Evolving concepts of diagnosis, pathogenesis, and therapy of Sjogren's syndrome

Current Opinion in Rheumatology

Volumn 10, Issue 5, 1998, Pages 446-456

  Fox, Robert I ^a   Törnwall, Jyrki ^a   Maruyama, Toshiaki ^a   Stern, Michael ^b  

^a SCRIPPS CLINIC   (United States)

^b ALLERGAN INC   (United States)

Author keywords

[No Author keywords available]

Indexed keywords

ALPHA TOCOPHEROL; ANTIMALARIAL AGENT; ANTINUCLEAR ANTIBODY; AUTOANTIBODY; AZATHIOPRINE; BROMHEXINE; CARBIDOPA; CARBIDOPA PLUS LEVODOPA; CYCLOSPORIN; FLUORIDE; LEVODOPA; METALLOPROTEINASE; METHOTREXATE; NONSTEROID ANTIINFLAMMATORY AGENT; PILOCARPINE; QUININE; SALIVA SUBSTITUTE; SALOGEN; TETRACYCLINE; UNCLASSIFIED DRUG;

ARTHRALGIA; CHRONIC FATIGUE SYNDROME; CLINICAL FEATURE; COGNITIVE DEFECT; DEPRESSION; DISEASE CLASSIFICATION; DRY EYE; FIBROMYALGIA; GASTROINTESTINAL SYMPTOM; HUMAN; MYOCLONUS; PRIORITY JOURNAL; REVIEW; SALIVARY GLAND; SALIVATION; SIDE EFFECT; SJOEGREN SYNDROME; SWEATING; TEAR FLOW; TOOTH DISEASE; UPPER RESPIRATORY TRACT INFECTION; XEROSTOMIA;

HUMANS; MODELS, BIOLOGICAL; SEROEPIDEMIOLOGIC STUDIES; SJOGREN'S SYNDROME;

EID: 0031715857     PISSN: 10408711     EISSN: None     Source Type: Journal    
DOI: 10.1097/00002281-199809000-00009     Document Type: Review

References (140)

1. Fox R: Sjögren's Syndrome. In Primer on the Rheumatic Diseases. Atlanta: Arthritis Foundation; 1998:283-286.
2. Vitali C, and the EEC Study Group: Criteria for the Classification of Sjögren's Syndrome. In Primer on the Rheumatic Diseases. Atlanta: Arthritis Foundation; 1998:458 (appendix).
3. Dafni UG, Tzioufas AG, Staikos P, Skopouli FN, Moutsopoulos HM: Prevalence of Sjögren's syndrome in a closed rural community. Ann Rheum Dis 1997, 56:521-525.
4. Zhang NZ, Shi CS, Yao QP, Pan GX, Wang LL, Wen ZX, Li XC, Dong Y: Prevalence of primary Sjögren's syndrome in China. J Rheumatol 1995, 22:659-661.
5. Bjerrum KB: Keratoconjunctivitis sicca and primary Sjögren's syndrome in a Danish population aged 30-60 years. Acta Ophthalmol Scand 1997, 75:281-286.
6. Whitcher JP, Daniels TE, Sherman MD: Correlation of labial salivary gland biopsies with ocular and oral findings in patients with Sjögren's syndrome. Adv Exp Med Biol 1994, 350:667-670.
7. Vitali C, Moutsopoulos HM, Bombardieri S: The European Community Study Group on diagnostic criteria for Sjögren's syndrome: sensitivity and specificity of tests for ocular and oral involvement in Sjögren's syndrome. Ann Rheum Dis 1994, 53:637-647.
8. Vitali C, Bombardieri S: The European classification criteria for Sjögren's syndrome (SS): proposal for modification of the rules for classification suggested by the analysis of the receiver operating characteristic (ROCS) curve of the criteria performance. J Rheum 1997, 24 (suppl):S18. A proposed revision of the EEC criteria would include antibodies to SS-A or SS-B as a requirement for inclusion. This would lead to greater agreement with San Diego criteria.
9. Pirisi M, Scott C, Fabris C, Ferraccioli G, Soardo G, Ricci R, Toniutto P, Avellini C, Vitulli D, Miotti AM, et al.: Mild sialoadenitis: a common finding in patients with hepatitis C virus infection. Scand J Gastroenterol 1994, 29:940-942.
10. Garcia-Carrasco M, Ramos M, Cervera R, Font J, Vidal J, Munoz FJ, Miret C, Espinosa G, Ingelmo M: Hepatitis C virus infection in 'primary' Sjögren's syndrome: prevalence and clinical significance in a series of 90 patients. Ann Rheum Dis 1997, 56:173-175.
