Sjögren's Syndrome

Atopic dermatitis and risk of autoimmune diseases: a systematic review and meta-analysis.

Wang H, Chen M, Wang T, Cai W, Li X, Huang L · Frontiers in immunology · 2025 · n=723

Atopic dermatitis (AD) is a common recurrent chronic inflammatory skin disease, and there is increasing evidence of a possible association between AD and autoimmune diseases. This study aimed to summarize existing epidemiological studies on the association between AD and autoimmune diseases and to perform a meta-analysis of combinable results. We conducted a thorough search for cohort studies, case-control studies and cross-sectional studies across the PubMed, Cochrane Library, and Embase databases, from their inception to May 24, 2024, using medical subject headings and relevant keywords. All data were meticulously analyzed using Stata statistical software version 17.0. The protocol was registered on PROSPERO (CRD42024547282). A total of 26 cohort studies, comprising 1,629,723 patients with atopic dermatitis and 15,106,889 control subjects, were included in this meta-analysis. These studies were published between 2014 and 2024 and included 19 cohort studies, 2 case-control studies,

Efficacy and safety of mesenchymal stromal cell transplantation in the treatment of autoimmune and rheumatic immune diseases: a systematic review and meta-analysis of randomized controlled trials.

Zeng L, Liu C, Wu Y, Liu S, Zheng Y, Hao W · Stem cell research & therapy · 2025 · n=183

This study aims to assess the effectiveness and safety of mesenchymal stem cell (MSC) transplantation in the treatment of autoimmune and rheumatic immune diseases through randomized controlled trials (RCTs). Two researchers conducted a comprehensive search of Chinese and English databases from their inception until Dec. 2023. The literature screening and data extraction were then performed. Statistical analysis was carried out using RevMan 5.4 software. A total of 42 relevant RCTs, involving 2,183 participants, were ultimately included in this study. These RCTs encompassed four types of rheumatic immune and bone diseases, namely rheumatoid arthritis (RA), osteoarthritis (OA), spondyloarthritis, systemic sclerosis arthritis, systemic lupus erythematosus (SLE), inflammatory bowel disease, multiple sclerosis, primary Sjögren's syndrome (PSS). The systematic review indicates that MSC transplantation may improve spondyloarthritis, RA, PSS. The meta-analysis reveals that MSC transplan

The association between primary Sjogren's syndrome and non-Hodgkin's lymphoma: a systematic review and meta-analysis of cohort studies.

Ansari N, Salesi M · Clinical rheumatology · 2024

Primary Sjögren's syndrome (pSS), a chronic autoimmune condition, has been associated with an increased risk of several cancers. This study aims to delve into the relationship between pSS and the potential development of non-Hodgkin's lymphoma (NHL) utilizing an in-depth systematic review and meta-analysis approach. To thoroughly explore the topic, we conducted a thorough examination of the literature, drawing from reputable databases such as ProQuest, PubMed, Web of Science, Cochrane, and Google Scholar. Our data collection spanned until February 8, 2024, with no time limitation. Data were analyzed with Stata 14 software at a significance threshold of p < 0.05. We examined 15 cohort studies encompassing a total of 50,308 individuals from 1997 to 2023. The findings revealed a substantial link between pSS and the risk of NHL, evident across all demographics. Specifically, the standardized incidence ratio (SIR) was generally 8.78 (95% CI 5.51, 13.99), with similar t

Novel therapies in Sjögren's disease: A systematic review of the literature.

