REVIEW - Autoimmune diseases and Sjögren's syndrome - biochemistry/physiology of saliva: implications for diagnostics

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Oral-Based Diagnostics Volume 1098 published March 2007

Ann. N.Y. Acad. Sci. 1098: 15–21 (2007). doi: 10.1196/annals.1384.003

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Part I. Biochemistry/Physiology of Saliva: Implications for Diagnostics

Autoimmune Diseases and Sjögren's Syndrome

An Autoimmune Exocrinopathy

PHILIP C FOXa,b

a Sjögren's Syndrome Foundation, Bethesda, land 20814, USA b

Department of Oral Medicine, Carolinas Medical Center, Charlotte,

North Carolina 28203, USA

Autoimmune diseases include a diverse group of over 80 conditions.

Sjögren'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 Sjögren's syndrome related to the autoimmune-mediated loss

of normal salivary function. Additionally, nonoral clinical

manifestations of Sjögren'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 Sjögren's syndrome. Establishing the

diagnosis of Sjögren'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 Sjögren'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 Sjögren'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.

http://www.annalsnyas.org/cgi/content/abstract/1098/1/15

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