Treatment of oral dryness related complaints (xerostomia) in Sjogren's syndrome

Abstract

Primary Sjögren's syndrome (SS) is a systemic autoimmune disorder characterised by a chronic, progressive loss of salivary and lacrimal function resulting in symptoms of oral and ocular dryness. The involvement of exocrine glands is the result of a focal, periductal mononuclear cell infiltrate and the subsequent loss of secretory epithelial cells.1 As a consequence, major changes occur in both the salivary flow rate and salivary composition. 2-9

The Protein Kinase A Pathway Contributes to Hg2+-Induced Alterations in Phosphorylation and Subcellular Distribution of Occludin Associated with Increased Tight Junction Permeability of Salivary Epithelial Cell Monolayers

“…It is possible that PKA and other molecular components of this paracellular pathway in the salivary epithelium may provide novel targets for pharmacological modification to improve fluid secretion in conditions such as xerostomia (dry mouth), which occurs commonly in Sjögren's syndrome, and in patients receiving radiation and chemotherapy for head and neck tumors (El-Sayed and Nelson, 1996;van der Reijden et al, 1999).…”

Dry mouth and denture plaque microflora in complete denture and palatal obturator prosthesis wearers

“…Saliva possesses antibacterial properties and inhibits microbial adherence 1 ; therefore, salivary gland hypofunction might increase the risk of opportunistic infections, such as candidiasis 1,2 . Published data have shown a significantly inverse relationship between the salivary flow rate and Candida colony-forming unit (CFU) counts in patients with xerostomia 3 , Sj€ ogren's syndrome 4,5 and a history of radiotherapy 6 .…”

Reduction of fatigue in Sjogren syndrome with rituximab: results of a randomised, double-blind, placebo-controlled pilot study

“…Neither corticosteroids nor disease modifying antirheumatic drugs (DMARDs) have been shown to have a significant effect on the disease course 5 6. Randomised, controlled studies have also failed to show significant differences between placebo and the anti-tumour necrosis factor (TNF) agents, infliximab and etanercept 7 8…”