Pelkas C, Franke KB, Vincent FB, Rischmueller M · Best practice & research. Clinical rheumatology · 2025

Sjögren's disease (SjD) is a chronic systemic autoimmune disorder that primarily involves lymphocytic infiltration of exocrine glands, with frequent extra-glandular manifestations. Historically, treatment options for SjD have been limited to alleviating symptoms, rather than treating the underlying cause or preventing disease progression. Furthermore, past clinical trials of therapies such as rituximab failed to demonstrate improvement in symptoms or disease activity. Recently, novel therapeutic strategies targeting underlying disease pathogenesis - including transcription factors, circulating RNA, and B and T cell activity - herald a paradigm shift. Given the complexities of diagnosis, clinical assessment and treatment in SjD, improved clinical trial design with enhanced patient stratification, greater inclusivity and better outcome measures are paramount in evaluating new therapeutics. This systematic review aims to provide a comprehensive overview of recent SjD therapeutic adva

Safety of Accelerated Rituximab Infusion in Rheumatic Diseases: A Systematic Review.

de Carvalho JF, de Oliveira Andrade S, Martinez ATA, Skare T, Appenzeller S · Rheumatology and therapy · 2025 · n=538

To systematically evaluate the safety and feasibility of rapid rituximab (RTX) infusion protocols in patients with autoimmune rheumatic diseases. A comprehensive literature review was conducted using PubMed, LILACS, and Scielo databases from 1965 to May 2024 without language restrictions. Studies reporting infusion reactions associated with accelerated RTX protocols (infusion over 90 to 120 min) in rheumatologic conditions were included. Infusion-related adverse events were assessed and graded according to the National Cancer Institute Common Terminology Criteria for Adverse Events (Grades 1-5). Key variables extracted included patient demographics, underlying diseases, RTX dosage, use of premedication, number of infusions, and frequency and severity of infusion reactions. Seven studies encompassing 538 patients aged 14-78 years were included. The patient cohort covered a spectrum of autoimmune rheumatic conditions, including systemic lupus erythematosus, rheumatoid arthrit

Extracellular vesicles in dry eye disease and Sjögren's syndrome: A systematic review on their diagnostic and therapeutic role.

Chopra P, Fatima A, Mohapatra S, Murugaiyan K, Vemuganti GK, Rengan AK · Survey of ophthalmology · 2025

Extracellular vesicles (EVs), defined as membrane-bound vesicles released from all cells, are being explored for their diagnostic and therapeutic role in dry eye disease (DED). We systematically shortlisted 32 articles on the role of EVs in diagnosing and treating DED. We cover the progress in the last 2 decades on the classification and isolation of EVs and their role in DED. The diagnostic predictability of exosomes was evaluated in Sjögren syndrome (SS) patients' tears, plasma, and saliva, where upregulation of inflammatory proteins was reported uniformly across studies. Also, we evaluate the therapeutic effects of MSC-derived EVs in in vitro and in vivo studies of SS and DED mouse models. A significant response occurs at a functional level with improved tear production and saliva flow rate and at a cellular level with reduced lymphocyte infiltration, improved corneal structural integrity, decreased epithelial cell apoptosis, and dampening of the inflammatory cytokine response.

Recommendations on neurologic, cognitive, and psychiatric manifestations in patients with Sjögren's disease by the Brazilian Society of Rheumatology.

de Oliveira FR, Appenzeller S, Pasoto SG, Fernandes MLMS, Lemos Lopes ML, de Magalhães Souza Fialho SC · Advances in rheumatology (London, England) · 2025

Neurological and psychiatric manifestations occur in patients with primary Sjogren's disease (SjD) with a wide-ranging clinical presentation, affecting quality of life, social participation, and prognosis. Despite this, neither central nor peripheral neurological symptoms are systematically evaluated in the context of autoimmunity or identified as manifestations of SjD. The EULAR Sjogren's Syndrome Disease Activity Index (ESSDAI) covers only part of them in the neurological domain. We performed a systematic review of the diagnosis and prevalence of central, peripheral, and autonomic nervous system manifestations in primary SjD, following the recommendations proposed by the Cochrane Collaboration Handbook. Observational studies were included when their main issue was the diagnosis and the prevalence of the manifestations individually. We employed a generalized linear mixed model (GLMM) method with a random-effects model, and the results were computed using logit transformation, impleme

British Society for Rheumatology guideline on management of adult and juvenile onset Sjögren disease.

