Sjögren’s syndrome at the crossroad of polyautoimmunity

Amador-Patarroyo, Manuel J.; Arbelaez, Juan G.; Mantilla, Rubén D.; Rodríguez, Alberto Rodríguez; Cárdenas-Roldán, Jorge; Pineda-Tamayo, Ricardo; Guarín, Mayra R.; Kleine, Liliana López; Rojas-Villarraga, Adriana; Anaya, Juan Manuel

doi:10.1016/j.jaut.2012.05.008

Cited by 88 publications

(55 citation statements)

References 58 publications

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“…The most common autoimmune disorder was hypothyroidism (14%). Similarly, a more recent cohort of 410 patients with SS [61] showed the presence of polyautoimmunity in 134 (32.6%), with thyroid disease being the most common (21.5%). The prevalence of systemic diseases such as RA and SLE was around 8%.…”

Section: Introductionmentioning

confidence: 92%

Novel aspects of Sjögren’s syndrome in 2012

Tincani

Andréoli

Cavazzana

et al. 2013

BMC Med

145

138

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Sjögren’s syndrome (SS) is a systemic progressive autoimmune disease characterized by a complex pathogenesis requiring a predisposing genetic background and involving immune cell activation and autoantibody production. The immune response is directed to the exocrine glands, causing the typical ‘sicca syndrome’, but major organ involvement is also often seen. The etiology of the disease is unknown. Infections could play a pivotal role: compared to normal subjects, patients with SS displayed higher titers of anti-Epstein-Barr virus (EBV) early antigens, but lower titers of other infectious agent antibodies such as rubella and cytomegalovirus (CMV) suggest that some infections may have a protective role against the development of autoimmune disease. Recent findings seem to show that low vitamin D levels in patients with SS could be associated with severe complications such as lymphoma and peripheral neuropathy. This could open new insights into the disease etiology. The current treatments for SS range from symptomatic therapies to systemic immunosuppressive drugs, especially B cell-targeted drugs in cases of organ involvement. Vitamin D supplementation may be an additional tool for optimization of SS treatment.

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Section: Introductionmentioning

confidence: 92%

Novel aspects of Sjögren’s syndrome in 2012

Tincani

Andréoli

Cavazzana

et al. 2013

BMC Med

145

138

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“…To what extent PR3-ANCA positive UC patients will develop full-blown AAV over the course of their disease needs to be assessed in large longitudinal studies. It is widely appreciated that different autoimmune diseases can overlap in certain patients, which was recently described as polyautoimmunity [99]. Therefore, additional studies are required to determine whether there is an overlap between the two chronic inflammatory diseases.…”

Section: Anca As Biomarkers In Inflammatory Bowel Diseasementioning

confidence: 99%

Novel Clinical and Diagnostic Aspects of Antineutrophil Cytoplasmic Antibodies

Schulte-Pelkum

Radice

Norman

et al. 2014

Journal of Immunology Research

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Antineutrophil cytoplasmic antibodies (ANCA) are the serological hallmark of some idiopathic systemic vasculitides. Besides the investigation of ANCA-associated vasculitis (AAV) and constant effort for a standardized nomenclature and classification of the AAV, a main focus of research during the last few years has been to constantly improve the performance of enzyme immunoassays. With the latest so called third generation ELISA, this goal seemed to be fulfilled. The International Consensus Statement on Testing and Reporting of ANCA gave recommendations for standardized strategies for the serological diagnosis of ANCA. New developments now target the system immanent drawbacks of the respective diagnostic methods, be it the need for batching and the long time to result for ELISA, or the high likelihood of error and subjectivity of indirect immunofluorescence (IIF). Random access technology and multiplexing for solid phase assays as well as digital imaging for IIF are tools which may help to expedite and simplify routine diagnostics in the lab and in emergency settings. Recent findings indicate that PR3-ANCA have clinical utility beyond the diagnosis of AAV. PR3-ANCA can also serve as an aid for the differentiation between ulcerative colitis (UC) and Crohn's disease (CrD) and the stratification of UC patients. This review provides a detailed review of what is known about ANCA and highlights the latest research and state-of-the-art developments in this area.

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“…The principal manifestations of the disease are dry eyes and dry mouth resulting from immune-mediated damage and dysfunction of the lacrimal and salivary glands3 4 which develop a characteristic lymphocytic infiltrate that can be objectively measured with a focus score 5. Approximately 67% of patients with SS have circulating autoantibodies to anti-Ro (SSA) and/or anti-La (SSB) 6.…”

Section: Introductionmentioning

confidence: 99%

Comparison of the American-European Consensus Group Sjögren's syndrome classification criteria to newly proposed American College of Rheumatology criteria in a large, carefully characterised sicca cohort

et al. 2013

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Objective To compare the performance of the American-European Consensus Group (AECG) and the newly proposed American College of Rheumatology (ACR) classification criteria for Sjögren's syndrome in a well-characterized sicca cohort, given ongoing efforts to resolve discrepancies and weaknesses in the systems. Methods In a multidisciplinary clinic for the evaluation of sicca, we assessed features of salivary and lacrimal gland dysfunction and autoimmunity as defined by tests of both AECG and ACR criteria in 646 participants. Global gene expression profiles were compared in a subset of 180 participants. Results Application of the AECG and ACR criteria resulted in classification of 279 and 268 participants with SS, respectively. Both criteria were met by 244 participants (81%). In 26 of the 35 AECG+/ACR- participants, the minor salivary gland biopsy focal score was ≥1 (74%), while 9 had positive anti-Ro/La (26%). There were 24 AECG-/ACR+ who met ACR criteria mainly due to differences in the scoring of corneal staining. All patients with SS, regardless of classification, had similar gene expression profiles, which were distinct from the healthy controls. Conclusion The two sets of classification criteria yield concordant results in the majority of cases and gene expression profiling suggests that patients meeting either set of criteria are more similar to other SS participants than to healthy controls. Thus, there is no clear evidence for increased value of the new ACR criteria over the old AECG criteria from the clinical or biological perspective. It is our contention, supported by this report, that improvements in diagnostic acumen will require a more fundamental understanding of the pathogenic mechanisms than is at present available.

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Sjögren’s syndrome at the crossroad of polyautoimmunity

Cited by 88 publications

References 58 publications

Novel aspects of Sjögren’s syndrome in 2012

Novel aspects of Sjögren’s syndrome in 2012

Novel Clinical and Diagnostic Aspects of Antineutrophil Cytoplasmic Antibodies

Comparison of the American-European Consensus Group Sjögren's syndrome classification criteria to newly proposed American College of Rheumatology criteria in a large, carefully characterised sicca cohort

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