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Immunopathogenesis of Sjögren's syndrome

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Abstract

Sjögren's syndrome (SS) is an autoimmune disease characterized by the sicca symptoms of dry eyes and dry mouth. Glandular dysfunction is thought to arise from destruction associated with lymphocytic infiltration. The degree of glandular destruction, however, does not correlate with the severity of sicca symptoms, suggesting that other mechanisms are involved, including abnormalities in parasympathetic neurotransmission. Autoantibodies against the muscarinic acetylcholine receptor have been implicated in this process, but multiple other autoantibodies have been found. Cytokines elaborated in the inflammatory lesions also appear to be involved and dysregulation of apoptosis are also involved in the pathogenesis of SS. A new two-stage model of SS has been proposed. First, there is a lymphocyte-independent phase during which inappropriate apoptosis results in the generation of apoptotic autoantigens which then attract lymphocytes. Subsequently, in the second lymphocyte-dependent phase, an immune attack causes further cell death and salivary dysfunction. Although the disease generally takes a rather stable and benign course, patients with SS have a significant risk of developing B cell lymphoma.

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Article 07 July 2016

Pilar Brito-Zerón, Chiara Baldini, … Manuel Ramos-Casals

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Authors and Affiliations

  1. Division of Rheumatology, Allergy and Clinical Immunology, University of California at Davis, TB 192, School of Medicine, 956 16, Davis, California

    Andrea T. Borchers, Stanley M. Naguwa & M. Eric Gershwin

  2. Department of Nutrition, University of California at Davis, 3135 Meyer Hall, 95616, Davis, California

    Carl L. Keen

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  1. Andrea T. Borchers
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Borchers, A.T., Naguwa, S.M., Keen, C.L. et al. Immunopathogenesis of Sjögren's syndrome. Clinic Rev Allerg Immunol 25, 89–104 (2003). https://doi.org/10.1385/CRIAI:25:1:89

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