11. Jorgensen C, Legouffe MC, Perney P, Coste J, Tissot B, Segarra C, Bologna C, Bourrat L, Combe B, Blanc F, Sany J: Sicca syndrome associated with hepatitis C virus infection. Arthritis Rheum 1996, 39:1166-1171.
12. Itescu S: Diffuse infiltrative lymphocytosis syndrome in human immunodeficiency virus infection: a Sjögren's-like disease. Rheum Dis Clin North Am 1991, 17:99-115.
13. Terada K, Katamine S, Eguchi K, Moriuchi R, Kita M, Shimada H, Yamashita I, Iwata K, Tsuji Y, Nagataki S, et al.: Prevalence of serum and salivary antibodies to HTLV-1 in Sjögren's syndrome. Lancet 1994, 344:1116-1119.
14. Tan EM, Feltkamp TE, Smolen JS, Butcher B, Dawkins R, Fritzler MJ, Gordon T, Hardin JA, Kalden JR, Lahita RG, Maini RN, McDougal JS, Rothfield NF, Smeenk RJ, Takasaki Y, Wiik A, Wilson MR, Koziol JA: Range of antinuclear antibodies in "healthy" individuals. Arthritis Rheum 1997, 40:1601-1611. The high prevalence of positive antinuclear antibodies in normal populations of adults indicates that this presence is not equal to an autoimmune disease.
15. Lightfoot R: Cost effective use of laboratory tests in rheumatology. Bull Rheum Dis 1997, 46:1-3. Using Bayesian statistical analysis, this study shows that only a small proportion of patients with a positive ANA actually have an autoimmune disease. The authors review associated factors that predict which patients will evolve a subsequent autoimmune disorder.
16. Emlen W, O'Neill L: Clinical significance of antinuclear antibodies: comparison of detection with immunofluorescence and enzyme-linked immunosorbent assays. Arthritis Rheum 1997, 40:1612-1618. This study points out that clinical laboratory "errors" must be seriously considered when interpreting either positive or negative results of enzyme-linked immunosorbent assays. In most laboratories, antigens are prepared by affinity columns, due to expense and problems with recombinant antigens.
17. Kang H-I, Fei HM, Saito I, Sawada S, Chen S-L, Yi D, Chan E, Peebles C, Bugawan TL, Erlich HA, Fox RI: Comparison of HLA class II genes in Caucasoid, Chinese, and Japanese patients with primary Sjögren's syndrome. J Immunol 1993, 150:3615-3623.
18. Reveille JD, Owerbach D, Goldstein R, Moreda R, Isern RA, Arnett FC: Association of polar amino acids at position 26 of the HLA-DQB1 first domain with the anticentromere autoantibody response in systemic sclerosis (scleroderma). J Clin Invest 1992, 89:1208-1213.
19. Ostuni PA, Ianniello A, Sfriso P, Mazzola G, Andretta M, Gambari PF: Juvenile onset of primary Sjögren's syndrome: report of 10 cases. Clin Exp Rheumatol 1996, 14:689-693.
20. Kumagai S, Kanagawa S, Morinobu A, Takada M, Nakamura K, Sugai S, Maruya E, Saji H: Association of a new allele of the Tap2 gene, TAp021*bky2 (Val577) with susceptibility to Sjögren's syndrome. Arthritis Rheum 1997, 40:1685-1670. Peptide transporters promote the loading of particular peptides onto the MHC molecule and could thus play a role in predisposition to autoimmunity.
21. Kay RA, Hutchings CJ, Ollier WE: A subset of Sjögren's syndrome associates with the TCRBV13S2 locus but not the TCRBV2S1 locus. Hum Immunol 1995, 42:328-330.
22. Wu J, Wilson J, He J, Xiang L, Schur PH, Mountz JD: Fas ligand mutation in a patient with systemic lupus erythematosus and lymphoproliferative disease. J Clin Invest 1996, 98:1107-1113.
23. Wilson AG, Symons JA, McDowell TL, McDevitt HO, Duff GW: Effects of a polymorphism in the human tumor necrosis factor alpha promoter on transcriptional activation. Proc Natl Acad Sci USA 1997, 94:3195-3199.
24. Hennekens C, Lee I, Cook N, Hebert P, Karlson E, LaMotte F, Manson J, Buring J: Serf-reported breast implants and connective-tissue diseases in female health professionals: a retrospective cohor study. JAMA 1996, 275:616-621.
25. Young VL, Nemecek JR, Schwartz BD, Phelan DL, Schorr MW: HLA typing in women with breast implants. Plast Reconstr Surg 1995, 96:1497-1519; discussion, 1520.
