Phases and Natural History of Sjögren's Disease: a new model for an old disease?

Adrian Y.S. Lee, Jing Jing Wang, Tom P. Gordon, Joanne H. Reed

Research output: Contribution to journalReview articlepeer-review

6 Citations (Scopus)
112 Downloads (Pure)

Abstract

Sjögren's disease (SjD) is an archetypal and heterogenous autoimmune disorder that is characterized by exocrine glandular dysfunction. A proportion of patients develop severe extraglandular manifestations, such as cryoglobulinemia, and have an increased risk of lymphoma, both of which can adversely affect quality of life and occasionally mortality. As with most autoimmune disorders, the pathogenesis is poorly understood and difficult to predict, and, frustratingly, there is a lack of targeted therapies to cure this disease. We review the disease manifestations of SjD and propose a staged model for understanding the evolution of pathology. In longitudinal studies, most patients remain relatively stable in terms of their laboratory and clinical parameters. However, in the setting of various risk factors, a proportion of patients develop severe symptoms and/or lymphoma. We discuss potential underlying mechanisms for disease progression and the strengths and limitations of using a staged model to correlate the pathogenesis and spectrum of manifestations in SjD. Ultimately, understanding how and why some patients remain relatively stable, whereas others progress and develop florid systemic disease and a fraction develop lymphoma, is key to developing preventative and therapeutic treatments.

Original languageEnglish
Pages (from-to)1580-1587
Number of pages8
JournalArthritis Care and Research
Volume75
Issue number7
Early online date5 Sept 2022
DOIs
Publication statusPublished - Jul 2023

Keywords

  • Sjogren's syndrome
  • exocrine glandular dysfunction
  • disease manifestations
  • systemic autoimmune diseases
  • SjD

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