Sjögren’s syndrome is a chronic autoimmune disease characterized by the abnormal production of certain antibodies that target the moisture-producing glands in the body, leading to dryness in the eyes, mouth, and other areas of the body. Henrik Sjögren first described the illness in 1933, however as you pointed out, previous descriptions of individuals with comparable symptoms exist. Although the precise cause of the illness is unknown, it is thought to be a result of both hereditary and environmental factors. The condition can cause a wide range of symptoms, such as dry eyes and mouth, weariness, joint discomfort, and issues with other organs like the lungs, kidneys, and liver.
Antibodies:
Anti-SSA (also known as Ro) and anti-SSB (commonly known as La) antibodies are the two most frequently discovered antibodies in persons with Sjögren’s disease. These antibodies are made against Ro (SSA) and La (SSB), respectively, which are parts of the cells’ own nucleic acid-protein complex.
These antibodies are found in the blood of persons with primary Sjogren’s disease, where the disease is the only one present, and secondary Sjogren’s disease, when the disease is a component of another autoimmune disease such systemic lupus erythematosus (SLE) or rheumatoid arthritis (RA)
It’s important to understand that Sjögren’s syndrome is not always present just because certain antibodies are present. They can also be found in healthy people and in people with various disorders. A combination of laboratory testing and a clinical evaluation by a specialist are needed to diagnose Sjögren’s.
Research Studies:
The most accurate biomarkers for Sjogren’s Syndrome are anti-SSA/Ro and anti-SSB/La antibodies. Numerous investigations have been made to ascertain the frequency of these antibodies in Sjogren’s patients as well as those with other autoimmune diseases.
- The 1990 study “The Sjogren’s syndrome – a review” by P. Sjogren et al. was one of the most influential ones. This study acts as a reference for subsequent studies in the field and provides an overview of what was known about the illness at the time. It also details the clinical, immunological, and serological aspects of the disease.
- Anti-SSA and anti-SSB antibodies in primary Sjogren’s syndrome: a study of prevalence, clinical correlates, and connections to other autoantibodies was the title of another study carried out by M.P. Theander et al in 2003. The objective of this study was to assess the prevalence of anti-SSA/Ro and anti-SSB/La antibodies in a large cohort of primary Sjogren’s syndrome (pSS) patients and to link the presence of these antibodies with other autoantibodies and clinical characteristics.
- A paper titled “Anti-SSA/Ro and Anti-SSB/La antibodies in Sjogren’s syndrome: From pathogenic mechanisms to therapeutic applications” was also released by researchers in 2016. This study set out to explore the current clinical uses of these antibodies in diagnosis and treatment as well as to offer an updated assessment of the pathogenic mechanisms behind the generation of anti-SSA/Ro and anti-SSB/La antibodies in SS patients.
Sjogren’s syndrome is typically treated by addressing the dryness and inflammation-related symptoms. The chronic nature of the disease means that while most treatments do not cure the disorder, they can help patients live better lives.
Drug Treatments:
Use of synthetic tears and other ocular lubricants is one of the main therapies for dry eyes in Sjögren’s syndrome. You can use them as often as necessary to reduce discomfort and enhance vision. Additionally, drugs known as immunomodulatory agents, such as Pilocarpine and Cevimeline, can be used to increase saliva and tear production.
Corticosteroids, non-steroidal anti-inflammatory drugs (NSAIDs), or immunosuppressive drugs like hydroxychloroquine, azathioprine, methotrexate, mycophenolate mofetil, and rituximab are examples of medications that can reduce inflammation and suppress the immune system.
Additionally, there has been some new study on the use of biologicals like rituximab and tocilizumab, which is demonstrating encouraging results in lowering sensations of dryness as well as delaying or even stopping organ deterioration in some Sjogren’s patients.
Joint pain, muscle weakness, and other symptoms may also be treated with physical therapy and occupational therapy.
It’s vital to understand that each person’s Sjogren’s syndrome treatment plan will be unique and may need to be modified depending on the severity of the symptoms, the presence of additional medical conditions, and the medication’s efficacy.
To create an efficient treatment plan, it’s essential to collaborate with a healthcare team that includes a rheumatologist, an ophthalmologist, a dentist, and other experts as needed.
Pilocarpine and Cevimeline are brand names of medications used to treat dry eyes and dry mouth caused by Sjogren’s syndrome.
Pilocarpine is a medication that belongs to a class of drugs called cholinergic agonists. It works by stimulating the glands that produce tears and saliva, thereby increasing the production of these fluids and relieving the symptoms of dry eyes and dry mouth. It is available in multiple brand names such as Salagen, Isopto Carpine and Pilocar
Cevimeline is a medication that also belongs to a class of drugs called cholinergic agonists, it works similar to Pilocarpine, by promoting the production of tears and saliva. It is available under the brand name Evoxac.
Both of these medications are prescription drugs and are only available with a physician’s prescription. They are not available as generics but there are multiple brands available for each medication.
Immune Suppressants:
The medications that are used to suppress the immune system and decrease inflammation in Sjögren’s syndrome include corticosteroids, non-steroidal anti-inflammatory drugs (NSAIDs), and immunosuppressive drugs. Here are a few examples of brand name and generic medications in each category:
Corticosteroids:
- Brand names: Prednisone, Medrol, Decadron
- Generic names: prednisone, methylprednisolone, dexamethasone
Non-Steroidal Anti-Inflammatory Drugs (NSAIDs):
- Brand names: Naprosyn, Celebrex, Motrin
- Generic names: naproxen, celecoxib, ibuprofen
Immunosuppressive drugs
- Brand names: Plaquenil, Azathioprine, Methotrexate, Mycophenolate Mofetil, Rituximab
- Generic names: Hydroxychloroquine, azathioprine, methotrexate, mycophenolate mofetil, rituximab.
It’s important to note that these are not exhaustive lists and there are many other medications that belong to each category. Each medication works differently and has its own potential side effects, so it’s important to work closely with a healthcare provider to determine the most appropriate medication for your individual needs. It’s also to mention that some of these medications might have different generic versions as well, manufactured by different pharmaceutical companies.
Other Risks:
Studies have shown that people with Sjögren’s syndrome have a higher risk of developing other autoimmune diseases, particularly rheumatic diseases such as rheumatoid arthritis, systemic lupus erythematosus (SLE) and systemic sclerosis.
Approximately 4 to 20% of people with Sjogren’s will have another autoimmune disorder along with it and more commonly the other autoimmune disorder is Rheumatoid Arthritis (RA) or SLE.
Having Sjögren’s syndrome can also increase the risk of developing certain other conditions, such as lymphoma, which is a type of cancer that affects the immune system.
People with Sjögren’s syndrome also have a higher risk of developing certain complications, such as pulmonary hypertension, which is high blood pressure in the lungs, or interstitial lung disease, which is a group of lung disorders that cause scarring of lung tissue.
It’s important to work closely with a healthcare team that includes a rheumatologist, an ophthalmologist, a dentist, and other specialists as needed to monitor your symptoms, rule out other diseases and treat any complications that may arise from Sjogren’s Syndrome.