• Journal of Oral Medicine and Pain
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• v.46 no.4
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• pp.99-108
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• 2021

Sjögren's syndrome (SjS) is a common autoimmune disorder characterized by lymphocytic infiltration in the salivary and lacrimal glands, resulting in severe dry mouth or eyes. The symptoms are complex and heterogeneous. Several diagnostic criteria have been proposed for SjS and its subsets over the years. However, on the other hands, great efforts have been made searching for reliable biomarkers able to ameliorate the diagnostic algorithm and the prognostic stratification of SjS patients. The aim of this article is to review biomarkers and treatments related to SjS for oral medicine specialists.

• Annals of Clinical Neurophysiology
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• v.25 no.1
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• pp.41-44
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• 2023

Overlap myositis (OM) associated with Sjögrens syndrome (SS) is a relatively uncommon disorder. It is more difficult to detect OM when a patient had not been previously diagnosed with SS. We report a case of OM associated SS that initially presented with dysphagia followed by proximal weakness. If proximal muscle weakness is preceded by dysphagia, the possibility of OM associated with connective-tissue disease should be considered.

• Journal of Oral Medicine and Pain
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• v.48 no.2
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• pp.39-44
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• 2023

Primary Sjögren's syndrome (pSS) is an autoimmune progressive disease characterized by dysfunction and inflammation of the salivary glands. The underlying mechanisms of salivary gland involvement in pSS remain unclear, and researchers have primarily focused on immunological phenomena, making it difficult to distinguish between the cause and effect of the disease. Consequently, our research aims to directly investigate changes in homeostasis occurring in acinar cells, specifically in the context of muscarinic signaling, mucins, aquaporins, and forkhead box protein O1, to elucidate the initial step of pSS. We compare the disease-related phenomena observed in salivary gland acinar cells in pSS with the overall process of salivary secretion.

• Journal of Oral Medicine and Pain
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• v.49 no.1
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• pp.22-27
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• 2024

A 74-year-old female presented with a complaint of dry mouth, continuous spontaneous burning sensation in the tongue, and asymptomatic submucosal soft tissue mass on both sides of the lower labial mucosa. She refused to undergo total excision of the mass due to concern about the possibility of complications such as nerve damage because of the large size of the mass. As her clinical features and magnetic resonance imaging indicated the possibility of Sjögren's syndrome, a biopsy of the minor salivary gland of the right lower lip was performed. Consequently, she was diagnosed with mucosa-associated lymphoid tissue (MALT) lymphoma. Although the patient had typical signs and symptoms of Sjögren's syndrome, the histopathological result of MALT lymphoma made it impossible to determine whether the patient had a history of Sjögren's syndrome. For patients with risk factors for MALT lymphoma, such as Sjögren's syndrome, a biopsy of the labial minor salivary gland with immunohistochemical staining can be helpful in the diagnosis of not only Sjögren's syndrome but also MALT lymphoma.

• Korean Circulation Journal
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• v.52 no.9
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• pp.715-716
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• 2022

• The Korean journal of internal medicine
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• v.39 no.4
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• pp.680-690
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• 2024

Background: To evaluate the effectiveness of Korean Red Ginseng (KRG) in managing fatigue in Korean patients with rheumatic diseases Methods: Patients were randomly assigned to KRG (2 g/day, n = 60) or placebo (n = 60) groups for 12 weeks of blind phase and then open-label KRG from weeks 12 to 24 (placebo-KRG, continuous-KRG). The primary outcome was the improvement rate in fatigue, defined by an increase in Functional Assessment of Chronic Illness Therapy (FACIT)-Fatigue scores at 12 weeks. Secondary outcomes included changes in FACIT-Fatigue and fatigue visual analog scale (VAS) between 0 and 12 weeks and those changes in both indices at 24 weeks. Results: The study enrolled 120 patients (Sjogren syndrome [n = 53], rheumatoid arthritis [n = 43], or both diseases [n = 24]). The mean age was 50.9 ± 11.6 years, with 97.5% being female. Baseline characteristics were similar between the two groups. The improvement rate in FACIT-Fatigue after 12 weeks was higher in the KRG group than in the placebo group, but the difference was statistically insignificant (38.3% vs. 26.7%, p = 0.242). Improvement in fatigue was observed in both groups by increases in FACIT-F (4.6 vs. 4.0) and reductions in fatigue VAS (-16.0 vs. -12.2) scores at 12 weeks. The most frequently reported adverse events during KRG use were pruritus and urticarial, with no significant difference between the two groups. Conclusions: Both KRG and placebo groups showed significant reductions in fatigue. KRG treatment for 24 weeks did not reduce fatigue symptoms more than the placebo in patients with rheumatic diseases.