Price EJ, Benjamin S, Bombardieri M, Bowman S, Carty S, Ciurtin C · Rheumatology (Oxford, England) · 2025

Sjögren disease (SD) is a chronic, autoimmune disease of unknown aetiology with significant impact on quality of life. Although dryness (sicca) of the eyes and mouth are the classically described features, dryness of other mucosal surfaces and systemic manifestations are common. The key management aim should be to empower the individual to manage their condition-conserving, replacing and stimulating secretions; and preventing damage and suppressing systemic disease activity. This guideline builds on and widens the recommendations developed for the first guideline published in 2017. We have included advice on the management of children and adolescents where appropriate to provide a comprehensive guideline for UK-based rheumatology teams.

2024 Comprehensive Recommendations of the Qazaq College of Rheumatology for the Diagnosis and Management of Sjögren's Syndrome.

Togizbayev G, Aubakirova B, Dilmanova D, Zaripova L, Tabenova A, Karina K · International journal of rheumatic diseases · 2025

Sjögren's syndrome (SjS) is a chronic autoimmune disease characterized by exocrine gland dysfunction and systemic involvement. Although international guidelines exist, regional adaptations are necessary to address specific healthcare settings. In 2024, the Qazaq College of Rheumatology (QCR) developed comprehensive national recommendations for the diagnosis and management of SjS in Kazakhstan. A panel of national experts reviewed and synthesized international guidelines (EULAR, ACR, and BSR) alongside local clinical data to create tailored diagnostic and therapeutic algorithms. Special emphasis was placed on the management of severe systemic manifestations and accessibility of therapies within Kazakhstan's healthcare system. The QCR recommendations propose a structured diagnostic approach combining clinical features, serological markers, and minor salivary gland biopsy. Treatment strategies emphasize non-pharmacological measures, symptomatic therapies, and immunomodulatory agent

A first-in-human, prospective pilot trial of umbilical cord-derived mesenchymal stem cell eye drops therapy for patients with refractory non-Sjögren's and Sjögren's syndrome dry eye disease.

Zhang D, Chen T, Liang Q, Feng X, Jiang J, Chen Z · Stem cell research & therapy · 2025

Patients with refractory dry eye disease (DED) often face the threat of diminished visual quality and have limited responses to existing treatments. Ocular injection of Mesenchymal stem cells (MSCs) has recently emerged as a promising new therapeutic strategy for DED. Topical eye drops are the clinical favorable choice for drug administration in DED. To date, the clinical use of MSC eye drops has not been reported in settings. This clinical trial represents a groundbreaking exploration into the preliminary therapeutic potential and safety of umbilical cord MSC eye drops for patients with refractory DED, including both non-Sjögren's dry eye (NSDE) and Sjögren's syndrome dry eye (SSDE). The study also aimed to investigate the possible underlying mechanisms. In this open-label, prospective, single-arm, self-controlled trial, 11 NSDE and 5 SSDE patients received twice-daily MSC eye drops for two weeks, subsequent follow-up visits were scheduled at 4 weeks and 12 months

Prospective Sham-Controlled trial: acupuncture for symptom-relieving in patients with Sjögren's disease.

Gomes-Silva JM, Torres CP, Teixeira LR, Saraiva MDCP, Oliveira FR, Rocha EM · Clinical rheumatology · 2025

This study aimed to assess the clinical efficacy of acupuncture in relieving sicca symptoms of SjD. A prospective, single-center, randomized, double-blind, controlled trial was conducted on SjD patients experiencing dry eyes and dry mouth. Forty-six patients were randomized and 27 completed the study (acupuncture, n = 15; sham, n = 12). Patients received either acupuncture or sham acupuncture (control) weekly for 8 weeks. Key outcomes, including Schirmer test (ST), corneal fluorescein staining score, tear film break-up time, Ocular Surface Disease Index, unstimulated whole salivary flow (UWSF), EULAR Sjögren's Syndrome Patient Reported Index (ESSPRI), Xerostomia Inventory (XI) score, Oral Health Impact Profile (OHIP-14) score, and Challacombe scale, were measured at baseline, immediately after treatment, and 4 weeks later. Statistical analysis consisted of comparing outcomes between groups over time. The acupuncture group exhibited significa

Metabolic impact of low dose IL-2 therapy for primary Sjögren's Syndrome in a double-blind, randomized clinical trial.

