Editor’s Comment: Sicca, or dry eyes and mouth, is included in both the Canadian and International case definitions for CFS/ME. In 1996, researchers in Japan found that fully one-third of the CFS/ME patients met the diagnostic criteria for Sjögren's.
Novel aspects of Sjögren’s syndrome in 2012
By Angela Tincani et al.
Sjögren’s syndrome (SS) is a systemic progressive autoimmune disease characterized by a complex pathogenesis requiring a predisposing genetic background and involving immune cell activation and autoantibody production. The immune response is directed to the exocrine glands, causing the typical ‘sicca syndrome’, but major organ involvement is also often seen.
The etiology of the disease is unknown. Infections could play a pivotal role: compared to normal subjects, patients with SS displayed higher titers of anti-Epstein-Barr virus (EBV) early antigens, but lower titers of other infectious agent antibodies such as rubella and cytomegalovirus (CMV) suggest that some infections may have a protective role against the development of autoimmune disease.
Recent findings seem to show that low vitamin D levels in patients with SS could be associated with severe complications such as lymphoma and peripheral neuropathy. This could open new insights into the disease etiology.
The current treatments for SS range from symptomatic therapies to systemic immunosuppressive drugs, especially B cell-targeted drugs in cases of organ involvement. Vitamin D supplementation may be an additional tool for optimization of SS treatment.
Source: BMC Medicine 2013, 11:93 doi:10.1186/1741-7015-11-93. Angela Tincani, Laura Andreoli2, Ilaria Cavazzana1, Andrea Doria, Marta Favero, Maria-Giulia Fenini, Franco Franceschini, Andrea Lojacono, Giuseppe Nascimbeni, Amerigo Santoro, Francesco Semeraro, Paola Toniati and Yehuda Shoenfeld.