26. Fei HM, Kang H-I, Scharf S, Erlich H, Peebles C, Fox RI: Specific HLA-DQA and HLA-DRB1 alleles confer susceptibility to Sjögren's syndrome and autoantibody SS-B production. J Clin Lab Anal 1991, 5:382-391.
27. Griffiths DJ, Venables PJ, Weiss RA, Boyd MT: A novel exogenous retrovirus sequence identified in humans. J Virol 1997, 71:2866-2872.
28. Rigby SP, Griffiths DJ, Weiss RA, Venables PJ: Human retrovirus-5 proviral DNA is rarely detected in salivary gland biopsy tissues from patients with Sjögren's syndrome. Arthritis Rheum 1997, 40:2016-2021.
29. Toda I, Wickham LA, Sullivan DA: Gender and androgen treatment influence the expression of proto-oncogenes and apoptotic factors in lacrimal and salivary tissues of MRL/lpr mice. Clin Immunol Immunopathol 1998, 86:59-71.
30. + subunit of the Sm ribonucleoprotein autoantigen with proline-rich polypeptides. Clin Immunol Immunopathol 1992, 62:285-290.
31. Nelson JD: Dry eye [editorial; comment]. Br J Ophthalmol 1997, 81:426.
32. Pflugfelder SC, Tseng SC, Yoshino K, Monroy D, Felix C, Reis BL: Correlation of goblet cell density and mucosal epithelial membrane mucin expression with rose bengal staining in patients with ocular irritation. Ophthalmology 1997, 104:223-235.
33. Xu KP, Yagi Y, Tsubota K: Decrease in corneal sensitivity and change in tear function in dry eye. Cornea 1996, 15:235-239.
34. Meneray MA, Bennett DJ, Nguyen DH, Beuerman RW: Effect of sensory denervation on the structure and physiologic responsiveness of rabbit lacrimal gland. Cornea 1998, 17:99-107. A surprising finding that denervation of sensory afferents from the ocular surface leads to significant changes in the lacrimal gland, indicating the importance of a functional circuit that includes mucosal surfaces, nerves, brain, blood vessels, and glands.
35. Tsubota K, Xu KP, Fujihara T, Katagiri S, Takeuchi T: Decreased reflex tearing is associated with lymphocytic infiltration in lacrimal glands. J Rheumatol 1996, 23:313-320.
36. Rhodus NL, Bloomquist C, Liljemark W, Bereuter J: Prevalence, density, and manifestations of oral Candida albicans in patients with Sjögren's syndrome. J Otolaryngol 1997, 26:300-305.
37. Tishler M, Yaron I, Shirazi I and Yaron M: Saliva: an additional diagnostic tool in Sjögren's syndrome. Semin Arthritis Rheum 1997, 27:173-179.
38. Tishler M, Yaron I, Raz A, Meyer FA, Yaron M: Salivary eicosanoid concentration in patients with Sjögren's syndrome. Ann Rheum Dis 1996, 55:202-204.
39. Gerli R, Muscat C, Giansanti M, Danieli MG, Sciuto M, Gabrielli A, Fiandra E, Vitali C: Quantitative assessment of salivary gland inflammatory infiltration in primary Sjögren's syndrome: its relationship to different demographic, clinical and serological features of the disorder. Br J Rheumatol 1997, 36:969-975.
40. Kruize AA, van Bijsterveld OP, Hene RJ, de Wilde PC, Feltkamp TE Kater L, Bijlsma JW: Long-term course of tear gland function in patients with keratoconjunctivitis sicca and Sjögren's syndrome. Br J Ophthalmol 1997, 81:435-438.
41. St Alenheim G, Gudbjornsson B: Anti-inflammatory drugs do not alleviate bronchial hyperreactivity in Sjögren's syndrome. Allergy 1997, 52:423-427.
42. Andoh Y, Shimura S, Saitoh H, Sasaki T, Mitsuhashi H, Shirato K: Serum secretory leukoprotease inhibitor levels in chronic bronchitis and Sjögren's syndrome. Tohoku J Exp Med 1997, 182:319-325.
43. Quismorio FP Jr: Pulmonary involvement in primary Sjögren's syndrome. Curr Opin Pulm Med 1996, 2:424-428.
44. Fishback N, Koss M: Update on lymphoid interstitial pneumonitis. Curr Opin Pulm Med 1996, 2:429-433.
45. Strimlan CV: Interstitial lung disease and primary Sjögren's syndrome: clinical-pathological evaluation and response to treatment [letter]. Am J Respir Crit Care Med 1997, 155:1489.
