primary infection by, and reactivation of, EpsteinBarr virus, cytomegalovirus, herpes virus-6, hepatitis C, or retroviruses (Burns, 1983;Fox, 1988;Green et al, 1989;Krueger et al, 1990;Mariette et al, 1991Mariette et al, , 1993Fox et al, 1991;Pflugfelder et al, 1993;Pepose et al, 1996;Sipsas et al, 2011). These viruses have been identified in the lacrimal and/or salivary tissues of Sjögren's patients (Burns, 1983;Fox et al, 1986;Fox, 1988;Krueger et al, 1990;Garry et al, 1990;Mariette et al, 1991;Pflugfelder et al, 1993;Tsubota et al, 1995;Pepose et al, 1996) and may possibly stimulate the inappropriate epithelial cell human leukocyte antigen-DR and Toll-like receptor expression, T helper/inducer cell activation, B cell hyperactivity, and autoantibody production evident in these affected tissues (Moutsopoulos and Talal, 1987;Maini, 1987;Fox, 1988;Homma et al, 1994;Berglova et al, 2011;Lambiase et al, 2011). In support of this possibility, certain viral infections in experimental animals exert a striking effect on the lacrimal gland and induce a periductular infiltration of plasma cells, lymphocytes, and macrophages; distinct nonsuppurative periductular inf...…”