[Pathogenesis and diagnosis of Sjögren's syndrome].
Sjögren's syndrome is a common autoimmune disorder. Several genetic risk factors such as STAT-4, ILT6 and the haplotype HLA-B8/DR3 have been identified. In addition, there are environmental risk factors, possibly chronic viral infections. In the pathophysiology of Sjögren's syndrome T and B cells infiltrate the salivary and lacrimal glands. As a consequence of the destruction of glandular cells by cytotoxic T cells, production of cytokines and autoantibodies inhibiting glandular function, the production of saliva and tears is decreased. The feeling of dry eyes and mouth is frequently not noticed by the patients. Therefore, Sjögren's syndrome should also be considered when extraglandular manifestations such as vasculitis, polyneuropathy or arthritis occur, even when the patients do not complain of dry eyes and mouth. Establishing the diagnosis of Sjögren's syndrome requires verification of reduced glandular function, for example using Schirmer's test and the Saxon test. The confirmation of Sjögren's syndrome as a cause of sicca syndrome is subsequently performed by the detection of autoantibodies against Ro (SS-A) and La (SS-B) and/or by a salivary gland biopsy.
Witte
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Klinik für Immunologie und Rheumatologie, Carl-Neuberg-Str. 1, 30625 Hannover. witte.torsten@mh-hannover.de
D001323:Autoantibodies / Q000097:blood; D001402:B-Lymphocytes / Q000276:immunology / Q000473:pathology; D001706:Biopsy; D002352:Carrier Proteins / Q000276:immunology; D004781:Environmental Exposure; D020022:Genetic Predisposition to Disease / Q000235:genetics*; D015795:HLA-B8 Antigen / Q000235:genetics; D015803:HLA-DR3 Antigen / Q000235:genetics; D006239:Haplotypes; D006801:Humans; D007638:Keratoconjunctivitis Sicca / Q000175:diagnosis / Q000235:genetics / Q000276:immunology / Q000473:pathology; D007765:Lacrimal Apparatus / Q000276:immunology / Q000473:pathology; D008840:Microfilament Proteins / Q000276:immunology; D011971:Receptors, Immunologic / Q000235:genetics; D012307:Risk Factors; D050797:STAT4 Transcription Factor / Q000235:genetics; D012469:Salivary Glands / Q000276:immunology / Q000473:pathology; D012859:Sjogren's Syndrome / Q000175:diagnosis* / Q000235:genetics* / Q000276:immunology / Q000473:pathology; D013601:T-Lymphocytes / Q000276:immunology / Q000473:pathology; D013049:Spectrin
D001323:Autoantibodies; D002352:Carrier Proteins; D015795:HLA-B8 Antigen; D015803:HLA-DR3 Antigen; D008840:Microfilament Proteins; D011971:Receptors, Immunologic; D050797:STAT4 Transcription Factor; D013049:Spectrin; C530062:LILRA3 protein, human; C494090:STAT4 protein, human