Sjogrens syndrome:

The Underestimated affliction

By Sam Holton

Definition and basic info.
SS is characterized by xerophthalmia and xerostomia
due to immune-mediated destruction of exocrine glands
immune system mistakenly attacks and destroys
moisture glands primarily lachrymal and ocular
Affects around 3,000,000 people in the u.s. alone, the
2
nd
most common autoimmune disorder
9 out of 10 sufferers are female
A disproportionate number of SS sufferers have
rheumatoid arthritis and vice versa suggesting basic
connection
Though not life threatening can be life changing; Venus
Williams couldnt compete in the 2011 U.S. Open

History
Potentially first discovered by Mikhail Mickulicz in
1882 but description was very general
Henrik Sjogren and his wife Maria discovered
and documented it officially while studying
Rheumatoid arthritis in 1930
Paper wasnt accepted by the review board in
1933 (15 subjects) but was later accepted in
1951 when they did larger trials (80 subjects)
1982 Elaine K. Harris founded the Sjogrens
Syndrome foundation

Symptoms
Biomolecular basis
Several overlapping
theories
Most center around
cytokine environment
TNF and Interleukins 1
and 21
IFN
Mutated HLAs
Aquaporin-7 dysfunction
Study of saliochemistry
showed women with SS had
more Cl, K and Ca ions in
saliva
Intracellular adhesion
dysfunction in salivary glands
Genetic/environmental basis
D3 increases risk fourfold
Muc-16 related to xeropthalmia
La/SS-b protein created due to
alternative splicing of exon-1 out
of the La gene
R.A. is closely related
Close relative with SS gives one
20:1 odds of having SS
Having Certain histocompatability
antigens
Epstein-Barr virus, Hepatitis-C
and Human T-cell leukemia
virus-1 all raise risk of getting SS
Hormonal differences between
men and women
Diagnosis and treatment
Sjogrens has no known cure
but the symptoms can be
alleviated with religious
application of topical
moisturizers, NSAIDs ect.
Diagnosed usually with eye
dryness (Shirmer) tests, Rose-
Bengal dye, lip assays or blood
work
Usually requires multiple
different tests for diagnosis
Diagnosis is mainly a last
resort and is often confused
with chronic fatigue syndrome,
depression, menopause or
multiple sclerosis
New research
4/18/12: researchers at Peking University
Peoples Hospital analyzed incidence rates of
certain symptoms
5/6/12: Department of Rheumatology and
Clinical Immunology, UMC Utrecht tested
efficacy of Leflunomide; able to decrease levels
of IL-4 and TNF ( inhibition of T-helper cell 1
cytokine release)
3/23/12: Experimental Laboratory Immunology,
Catholic University Leuven used Antinuclear
antibody immunoassays to detect SS along with
similar diseases