Introduction
Around 8,551,845 people in the United States alone suffer from autoimmune diseases. Generally autoimmune diseases are caused by a failure of the immune system to recognize itself, this is known as a “breach of tolerance”. Both genetic and environmental factors contribute to the pathogenesis of these diseases. Environmental factors like nutrition, microbiota, hormones, and heavy metals have been associated with immune dysfunction. Additionally genetic factors such as mutations and epigenetic changes have been found to be impactful in these diseases. There are around 100 distinctly recognized autoimmune diseases, which represent a variety of dysfunction. Some, such as Systemic Lupus Erythematosus, involve multiple organs. While others are more localized in their impact. One of these many autoimmune diseases is known as Sjögren's disease.
What is Sjögren's disease
Sjögren's disease is caused by the lymphocytic infiltration of exocrine glands, leading to intense dryness of the eyes, mouth, and other mucus membranes. This dryness is known as sicca symptoms and can cause great discomfort and pain. Sjögren's disease can be life threatening, with individuals with Sjögren's being 44 times more likely to develop B-cell lymphoma. Demographically, Sjögren's primarily affects middle-aged caucasian females with around 400,000 to 1.3 million people being affected. The presence of autoantibodies are also a hallmark of Sjögren's disease, such as anti-SSA/Ro and anti-SSB/La antibodies, which can aid in diagnosis. However, Sjögrens disease is still difficult to diagnose. The mix and overlap of Sjögren symptoms with other autoimmune diseases along with their being no universal classification criteria complicates diagnosis. Additionally, Sjögren’s patients commonly have multiple autoimmune diseases, further obscuring the clinical picture and making diagnosis even more challenging.
What causes Sjögren's and how is it treated?
Like with most autoimmune diseases, a variety of factors can contribute to disease development. Epigenetic changes, like DNA methylation, have been observed primarily affecting type 1-interferon genes which regulate the immune system. The up and down regulation of important genes may contribute to disease development. Moreover, genetic predispositions can be triggered by environmental factors, such as viral infection, leading to disease development. Despite the recent progress made in understanding the mechanisms of Sjögrens, the exact cause remains unknown, making targeted treatments challenging.
Current treatments for Sjögren's focus on managing symptoms. Artificial tears and saliva are commonly used to control the intense dryness commonly experienced. Immunosuppressive drugs are also used to control the disease. However these treatments only provide relief, and no permanent cure exists. Some potential treatment targets exist, such as the muscarinic acetylcholine receptors, but research is still ongoing in developing a true cure and discovering biomarkers that could serve to aid diagnosis. This research could be vital in improving the quality of life of those affected by Sjögren's, as early diagnosis and effective treatment could mitigate complications associated with the disease.
Conclusion
Ongoing research holds the promise of transforming current Sjögren's treatments. Soon treatments may be able to focus on entirely curing the disease instead of managing the symptoms. In the future, there is hope that Sjögren's disease may be better understood, treated, and could eventually be curable.
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