Sjogren’s syndrome:☆
Section snippets
Diagnostic issues
In 1932, Henrik Sjögren reported the triad of keratoconjunctivitis sicca (KCS), xerostomia, and rheumatoid arthritis. The clinical spectrum of SS as a systemic autoimmune disease was further defined by Bloch et al.1 in 1956. In patients with extreme manifestations there is good agreement on diagnosis among clinicians, but the diagnosis in patients with milder sicca symptoms has remained controversial owing to the absence of good noninvasive methods for documenting xerostomia. The demonstration
Pathogenesis of Sjogren’s syndrome
The epithelial cells lie upon a specific extracellular matrix including collagens, laminins, vitronectin, and nonmatrix proteins. Cell-matrix interactions are important for cellular functions of the epithelial cell, including response to growth factor signals and ability for cellular regeneration.42 The epithelial cells express a family of specific receptors including integrins to bind these matrix proteins, as well as receptors for cyclic AMP (cAMP), growth factors, estrogens, and cytokines.43
Therapy of Sjogren’s syndrome
The characteristic symptoms of SS patients involve dry, painful eyes and mouth. For dry eyes, the initial therapy is artificial tears on a regular basis. It is a common problem to wait for symptoms and then play “catch up.” The patient needs to evaluate the needs in the day ahead (ie. dry winds, low humidity such as an airplane) and adjust the tear use in anticipation. Different brands of artificial tears have distinct characteristics in terms of their viscosity (ie. the more viscous tears last
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The research of R.I.F. was supported by NIH grant M01-RR000831 and the Department of Academic Affairs of Scripps Institute for Medicine. Additional support for postdoctoral fellows (J.H. and C.C.) was provided by grants from the Hennings Memorial Trust, and the Florence, Scripps-Stedham, Kovler and Ramsdell Foundations.