Research Highlights on Sjogren's Syndrome

Research Highlights on Sjogren's Syndrome from the National Institues of Health, Department of Health & Human Services

Through basic research on the immune system, autoimmunity, genetics, and connective tissue diseases, researchers continue to learn more about Sjögren’s syndrome. The hope is that a better understanding of the disease and its causes will lead to better treatments and perhaps even prevention.

Some of the areas of research into Sjögren’s syndrome include the following:

•Genetic studies. Recent research has discovered that the STAT4 gene variant associated with rheumatoid arthritis and lupus is also associated with Sjögren’s syndrome. This suggests that variants of this gene play a crucial role in autoimmunity. This discovery may lead to new treatment approaches that will ultimately be effective not only in Sjögren’s syndrome, but possibly in other autoimmune diseases as well.

•Hormonal factors. Because Sjögren’s syndrome affects mostly women, female reproductive hormones may play a role. Although studies have shown that levels of estrogen and progesterone differ little between women with Sjögren’s syndrome and those without, higher levels of prolactin (a hormone that stimulates the production of milk after childbirth and the production of progesterone in the ovary) are found in women with Sjögren’s syndrome. Research is also looking at how the disease affects men and women differently.

•Medication treatment. Studies have shown that cevimeline, is effective at easing dry eyes, as well as dry mouth, and that the immunosuppressive drug cyclophosphamide is effective for treating some of the nervous system effects of Sjögren’s syndrome. In a mouse model of this disorder, eye drops of an anti-CD4 antibody were effective at promoting moisture. On the other hand, at least two other therapies under investigation for Sjögren’s syndrome—the biologic response modifier etanercept and the mild male hormone dehydroepiandrosterone have not proven to be effective.

•Prevalence of extraglandular involvement. Studies have shown that neurological involvement and Sjögren’s-related problems with the skin—including alopecia (a condition characterized by hair loss), vitiligo (a condition in which areas of the skin lose their pigment and become white), and vasculitis (a raised rash)—may be more common than previously thought. Studies also indicate that identifying and treating these problems in people with Sjögren’s syndrome is an important part of managing the disease. Another study shows that clinical depression is also common among Sjögren’s syndrome patients, and may warrant treatment.

•Predicting lung involvement. Knowing who is at highest risk of certain complications can enable doctors to identify and treat these problems earlier and more appropriately. One study showed that serum levels of beta-2 microglobulin (a protein made by plasma cells and associated with inflammation) were higher in people who later developed lung problems with primary Sjögren’s syndrome.

•Role of infection. Doctors believe that infections may trigger Sjögren’s syndrome in people genetically predisposed to the disease. Viral infection is under investigation as a possible trigger for Sjögren’s syndrome and other autoimmune diseases. Epstein-Barr virus, hepatitis C virus and Coxsackie virus are being studied.

•Long-term relief for dry mouth. Gene therapy studies suggest that we may someday be able to insert molecules into salivary glands that will control inflammation and prevent their destruction. Scientists also envision a day when they will be able to transplant salivary glands from one person to another. Development of a safe and effective artificial salivary gland is already underway.

The National Institute of Dental and Craniofacial Research conducts studies to help scientists understand, manage, and treat Sjögren’s syndrome. If you think you might like to take part in a clinical trial, speak with your doctor or check www.clinicaltrials.gov for a listing of trials for which you may be eligible.

Taken from http://www.niams.nih.gov/health_info/sjogrens_syndrome/#resea