Feng R, Xiao X, Wang Y, Huang B, Chen J, Cheng G · Clinical rheumatology · 2024 · n=60

Low-dose interleukin 2 (Ld-IL2) is increasingly being explored as an immune-modulating treatment for autoimmune diseases which mainly affect T cell subsets. This study investigates the metabolic effects of Ld-IL2 therapy in patients with primary Sjögren's syndrome (pSS). A total of 60 patients were recruited to conduct a double-blind, randomized clinical trial. Of these patients, 50% (30/60) received Ld-IL2 therapy along with standard treatment for 12 weeks, followed by 12 weeks of follow-up. The effectiveness was evaluated by Sjögren's Tool for Assessing Response (STAR). An untargeted analysis was performed to profile hydrophilic metabolites. Metabolic profiling revealed significant alterations post-treatment, notably in metabolites like acetyl-CoA, ascorbic acid, and glutathione, which are beneficial in managing autoimmune diseases. In addition, the levels of metabolite accumulation were correlated with variations in immune cell subsets (p < 0.05), particularly Tr

Causal effect of three autoimmune diseases on brain functional networks and cerebrospinal fluid metabolites to underlie the pathogenesis of autoimmune psychosis: a two-sample mendelian randomization analysis.

Shi W, Chen M, Wang R, Wen C, Huang L, Wang Q · Journal of translational medicine · 2025

Autoimmune diseases such as Systemic Lupus Erythematosus (SLE), Sjögren's Syndrome (SS), and Hashimoto's Thyroiditis (HT) frequently exhibit neuropsychiatric manifestations, including cognitive impairment, depression, anxiety, and so on, yet the exact pathogenesis underlying this association remain incompletely understood. Dysfunction of brain resting-state functional networks and cerebrospinal fluid (CSF) metabolite disturbances have been widely reported in psychiatric disorders. However, the application of resting-state functional magnetic resonance imaging (rsfMRI) and CSF metabolomics in the diagnosis and monitoring of autoimmune psychosis is still limited. A two-sample Mendelian randomization (MR) analysis was performed to investigate the causal relationships between three autoimmune diseases (SLE, SS, and HT, n = 14,267 to 402,090 individuals) and 191 rsfMRI phenotypes (n = 47,276 individuals), as well as 338 CSF metabolites. The genome-wide asso

Sjögren's syndrome is associated with a reduction in the surface area of the right caudal anterior cingulate gyrus.

Wang P, Tai Y, Zhu X, Wan X, Sun A, Wang J · BMC medicine · 2025

Sjögren's syndrome (SS) is a common chronic autoimmune disease. Neurological involvement in SS represents one of the more severe and challenging aspects, with complications affecting the central system leading to cognitive dysfunction, sensory neuropathy, and multifocal sensorimotor neuropathies among other cortical function abnormalities. The relationship between cerebral cortex structure and neurological pathologies is well-documented, yet the impact of SS on cerebral cortex structure remains unclear. A two-sample Mendelian randomization (MR) analysis was conducted using four single-nucleotide polymorphisms (SNPs) associated with SS. Summary data from genome-wide association studies (GWAS) on SS and brain cortical structure were analyzed using inverse-variance weighted (IVW), MR-Egger, and weighted median (WM) methods. Sensitivity analyses were performed to ensure reliability. Brain magnetic resonance imaging (MRI) scanning of a group of established but treatment-naïve SS

Clinical features of anti-RNP-positive primary Sjögren's syndrome.