46. Meyer CA, Pina JS, Taillon D, Godwin JD: Inspiratory and expiratory high-resolution CT findings in a patient with Sjögren's syndrome and cystic lung disease. AJR Am J Roentgenol 1997, 168:101-103.
47. Franquet T, Gimenez A, Monill JM, Diaz C, Geli C: Primary Sjögren's syndrome and associated lung disease: CT findings in 50 patients. AJR Am J Roentgenol 1997, 169:655-658.
48. Sheikh SH, Shaw-Stiffel TA: The gastrointestinal manifestations of Sjögren's syndrome. Am J Gastroenterol 1995, 90:9-14.
49. Collin P, Karvonen AL, Korpela M, Laippala P, Helin H: Gastritis classified in accordance with the Sydney system in patients with primary Sjögren's syndrome. Scand J Gastroenterol 1997, 32:108-111.
50. Nieminen U, Koivisto T, Kahri A, Farkkila M: Sjögren's syndrome with chronic pancreatitis, sclerosing cholangitis, and pulmonary infiltrations. Am J Gastroenterol 1997, 92:139-142.
51. Collin P, Reunala T, Rasmussen M, Kyronpalo S, Pehkonen E, Laippala P, Maki M: High incidence and prevalence of adult coeliac disease. Augmented diagnostic approach. Scand J Gastroenterol 1997, 32:1129-1133.
52. Thieblemont C, Berger F, Coiffier B: Mucosa-associated lymphoid tissue lymphomas. Curr Opin Oncol 1995, 7:415-420.
53. Grant IA, Hunder GG, Homburger HA, Dyck PJ: Peripheral neuropathy associated with sicca complex. Neurology 1997, 48:855-862.
54. van Dijk GW, Notermans NC, Kater L, Kruize AA, Linssen WH, Wokke JH: Sjögren's syndrome in patients with chronic idiopathic axonal polyneuropathy. J Neurol Neurosurg Psychiatry 1997, 63:376-378.
55. Mandl T, Jacobsson L, Lilja B, Sundkvist G, Manthorpe R: Disturbances of autonomic nervous function in primary Sjögren's syndrome. Scand J Rheumatol 1997, 26:401-406. [corrected and republished article originally printed in Scand J Rheumatol 1997;26:253-258].
56. Mandl T, Jacobsson L, Lilja B, Sundkvist G, Manthorpe R: Disturbances of autonomic nervous function in primary Sjögren's syndrome. Scand J Rheumatol 1997, 26:401-406. [corrected and republished article originally printed in Scand J Rheumatol 1997;26:253-258].
57. Tajima Y, Mito Y, Owada Y, Tsukishima E, Moriwaka F, Tashiro K: Neurological manifestations of primary Sjögren's syndrome in Japanese patients. Intern Med 1997, 36:690-693.
58. Nakamura H, Eguchi K, Nakamura T, Mizokami A, Shirabe S, Kawakami A, Matsuoka N, Migita K, Kawabe Y, Nagataki S: High prevalence of Sjögren's syndrome in patients with HTLV-1 associated myelopathy. Ann Rheum Dis 1997, 56:167-172.
59. Eguchi K, Matsuoka N, Ida H, Nakashima M, et al.: Primary Sjögren's syndrome with antibodies to HTLV-1: clinical and laboratory features. Ann Rheum Dis 1992, 51:769-776.
60. Valesini G, Priori R, Bavoillot D, Osborn J, Danieli MG, Del Papa N, Gerli R, Pietrogrande M, Sabbadini MG, Silvestris F, Valsecchi L: Differential risk of non-Hodgkin's lymphoma in Italian patients with primary Sjögren's syndrome. J Rheumatol 1997, 24:2376-2380.
61. Royer B, Cazals-Hatem D, Sibilia J, Agbalika F, Cayuela JM, Soussi T, Maloisel F, Clauvel JP, Brouet JC, Mariette X: Lymphomas in patients with Sjögren's syndrome are marginal zone B-cell neoplasms, arise in diverse extranodal and nodal sites, and are not associated with viruses. Blood 1997, 90:766-775.
62. Sorrentino D, Ferraccioli GF, Devita S, Labombarda A, Avellini C, Ponzetto A, Beltrami CA, Boiocchi M, Bartoli E: Gastric B-cell clonal expansion and Helicobacter pylori infection in patients with autoimmune diseases and with dyspepsia: a follow-up study. Scand J Gastroenterol 1997, 32:1204-1208.
63. Lasota J, Miettinen MM: Coexistence of different B-cell clones in consecutive lesions of low-grade MALT lymphoma of the salivary gland in Sjögren's disease. Mod Pathol 1997, 10:872-878.
