Autoimmune diseases and Sjogren's syndrome - An autoimmune exocrinopathy
Autoimmune diseases and Sjogren's syndrome - An autoimmune exocrinopathy
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DOI：
10.1196/annals.1384.003
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发表时间：
2007-01-01
期刊：
影响因子：
--
通讯作者：
Fox, Philip C.
中科院分区：
文献类型：
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作者：
Fox, Philip C.
自身免疫性疾病包括80多种不同的疾病。干燥综合征是第二常见的自身免疫性风湿性疾病，在美国估计患病率为2-4百万人。干燥综合征患者的口腔和牙科表现突出且一致，与自身免疫介导的正常唾液腺功能丧失有关。此外，舍格伦综合征的非口腔临床表现包括：干眼症（具有称为干燥性角膜结膜炎的特定眼表变化）;其他干燥症，如鼻、喉、皮肤和阴道干燥;外周（和较不常见的中枢）神经病变;肌痛和关节痛;甲状腺疾病（特别是自身免疫性甲状腺炎）;肺部疾病;肾脏疾病;和淋巴瘤。恶性淋巴瘤的发病率显著增加（20- 40倍），尤其是原发性干燥综合征。由于干燥综合征的非特异性症状（眼干和口干）、诊断标准的不一致以及缺乏敏感和特异的实验室标志物，因此很难确定干燥综合征的诊断。许多血清和唾液的生物标志物干燥综合征已被提出，但迄今为止，没有被证明是足够的具体诊断目的或已与疾病活动措施。研究人员最近开始应用现代基因组学和蛋白质组学方法来鉴定干燥综合征的候选生物标志物。这些调查的结果有望提供丰富的信息候选生物标志物和潜在的这种疾病的发病机制。此外，这些信息将通过促进新的合理治疗方法的设计和协助监测临床疾病来改善临床结果。
Autoimmune diseases include a diverse group of over 80 conditions. Sjogren's syndrome is the second most common autoimmune rheumatic disease, with an estimated prevalence in the United States of 2-4 million persons. There are prominent and consistent oral and dental findings in Sjogren's syndrome related to the autoimmune-mediated loss of normal salivary function. Additionally, nonoral clinical manifestations of Sjogren's syndrome include: dry eyes (with specific ocular surface changes termed keratoconjunctivitis sicca); other xeroses, such as dryness of the nose, throat, skin, and vagina; peripheral (and less frequently central) neuropathies; myalgias and arthralgias; thyroid disorders (particularly autoimmune thyroiditis); pulmonary disorders; renal disorders; and lymphoma. There is a significant (20- to 40-fold) increase in the incidence of malignant lymphoma, particularly in primary Sjogren's syndrome. Establishing the diagnosis of Sjogren's syndrome has been difficult in the light of its nonspecific symptoms (dry eyes and mouth), disagreement on diagnostic criteria, and a lack of both sensitive and specific laboratory markers. Many serum and salivary biomarkers for Sjogren's syndrome have been proposed although, to date, none has proven to be sufficiently specific for diagnostic purposes or has been well correlated with disease activity measures. Investigators have recently begun to apply modern genomic and proteomic approaches to identify candidate biomarkers in Sjogren's syndrome. The results of these investigations promise to provide a wealth of information on candidate biomarkers and possible etiopathological mechanisms underlying this disorder. Further, this information will improve clinical outcomes by fostering the design of new rational therapeutics and assisting in the monitoring of clinical disease.