Primary Sjögren's syndrome in Asia: Yin and Yang?

Sandhya, Pulukool; Danda, Debashish

doi:10.1111/1756-185x.13201

Cited by 10 publications

(7 citation statements)

References 26 publications

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“…De de Paiva et al (2016) and Zhou et al (2018) consistent with those of three previous studies. As reported previously, Indian patients have fewer sicca symptoms and this is reflected in our cohort of patients with pSS (Sandhya & Danda, 2017;Sandhya, Jeyaseelan, Scofield, & Danda, 2015).…”

Section: Discussionsupporting

confidence: 85%

“…We also observed a difference in alpha diversity in patients with RTA. RTA is a manifestation of SS which is more seen in Asians compared to Caucasians (Sandhya & Danda, ; Sandhya, Danda, Rajaratnam, & Thomas, ). While no plausible explanation for the differential alpha diversity in RTA can be made at this point, we hypothesize this could also be influenced due to acidosis, or bicarbonate supplementation in patients with RTA, both of which stands to be tested.…”

Section: Discussionmentioning

confidence: 99%

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Saliva microbiome in primary Sjögren’s syndrome reveals distinct set of disease‐associated microbes

et al. 2020

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Objective This study systematically aims to evaluate the salivary microbiome in patients with primary Sjögren's syndrome (pSS) using 16S rRNA sequencing approach. Methods DNA isolation and 16S rRNA sequencing was performed on saliva of 37 pSS and 35 control (CC) samples on HiSeq 2500 platform. 16S rRNA sequence analysis was performed independently using two popular computational pipelines, QIIME and less operational taxonomic units scripts (LoTuS). Results There were no significant changes in the alpha diversity between saliva of patients and controls. However, four genera including Bifidobacterium, Lactobacillus, Dialister and Leptotrichia were found to be differential between the two sets, and common between both QIIME and LoTuS analysis pipelines (Fold change of 2 and p < .05). Bifidobacterium, Dialister and Lactobacillus were found to be enriched, while Leptotrichia was significantly depleted in pSS compared to the controls. Exploration of microbial diversity measures (Chao1, observed species and Shannon index) revealed a significant increase in the diversity in patients with renal tubular acidosis. An opposite trend was noted, with depletion of diversity in patients with steroids. Conclusion Our analysis suggests that while no significant changes in the diversity of the salivary microbiome could be observed in Sjögren's syndrome compared to the controls, a set of four genera were significantly and consistently differential in the saliva of patients with pSS. Additionally, a difference in alpha diversity in patients with renal tubular acidosis and those on steroids was observed.

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Section: Discussionsupporting

confidence: 85%

Section: Discussionmentioning

confidence: 99%

Saliva microbiome in primary Sjögren’s syndrome reveals distinct set of disease‐associated microbes

et al. 2020

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“…Our results confirm that the systemic phenotype of SS at diagnosis is also strongly driven by ethnicity, with enhanced systemic activity detected in BAA patients compared with the other ethnicities; in terms of global systemic activity, BAA patients were followed by White patients, with Asian and Hispanic patients having the lowest rates. In addition, organ-by-organ systemic involvement follows a clearly differentiated pattern between ethnicities; no studies have compared the systemic phenotype between ethnicities, while only studies in Asian cohorts have reported an enhanced risk of pulmonary and renal involvement [36], as shown by our results. Recent studies have reported a differing genetic susceptibility to Sjo ¨gren's syndrome, driven by ethnicity [37,38].…”

Section: Discussionsupporting

confidence: 47%

“…Ethnicity has a strong influence on the age at diagnosis [14,32,33] and the phenotypic expression of sicca symptomatology, with an enhanced frequency in White patients, and a decreased frequency in BAA and Asian patients [14,34,35]. Underreporting of sicca symptoms has been suggested to be related to differentiated patient perceptions, understanding and socio-economic status in Asian cohorts [36]. Our results confirm that the systemic phenotype of SS at diagnosis is also strongly driven by ethnicity, with enhanced systemic activity detected in BAA patients compared with the other ethnicities; in terms of global systemic activity, BAA patients were followed by White patients, with Asian and Hispanic patients having the lowest rates.…”

Section: Discussionmentioning

confidence: 99%

Epidemiological profile and north–south gradient driving baseline systemic involvement of primary Sjögren’s syndrome