64. Freimark B, Fantozzi R, Bone R, Bordin G, Fox R: Detection of clonally expanded salivary gland B-lymphocytes but not T-cells in Sjögren's syndrome. Arthritis Rheum 1989, 32:859-869.
65. Andonopoulos AP, Tiniakou M, Melachrinou M, Sfountouris H, Bounas A, Zervas C, Zoumbos NC: Sjögren's syndrome in patients with newly diagnosed untreated non-Hodgkin's lymphoma. Rev Rhum Engl Ed 1997, 64:287-292.
66. Mulherin DM, Sheeran TP, Kumararatne DS, Speculand B, Luesley D, Situnayake RD: Sjögren's syndrome in women presenting with chronic dyspareunia. Br J Obstet Gynaecol 1997, 104:1019-1023.
67. Robinson CP, Yamachika S, Bounous DI, Brayer J, Jonsson R, Holmdahl R, Peck AB, Humphreys-Beher MG: A novel NOD-derived murine model of primary Sjögren's syndrome. Arthritis Rheum 1998, 41:150-156.
68. Robinson CP, Brayer J, Yamachika S, Esch TR, Peck AB, Stewart CA, Peen E, et al.: Transfer of human serum IgG to nonobese diabetic Igmunull mice reveals a role for autoantibodies in the loss of secretory function of exocrine tissues in Sjögren syndrome. Proc Natl Acad Sci USA 1998, 95:7538-7543.
69. von Boemer H, Sarukan A, Buer J: Induction of and rescue from programmed cell death. Immunologist 1998, 5:185-190. A clearly written review about the complex pathways that can lead to apoptosis or survival.
70. Robinson C, Cornelius J, Bounous D, Yamatomo H, Humphrey-Beher M, Peck A: Characterization of the changing lymphocyte population and cytokine expression in the exocrine tissues of autoimmune NOD mice. Autoimmunity 1998, 27:29-44.
71. Hu Y, Purushotham KR, Wang P, Dawson R Jr, Humphreys-Beher MG: Downregulation of beta-adrenergic receptors and signal transduction response in salivary glands of NOD mice. Am J Physiol 1994, 266:G433-G443.
72. Wicker LS, Todd JA, Peterson LB: Genetic control of autoimmune diabetes in the NOD mouse. Annu Rev Immunol 1995, 13:179-200.
73. Yang XD, Michie SA, Tisch R, Karin N, Steinman L, McDevitt HO: Cell adhesion molecules: a selective therapeutic target for alleviation of IDDM. J Autoimmun 1994, 7:859-864.
74. Humphreys-Beher MG: Animal models for autoimmune disease: associated xerostomia and xerophthalmia. Adv Dent Res 1996, 10:73-75.
75. Sullivan DA, Edwards JA: Androgen stimulation of lacrimal gland function in mouse models of Sjögren's syndrome. J Steroid Biochem Mol Biol 1997, 60:237-245.
76. Apelgren L, Bailey D, Fouts R, Glasebrook A, Bumol T: The effect of a selective estrogen receptor modulator on the progression of spontaneous autoimmune disease in MRL/lpr mice. Cell Immunol 1996, 173:55-63.
77. Haneji N, Nakamura T, Takio K, Yanagi K, Higashiyama H, Saito I, Noji S, Sugino H, Hayashi Y: Identification of alpha fodrin as a candidate autoantigen in primary Sjögren's syndrome. Science 1997, 276:604-607. A carefully studied animal model that has identified an apoptotic breakdown product of a cytoskeletal molecule (fodrin) as a target antigen in the submandibular gland. Antibodies against fodrin in human SS sera make this molecule a candidate in human SS.
78. McCartney-Francis NL, Mizel DE, Redman RS, Frazier-Jessen M, Panek RB, Kulkarni AB, Ward JM, McCarthy JB, Wahl SM: Autoimmune Sjögren's-like lesions in salivary glands of TGF-beta1-deficient mice are inhibited by adhesion-blocking peptides. J Immunol 1996, 157:1306-1312.
79. McCartney-Francis NL, Mizel DE, Frazier-Jessen M, Kulkami AB, McCarthy JB, Wahl SM: Lacrimal gland inflammation is responsible for ocular pathology in TGF-beta 1 null mice. Am J Pathol 1997, 151:1281-1288.
80. Hoffman M, Kibbey M, Letterio J, Kleinman H: Role of laminin-1 and TGF-beta 3 in acinar differentiation of a human submandibular gland cell cline (HSG). J Cell Sci 1996, 109:2012-2021.
