title: Use of muscarinic agonists in the treatment of Sjögren's syndrome.
abstract: Two muscarinic agonists (pilocarpine and cevimeline) have recently been approved for the treatment of symptoms of xerostomia in Sjögren's syndrome (SS). These agents stimulate the M1 and M3 receptors present on salivary glands, leading to increased secretory function. The use of these agents emphasizes the importance of neuroendocrine mechanisms in SS, which is considered an autoimmune disorder. We review recent studies on the release of cytokines and metalloproteinases in SS-affected glands and their influence on the release of and response to neurotransmitters. Also, we review the structure and function of muscarinic receptors as they may relate to SS and the potential use of novel muscarinic agonists in SS.
authors.affiliation: Allergy and Rheumatology Clinic, Scripps Memorial Hospital and Research Foundation, La Jolla, California 92037, USA. bobfox@adnc.com
authors.forename: R I
authors.initials: RI
authors.lastname: Fox
authors.forename: Y
authors.initials: Y
authors.lastname: Konttinen
authors.forename: A
authors.initials: A
authors.lastname: Fisher
mesh_terms: D006801:Humans; D018721:Muscarinic Agonists / Q000378:metabolism / Q000494:pharmacology / Q000627:therapeutic use*; D015213:Neuroimmunomodulation; D009490:Neurosecretory Systems / Q000378:metabolism; D010862:Pilocarpine / Q000378:metabolism / Q000494:pharmacology / Q000627:therapeutic use; D011812:Quinuclidines / Q000378:metabolism / Q000494:pharmacology / Q000627:therapeutic use; D011976:Receptors, Muscarinic / Q000378:metabolism*; D012859:Sjogren's Syndrome / Q000188:drug therapy* / Q000378:metabolism; D013876:Thiophenes
chemical_list: D018721:Muscarinic Agonists; D011812:Quinuclidines; D011976:Receptors, Muscarinic; D013876:Thiophenes; D010862:Pilocarpine; C059240:cevimeline