title: Childhood Sjögren syndrome: insights from adults and animal models.
abstract: OBJECTIVE
  Sjögren syndrome is a chronic autoimmune disease affecting lacrimal and salivary glands that often is accompanied by extraglandular disease manifestations. Although common in adults, the prevalence and prognosis of childhood Sjögren syndrome are unknown, in part due to lack of child-specific diagnostic and classification criteria. This review discusses difficulties in diagnosing childhood Sjögren syndrome and highlights recent findings in Sjögren syndrome treatment and pathogenesis from studies in adults and animal models over the past 18 months.
  
  
  RESULTS
  Studies of rituximab show some therapeutic potential in adult Sjögren syndrome, whereas newer modalities including gene therapy and mesenchymal stem cell transfer are promising. The pathogenesis of Sjögren syndrome is emerging, including roles of T and B lymphocytes, autoantibodies, interferons, and glandular epithelial cells. Specific recent notable findings in Sjögren syndrome pathogenesis include identification of a type II interferon signature in salivary glands of Sjögren syndrome patients, characterization of salivary gland-infiltrating T-cell subsets, and characterization of antimuscarinic acetylcholine receptor type 3 autoantibodies.
  
  
  CONCLUSIONS
  Childhood Sjögren syndrome is a poorly defined and underdiagnosed autoimmune disease that requires child-specific criteria in order to study disease burden and prognosis. Studies in adults and animal models continue to elucidate new potential diagnostic and therapeutic targets, which may be relevant for childhood Sjögren syndrome.
  http://links.lww.com/COR/A3.
authors.affiliation: Division of Rheumatology, The Children's Hospital of Philadelphia and Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA. scott-lieberman@uiowa.edu
authors.forename: Scott M
authors.initials: SM
authors.lastname: Lieberman
mesh_terms: D000328:Adult; D000818:Animals; D058846:Antibodies, Monoclonal, Murine-Derived / Q000627:therapeutic use; D001402:B-Lymphocytes / Q000276:immunology; D015415:Biomarkers / Q000032:analysis; D004195:Disease Models, Animal; D020022:Genetic Predisposition to Disease; D015316:Genetic Therapy / Q000379:methods; D006801:Humans; D007155:Immunologic Factors / Q000627:therapeutic use; D045164:Mesenchymal Stem Cell Transplantation / Q000379:methods; D000069283:Rituximab; D012859:Sjogren's Syndrome / Q000175:diagnosis* / Q000209:etiology / Q000628:therapy; D016176:T-Lymphocyte Subsets / Q000276:immunology
chemical_list: D058846:Antibodies, Monoclonal, Murine-Derived; D015415:Biomarkers; D007155:Immunologic Factors; D000069283:Rituximab
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