81. Chandross KJ, Chanson M, Spray DC, Kessler JA: Transforming growth factor-beta 1 and forskolin modulate gap junctional communication and cellular phenotype of cultured Schwann cells. J Neurosci 1995, 15:262-273.
82. Brown CT, Applebaum E, Banwatt R, Trinkaus-Randall V: Synthesis of stromal glycosaminoglycans in response to injury. J Cell Biochem 1995, 59:57-68.
83. Fini ME, Girard MT, Matsubara M, Bartlett JD: Unique regulation of the matrix metalloproteinase, gelatinase B. Invest Ophthalmol Vis Sci 1995, 36:622-633.
84. Huang Z, Gao J, Wickham L, Sullivan D: Influence of gender and androgen treatment on TGF-b1 mRNA levels in the rat lacrimal gland. Invest Ophthal Vis Sci 1995, 35:3991.
85. Koski H, Konttinen YT, Hietanen J, Tervo T, Malmstrom M: Epidermal growth factor, transforming growth factor-alpha, and epidermal growth factor receptor in labial salivary glands in Sjögren's syndrome. J Rheumatol 1997, 24:1930-1935. Decreased production of epidermal growth factor and TGF-α in salivary glands in patients with SS could contribute to the inflammatory response and inadequate healing response of the mucosal surfaces.
86. Saegusa J, Kubota H: Sialadenitis in IQI/Jic mice: a new animal model of Sjögren's syndrome. J Vet Med Sci 1997, 59:897-903.
87. Andoh Y, Shimura S, Sawai T, Sasaki H, Takishima T, Shirato K: Morphometric analysis of secretory glands in Sjögren's syndrome. Am Rev Respir Dis 1993, 148:1358-1362.
88. Fox RI: Sjögren's syndrome: controversies and progress. Clin Lab Med 1997, 17:431-444.
89. Soliven B, Wang N: Tumor necrosis factor alpha regulates responses of cultures of sympathetic neurons and non-neuronal cells. J Neurochem 1995, 64:883-894.
90. Campbell IL, Chiang CS: Cytokine involvement in central nervous system disease: implications from transgenic mice. Ann N Y Acad Sci 1995, 771:301-312.
91. Bacman S, Sterin-Borda L, Camusso JJ, Arana R, Hubscher O, Borda E: Circulating antibodies against rat parotid gland M3 muscarinic receptors in primary Sjögren's syndrome. Clin Exp Immunol 1996, 104:454-459.
92. Borda ES, Perez Leiros C, Camusso JJ, Bacman S, Sterin-Borda L: Differential cholinoceptor subtype-dependent activation of signal transduction pathways in neonatal versus adult rat atria. Biochem Pharmacol 1997, 53:959-967.
93. Bacman S, Perez Leiros C, Sterin-Borda L, Hubscher O, Arana R, Borda E: Autoantibodies against lacrimal gland M3 muscarinic acetylcholine receptors in patients with primary Sjögren's syndrome. Invest Ophthalmol Vis Sci 1998, 39:151-156.
94. Borda E, Camusso JJ, Perez Leiros C, Bacman S, Hubscher O, Arana R, Sterin-Borda L: Circulating antibodies against neonatal cardiac muscarinic acetylcholine receptor in patients with Sjögren's syndrome. Mol Cell Biochem 1996, 163-164:335-341.
95. Tornwall J, Konttinen Y, Tuomen R, Tornwall M: Salivary gland acinar epithelial cells are deficient in their protein kinase C expression in Sjögren syndrome. Lancet 1997, 349:1814-1815. Abnormalities in protein kinase C may influence the gland response to acetyl choline released by neural stimulation. The abnormalities may either be a primary event or secondary to chronic attempts at stimulation of the gland.
96. Maltzman JS, Carman JA, Monroe JG: Role of EGR1 in regulation of stimulus-dependent CD44 transcription in B lymphocytes. Mol Cell Biol 1996, 16:2263-2294.
97. Taher TE, Smit L, Griffioen AW, Schilder-Tol EJ, Borst J, Pals ST: Signaling through CD44 is mediated by tyrosine kinases: association with p56lck in T lymphocytes. J Biol Chem 1996, 271:2863-2867.
98. Jones LL, Kreutzberg GW, Raivich G: Regulation of CD44 in the regenerating mouse facial motor nucleus. Eur J Neurosci 1997, 9:1854-1863.
99. Hiraoka M, Saito I, Tsubota K, Sugai S, Miyasaka N: Augmented expression of CD44 splice variants in lymphoproliferative disorder of the lacrimal gland in Sjögren's syndrome. Jpn J Ophthalmol 1997, 41:312-318. CD44 serves as a lymphocyte homing receptor and plays a role in the metastasis of tumors. Although the role of a splice variant in SS remains unclear, it will be important to determine if this finding is true in other populations of patients with SS.