Cheng F, Wang YL, Ai XY, Liu Y, Zhu ZH, Zhang KK · Clinical rheumatology · 2025

This study sought to explore the clinical features exhibited by individuals with anti-RNP antibodies who had primary Sjögren's syndrome (pSS). Various clinical data of 410 pSS patients from our hospital between September 2018 and August 2023 were retrospectively analysed. Each individual fulfilled the 2016 American College of Rheumatology/European League Against Rheumatism (EULAR) classification criteria for pSS. Comparative analyses were conducted between pSS individuals with and without anti-RNP antibodies. Logistic regression analysis was utilized to ascertain relevant factors. Among the cohort, 38 (9.3%) of pSS patients were anti-RNP positive and 372 were anti-RNP negative. Anti-RNP-positive individuals had a higher median EULAR Sjögren's syndrome disease activity index at diagnosis (p = 0.001) and more frequent extraglandular manifestations (p < 0.001), including articular, pulmonary and muscular involvement (p = 0.001, p&#x

ROS-Responsive Microneedle Patches Enable Peri-Lacrimal Gland Therapeutic Administration for Long-Acting Therapy of Sjögren's Syndrome-Related Dry Eye.

Mu J, Ding X, Song Y, Mi B, Fang X, Chen B · Advanced science (Weinheim, Baden-Wurttemberg, Germany) · 2025

Sjögren's syndrome-related dry eye (SSDE) is a severe dry eye subtype characterized by significant immune cell attacks on the lacrimal gland. However, delivering immunosuppressive drugs to the lacrimal glands for SSDE therapy safely and sustainably poses significant challenges in clinical practice. Herein, a ROS-responsive microneedle patch with detachable functionality (CE-MN) is developed to enable straightforward and minimally invasive administration to the lacrimal gland area by penetrating the periocular skin. CE-MN is loaded with immunosuppressive cyclosporin A and anti-inflammatory drug epigallocatechin gallate, the latter also serving as a cross-linker for the microneedle matrix. Poly(N-isopropylacrylamide-co-butylacrylate), a temperature-sensitive polymer is utilized to fabricate separable layers that allow controlled detachment of the base from the needle, reducing patient discomfort. CE-MN is capable of modulating drug release by responding to ROS, facilitating on-deman

Cross-tissue, single-cell stromal atlas identifies shared pathological fibroblast phenotypes in four chronic inflammatory diseases.

Korsunsky I, Wei K, Pohin M, Kim EY, Barone F, Major T · Med (New York, N.Y.) · 2022

Pro-inflammatory fibroblasts are critical for pathogenesis in rheumatoid arthritis, inflammatory bowel disease, interstitial lung disease, and Sjögren's syndrome and represent a novel therapeutic target for chronic inflammatory disease. However, the heterogeneity of fibroblast phenotypes, exacerbated by the lack of a common cross-tissue taxonomy, has limited our understanding of which pathways are shared by multiple diseases. We profiled fibroblasts derived from inflamed and non-inflamed synovium, intestine, lungs, and salivary glands from affected individuals with single-cell RNA sequencing. We integrated all fibroblasts into a multi-tissue atlas to characterize shared and tissue-specific phenotypes. Two shared clusters, CXCL10+CCL19+ immune-interacting and SPARC+COL3A1+ vascular-interacting fibroblasts, were expanded in all inflamed tissues and mapped to dermal analogs in a public atopic dermatitis atlas. We confirmed these human pro-inflammatory fibroblasts in animal models o

Sjögren's syndrome

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The NHS website offers a detailed overview of Sjögren's syndrome, including symptoms, diagnosis, treatment options, and advice for managing the condition. It is a key resource for public health information in the UK.

Sjogren's Syndrome

NIH/MedlinePlus

MedlinePlus provides comprehensive information on Sjögren's Syndrome, including causes, symptoms, diagnosis, treatment, and living with the condition. It is a trusted source for patient-friendly health information from the National Library of Medicine.