Brito-Zerón

Acar-Denizli

et al. 2019

Rheumatology

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Objective To characterize the systemic phenotype of primary Sjögren’s syndrome at diagnosis by analysing the EULAR-SS disease activity index (ESSDAI) scores. Methods The Sjögren Big Data Consortium is an international, multicentre registry based on worldwide data-sharing cooperative merging of pre-existing databases from leading centres in clinical research in Sjögren’s syndrome from the five continents. Results The cohort included 10 007 patients (9352 female, mean 53 years) with recorded ESSDAI scores available. At diagnosis, the mean total ESSDAI score was 6.1; 81.8% of patients had systemic activity (ESSDAI score ≥1). Males had a higher mean ESSDAI (8.1 vs 6.0, P < 0.001) compared with females, as did patients diagnosed at <35 years (6.7 vs 5.6 in patients diagnosed at >65 years, P < 0.001). The highest global ESSDAI score was reported in Black/African Americans, followed by White, Asian and Hispanic patients (6.7, 6.5, 5.4 and 4.8, respectively; P < 0.001). The frequency of involvement of each systemic organ also differed between ethnic groups, with Black/African American patients showing the highest frequencies in the lymphadenopathy, articular, peripheral nervous system, CNS and biological domains, White patients in the glandular, cutaneous and muscular domains, Asian patients in the pulmonary, renal and haematological domains and Hispanic patients in the constitutional domain. Systemic activity measured by the ESSDAI, clinical ESSDAI (clinESSDAI) and disease activity states was higher in patients from southern countries (P < 0.001). Conclusion The systemic phenotype of primary Sjögren’s syndrome is strongly influenced by personal determinants such as age, gender, ethnicity and place of residence, which are key geoepidemiological players in driving the expression of systemic disease at diagnosis.

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“…An enhanced risk of pulmonary and renal involvement has been reported in an Asian cohort study. 27 Brito-Zerón et al 28 were the first to report significant geoepidemiological variations in the prevalence of xerostomia, xerophthalmia, abnormal diagnostic tests and positivity of immunological marker.…”

Section: Discussionmentioning

confidence: 99%

Hypocomplementemia in Primary Sjogren’s Syndrome: A Retrospective Study of 120 Treatment-Naive Chinese Patients

Zhou¹,

Yuan²

2022

IJGM

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Objective To determine the prevalence of hypocomplementemia in primary Sjogren’s syndrome (pSS) patients and compare the clinical characteristics of patients with and without hypocomplementemia. Methods A retrospective study was conducted in 120 treatment-naive Chinese patients that met the 2012 American College of Rheumatology Classification Criteria for pSS and were followed up for 3 to 24 months. Based on the complement results, patients were divided into four groups: only low C3, only low C4, both low C3 and C4 (double low), normal group. The data on patient demographics, clinical manifestations, laboratory results, disease activity and pharmacologic therapy were collected and compared among the four groups. Results The prevalence of only low C3, only low C4, both low C3 and C4 in pSS patients was 21.7%, 16.7%, and 10%, respectively. The mean age of the four groups was significantly different. Unlike rampant caries and parotitis, the prevalence of dry eyes and dry mouth differed among the four groups. The proportion of patients with anemia, leukocytopenia, lymphadenopathy, hematological involvement and fatigue was significantly higher in the double low group and lower in the normal complement group. The proportion of patients with increased serum IgG was higher in the only low C4 group than in the other groups. Logistic regression revealed that hypocomplementemia was an independent risk factor for lymphadenopathy and leukopenia. The double low group had a significant history of exposure to glucocorticoids and cyclophosphamide, compared with other groups. Conclusion Our study found that the clinical characteristics of pSS patients with hypocomplementemia differed from those without hypocomplementemia. Hypocomplementemia in pSS was associated with hematological involvement, hyper-IgG, lymphadenopathy, and fatigue, contributing to more significant exposure to glucocorticoid and cyclophosphamide.

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Primary Sjögren's syndrome in Asia: Yin and Yang?

Cited by 10 publications

References 26 publications

Saliva microbiome in primary Sjögren’s syndrome reveals distinct set of disease‐associated microbes

Saliva microbiome in primary Sjögren’s syndrome reveals distinct set of disease‐associated microbes

Epidemiological profile and north–south gradient driving baseline systemic involvement of primary Sjögren’s syndrome

Hypocomplementemia in Primary Sjogren’s Syndrome: A Retrospective Study of 120 Treatment-Naive Chinese Patients

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