100. Ristamaki R, Joensuu H, Soderstrom KO, Jalkanen S: CD44v6 expression in non-Hodgkin's lymphoma: an association with low histological grade and poor prognosis. J Pathol 1995, 176:259-267.
101. Tseng CE, Chan EK, Miranda E, Gross M, Di Donato F, Buyon JP: The 52-kd protein as a target of intermolecular spreading of the immune response to components of the SS-A/Ro-SS-B/La complex. Arthritis Rheum 1997, 40:936-944. Antigenic spreading is an important step in the development of autoimmune disease in mice. This study demonstrates that a similar process occurs in patients with SS.
102. Mamula M, Janeway C: B cells drive the diversification of the immune response. Immun Today 1993, 14:151-154.
103. McDevitt HO: Autoimmune diabetes and its antigenic triggers. Hosp Pract (Off Ed) 1995, 30:55-62.
104. Altmann D, Hogg J, Trowsdale J, Wilkinson D: Cotransfection of ICAM-1 and HLA-DR reconstitutes human antigen-presenting cell function in mouse L cells. Nature 1989, 338:512-514.
105. Aziz KE, McCluskey PJ, Wakefield D: Expression of selectins (CD62 E,L,P) and cellular adhesion molecules in primary Sjögren's syndrome: questions to immunoregulation. Clin Immunol Immunopathol 1996, 80:55-66.
106. Mizushima N, Kohsaka H, Tsubota K, Saito I, Miyasaka N: Diverse T cell receptor beta gene usage by infiltrating T cells in the lacrimal glands of Sjögren's syndrome. Clin Exp Immunol 1995, 101:33-38.
107. Sumida T, Matsumoto I, Maeda T, Nishioka K: T-cell receptor in Sjögren's syndrome. Br J Rheumatol 1997, 36:622-629.
108. Sumida T, Namekawa T, Maeda T, Nishioka K: New T-cell epitope of Ro/SS-A 52 kDa protein in labial salivary glands from patients with Sjögren's syndrome [letter]. Lancet 1996, 348:1667. Demonstration that glandular T cells react with a defined antigen that was previously defined by antibody reactivity.
109. Kino-Ohsaki J, Nishimori I, Morita M, Okazaki K, Yamamoto Y, Onishi S, Hollingsworth MA: Serum antibodies to carbonic anhydrase I and II in patients with idiopathic chronic pancreatitis and Sjögren's syndrome. Gastroenterology 1996, 110:1579-1586.
110. Helsloot J, Sturgess A: T cell reactivity to Sjögren's syndrome related antigen La(SSB). J Rheumatol 1997, 24:2340-2347.
111. Alpert S, Kang H, Weissman I, Fox R: Granzyme expression in Sjögren's syndrome. Arth Rheum 1994, 37:1048-1054.
112. Kong L, Ogawa N, Nakabayashi T, Liu GT, D'Souza E, McGuff HS, Guerrero D, Talal N, Dang H: Fas and Fas ligand expression in the salivary glands of patients with primary Sjögren's syndrome. Arthritis Rheum 1997, 40:87-97. Increased apoptosis of glandular epithelial cells is reported, whereas the lymphocytes appear resistant to apoptosis.
113. Fox RI, Kang HI, Ando D, Abrams J, Pisa E: Cytokine mRNA expression in salivary gland biopsies of Sjögren's syndrome. J Immunol 1994, 152:5532-5539.
114. Laurie G, Glass D, Ogle R, Stone C, Sluss J, Chen L: BM180: a novel basement membrane protein with a role in stimulus secretion coupling by lacrimal acinar cells. Am J Physiol 1996, 39:C1743-C1750.
115. Brooks P, Silletti S, von Schalscha T, Friedlaender M, Cheresh D: 4Disruption of angiogenesis by Pex, a noncatalytic metalloproteinase fregament with integrin binding activity. Cell 1998, 92:391-400.
116. Wu AJ, Lafrenie RM, Park C, Apinhasmit W, Chen ZJ, Birkedal-Hansen H, Yamada KM, Stetler-Stevenson WG, Baum BJ: Modulation of MMP-2 (gelatinase A) and MMP-9 (gelatinase B) by interferon-gamma in a human salivary gland cell line. J Cell Physiol 1997, 171:117-124.
117. Virtanen T, Konttinen YT, Honkanen N, Harkonen M, Tervo T: Tear fluid plasmin activity of dry eye patients with Sjögren's syndrome. Acta Ophthalmol Scand 1997, 75:137-141.
