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Sjögren’s Syndrome

  • Luca Quartuccio
  • Saviana Gandolfo
  • Sara Zandonella Callegher
  • Salvatore De Vita
Chapter

Abstract

Sjögren’s syndrome (SS) is a systemic autoimmune disease characterized by exocrine gland dysfunction and destruction, mainly localized at the level of salivary and lacrimal glands, leading to dryness of the mouth and eyes, as the most frequent symptoms of the disease. From a pathological point of view, SS is an exocrinopathy (i.e. an autoimmune epitheliitis of the exocrine glands) characterized by dense lymphocytic infiltrates of glandular tissue and B-cell hyperreactivity.

As an autoimmune disorder, SS shows a broad clinical presentation and evolution, usually starting from sicca symptoms to involvement of multiple organs. Importantly, SS is the autoimmune disease where lymphoma risk is the highest. Thus, it can represent a very good model of lymphomagenesis, where a benign lymphoproliferation can evolve into a malignant process. Thus, the study of SS may provide insights into the pathogenesis of autoimmune disorders and lymphoma. Additionally, SS is one of the so-called rheumatoid factor-positive autoimmune diseases (as rheumatoid arthritis or mixed cryoglobulinaemia), and rheumatoid factor is a well-recognized autoantibody often found in diseases other than autoimmune diseases, such as infectious diseases, and in particular chronic infectious ones (i.e. HCV). A viral infection has been long suspected for induction of SS, since transient or persistent infection of epithelial cells by a putative virus may be an initiating event for local autoimmune reactions. Many types of viruses were the objective of several research studies focusing on a possible role of such viruses in the etiopathogenesis of SS. However, results have been inconclusive up till now. Nevertheless, similarities between chronic inflammatory sialadenitis in the course of chronic infections (i.e. HCV, HIV) and SS sialadenitis, as well as the biological evidence of a local chronic (auto)antigen stimulation in the salivary glands of SS patients, leave question of the possible role of infections (even unknown) in the pathogenesis of SS unanswered.

Keywords

Sjögren’s syndrome Hepatitis Lymphoma Infection Cryoglobulinaemia 

Abbreviations

AhR

Aryl hydrocarbon receptor

ATL

Adult T-cell leukaemia-lymphoma

BAFF

B-cell activating factor

CMV

Cytomegalovirus

Cp

Chlamydia psittaci

CV

Coxsackievirus

EBV

Epstein-Barr virus

GC

Germinal centre

GPCR

G-protein-coupled receptor

HAM/TSP

HTLV-1 associated myelopathy/tropical spastic paraparesis

HBV

Hepatitis B virus

HCV

Hepatitis C virus

HIV

Human immunodeficiency virus

HP

Helicobacter pylori

HTLV-1

Human T-lymphotropic virus type 1

MALT

Mucosa-associated lymphoid tissue

MCMV

Murine CMV

MESA

Myoepithelial sialadenitis

NHL

Non-Hodgkin lymphoma

SG

Salivary gland

SLE

Systemic lupus erythematosus

SS

Sjögren’s syndrome

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Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  • Luca Quartuccio
    • 1
  • Saviana Gandolfo
    • 1
  • Sara Zandonella Callegher
    • 1
  • Salvatore De Vita
    • 1
  1. 1.Rheumatology Clinic, Academic Hospital Santa Maria della Misericordia, Udine, Department of Medical and Biological SciencesUdineItaly

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