Primary Sjögren Syndrome

n=44 · NCT01989819 · COMPLETED · COMPLETED

Primary Sjögren syndrome (pSS) is an inflammatory, autoimmune, multiorgan disease often involving the central and peripheral nervous systems. Fifteen to twenty percent of patients with the primary Sjögren's syndrome have neurological complications involving the peripheral nervous system. Although some patients have large fiber neuropathy, around forty percent of patients with Sjögren's syndrome experience neuropathic pain with normal electrodiagnostic studies. Although these patients may be diagnosed with fibromyalgia or depressive symptoms, some have been shown to have small fiber neuropathy (SFN). A recent study proved that more than 90% of pSS patients with such neuropathic pain have SFN {Fauchais, 2010 #188}. The aim of this study will be to investigate the occurrence of small fiber neuropathy in patients with pSS and neuropathic pain with normal electromyographic studies and to determine the existence of a conjoint local inflammatory process mediated by cellular, cytokinic or auto-antibody response. Quantification of epidermal nerve fiber density after skin biopsy is a valuable tool to diagnose small fiber neuropathy and the method has been widely validated. A skin biopsy will be performed in patients and control and will allow quantification of small fiber density in skin sample along with measurement of sweat gland innervation. Moreover, pathophysiological studies will be carried on in order to evaluate the causal relationship between cellular and humoral inflammation and small fiberneuropathy. Recent studies have pointed out the inconstant efficacy of both corticosteroid and immunosuppressive drugs in pSS-related SFN. Dissecting the molecular mechanisms of small fiber neuropathy in these patients may help designing new therapeutic strategies.

Fatigue and General Well-Being in Patients With Systemic Lupus Erythematosus or Primary Sjögren's Syndrome: Effects of Dehydroepiandrosterone Administration

n=120 · NCT00391924 · COMPLETED · COMPLETED

The purpose of the study is to examine whether dehydroepiandrosterone (DHEA) administration improves fatigue and general well-being in patients with systemic lupus erythematosus or primary Sjögren's syndrome

TREATMENT OF VAGINAL DRYNESS IN SJÖGREN'S DISEASE WITH CO2-LASER VERSUS TOPICAL PROMESTRIENE: A PROSPECTIVE RANDOMIZED STUDY

n=60 · NCT07153276 · RECRUITING · RECRUITING

Sjögren's disease (SjD) is a chronic, immune-mediated, systemic inflammatory disease characterized mainly by involvement of the salivary and lacrimal glands, causing symptoms of sicca syndrome. The disease predominantly affects women (9:1 to 20:1), with a peak incidence between 40 and 60 years of age. Symptoms of dryness include those resulting from vaginitis sicca, such as vulvovaginal irritation, dryness, pruritus, dyspareunia, polyuria, nocturia, dysuria, and urinary urgency/incontinence, which may begin before and worsen after menopause. These symptoms impact the sexual life and health-related quality of life of SjD patients. However, there are no specific recommendations for the management of vaginal dryness in this disease. Urogenital syndrome (UGS), a condition that affects women from the general population in the menopausal phase, is characterized by similar symptoms and can be treated with systemic or local hormone therapy (e.g., topical promestriene). Current data also demonstrate the efficacy and safety of vaginal fractional CO2 laser treatment for UGS. However, there are no studies on the efficacy of vaginal fractional CO2 laser and topical promestriene in the treatment of vaginal dryness in SjD.

Cochrane Library Search: Sjögren's Syndrome

Cochrane

The Cochrane Library provides access to systematic reviews and clinical trials on Sjögren's Syndrome, offering high-quality evidence to inform healthcare decisions.

Clinical search for Sjogren's Syndrome

TRIP Database

TRIP Database offers a comprehensive search engine to find high-quality evidence for clinical practice, including guidelines, systematic reviews, and primary research related to Sjögren's Syndrome.

TRIP Database: Sjögren's Syndrome

TRIP Database

The TRIP Database is a clinical search engine designed to allow users to quickly and easily find high-quality research evidence to support their practice. It aggregates evidence on Sjögren's syndrome from various sources.