118. Watanabe H, Fabricant M, Tisdale AS, Spurr-Michaud SJ, Lindberg K, Gipson IK: Human corneal and conjunctival epithelia produce a mucin-like glycoprotein for the apical surface. Invest Ophthalmol Vis Sci 1995, 36:337-344.
119. Gipson IK, Spurr-Michaud SJ, Tisdale AS, Kublin C, Cintron C, Keutmann H: Stratified squamous epithelia produce mucin-like glycoproteins. Tissue Cell 1995, 27:397-404.
120. Saari H, Halinen S, Ganlov K, Sorsa T and Konttinen YT: Salivary mucous glycoprotein MG1 in Sjögren's syndrome. Clin Chim Acta 1997, 259:83-96.
121. Berry M, Ellingham RB, Corfield AP: Polydispersity of normal human conjunctival mucins. Invest Ophthalmol Vis Sci 1996, 37:2559-2571.
122. Sidagis J, Ueno K, Wang ZH, Hanamure Y, Furuta S, Ohyama M: Expression of glycoconjugates in normal and Sjögren's syndrome labial glands. Acta Otolaryngol (Stockh) 1997, 117:871-877.
123. Wilder RL: Neuroendocrine-immune system interactions and autoimmunity. Annu Rev Immunol 1995, 13:307-338.
124. Fox R: Sjögren's syndrome (current therapy). In Current Diagnosis, vol 9. Philadelphia: WB Saunders; 1997, 1053-1057.
125. Tishler M, Barak Y, Paran D, Yaron M: Sleep disturbances, fibromyalgia and primary Sjögren's syndrome. Clin Exp Rheumatol 1997, 15:71-74.
126. Rhodus NL: Oral pilocarpine HCI stimulates labial (minor) salivary gland flow in patients with Sjögren's syndrome. Oral Dis 1997, 3:93-98.
127. Spiera H, Asbell PA, Simpson DM: Botulinum toxin increases tearing in patients with Sjögren's syndrome: a preliminary report. J Rheumatol 1997, 24:1842-1843.
128. Williams DL: A comparative approach to topical cyclosporine therapy. Eye 1997, 11:453-464.
129. Bron AJ: The Doyne lecture. Reflections on the tears. Eye 1997, 11:583-602.
130. Gobetti JP, Froeschle ML: Sjögren's syndrome: a challenge for dentistry. Gen Dent 1997, 45:268-272.
131. Nanni JM, Nguyen KH, Alford CE, Robinson CP, Stewart CM, Maeda N, Humphreys-Beher MG: Assessment of bromhexine as a treatment regimen in Sjögren's syndrome-like disease in the NOD (non-obese diabetic) mouse. Clin Exp Rheumatol 1997, 15:515-521.
132. Davies AN, Singer J: A comparison of artificial saliva and pilocarpine in radiation-induced xerostomia. J Laryngol Otol 1994, 108:663-665.
133. Slomiany BL, Murty VL, Piotrowski J, Slomiany A: Salivary mucins in oral mucosal defense. Gen Pharmacol 1996, 27:761-771.
134. Colina AR, Aumont F, Belhumeur P, de Repentigny L: Development of a method to detect secretory mucinolylic activity from Candida albicans. J Med Vet Mycol 1996, 34:401-406.
135. Matsuo R, Yamauchi Y, Morimoto T: Role of submandibular and sublingual saliva in maintenance of taste sensitivity recorded in the chorda tympani of rats. J Physiol (Lond) 1997, 498:797-807.
136. Fox RI, Dixon R, Guarrasi V and Kubrel S: Treatment of primary Sjögren's syndrome with hydroxychloroquine: a retrospective, open-label study. Lupus 1996, 5 (suppl 1):S31-S36.
137. Greenwalt R, Golub L, Lavietas B, Ramamu;rth;y N, Gruber B, Laskin R, McNamera T: Tetracyclines inhibit human collagenase in vivo and in vitro. J Rheum 1994, 14:28-32.
138. Skopouli FN, Jagiello P, Tsifetaki N, Moutsopoulos HM: Methotrexate in primary Sjögren's syndrome. Clin Exp Rheumatol 1996, 14:555-558.
139. Moutsopoulos HM: Sjögren's syndrome therapy: future directions. J Rheumatol 1997, 24 (suppl 50):33-34. Arthritis and myalgias appear more responsive to methotrexate than does increased salivary or tear flow.
140. Linardaki G, Moutsopoulos HM: The uncertain role of immunosuppressive agents in Sjögren's syndrome. Cleve Clin J Med 1997, 64:523-526.