• Journal of Oral Medicine and Pain
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• v.46 no.2
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• pp.54-62
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• 2021

Sjögren's syndrome (SS) is an autoimmune rheumatic disease characterized by the presence of lymphocytic infiltration of exocrine glands and other organs. Due to the rarity of SS, it is frequently overlooked by dentists as a cause of xerostomia. Clinicians should be aware that patients may have oral complications from SS including oral mucosal pain caused by frictional damage. Use of the latest diagnostic criteria approved by the American College of Rheumatology/European League against Rheumatism in 2016 for SS diagnosis provides the advantage of early identification of patients who have not yet developed dry mouth symptoms. A case of primary SS with the chief complaint of oral mucosal pain caused by mucosal damage associated with dry mouth is presented here. This case represents the importance of recognizing oral complications of xerostomia caused by SS, and illustrates use of the latest diagnostic criteria to diagnose the suspected symptoms by dental clinicians, who typically might be the first medical professional to encounter these symptoms.

• The Korean Journal of Physiology and Pharmacology
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• v.27 no.4
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• pp.357-364
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• 2023

Sjögren syndrome (SS) is a systemic inflammatory autoimmune disease that involves exocrine glands. Shikonin is extracted from comfrey, which is conventionally used as an anti-tumor, antibacterial, and antiviral drug in China. However, the application of Shikonin in SS remains unreported. This study aimed to verify the potential functions of Shikonin in SS progression. Firstly, non-obese diabetic mice were used as the SS mouse model, with C57BL/6 mice serving as the healthy control. It was demonstrated that the salivary gland damage and inflammation were aggravated in the SS mouse model. Shikonin improved salivary gland function decline and injury in the SS mouse model. Moreover, Shikonin reduced inflammatory cytokines and immune infiltration in the SS mouse model. Further experiments discovered that Shikonin attenuated the MAPK signaling pathway in the SS mouse model. Lastly, inhibition of the MAPK signaling pathway combined with Shikonin treatment further alleviated the symptoms of SS. In conclusion, Shikonin ameliorated salivary gland damage and inflammation in a mouse model of SS by modulating the MAPK signaling pathway. Our findings indicate that Shikonin may be a useful drug for SS treatment.

• IMMUNE NETWORK
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• v.22 no.4
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• pp.32.1-32.20
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• 2022

Sjögren syndrome (SS) is a chronic autoimmune disorder that primarily targets the salivary and lacrimal glands. The pathology of these exocrine glands is characterized by periductal focal lymphocytic infiltrates, and both T cell-mediated tissue injury and autoantibodies that interfere with the secretion process underlie glandular hypofunction. In addition to these adaptive mechanisms, multiple innate immune pathways are dysregulated, particularly in the salivary gland epithelium. Our understanding of the pathogenetic mechanisms of SS has substantially improved during the past decade. In contrast to viral infection, bacterial infection has never been considered in the pathogenesis of SS. In this review, oral dysbiosis associated with SS and evidence for bacterial infection of the salivary glands in SS were reviewed. In addition, the potential contributions of bacterial infection to innate activation of ductal epithelial cells, plasmacytoid dendritic cells, and B cells and to the breach of tolerance via bystander activation of autoreactive T cells and molecular mimicry were discussed. The added roles of bacteria may extend our understanding of the pathogenetic mechanisms and therapeutic approaches for this autoimmune exocrinopathy.

• Journal of Oral Medicine and Pain
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• v.44 no.4
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• pp.179-182
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• 2019

Sjögren syndrome (SS) is a chronic autoimmune disease characterized by dryness of the mouth and eyes due to lymphocytic infiltration of the exocrine glands. In American European Consensus Group (AECG) criteria, abnormal salivary gland scintigraphy (SGS) result is one of the objective signs of SS and it has been proposed as a valid and non-invasive alternative approach to functional evaluation of salivary gland, especially in the case when unstimulated whole salivary flow is more than 1.5 mL in 15 minutes or other AECG criteria is unmet. Patients with SS are more likely to have the thyroid disease (TD), but this association remains controversial. We present a case of the use of SGS for diagnosis of primary SS and TD in patients with dry mouth and burning sensation of tongue. Through this case, we suggest the usefulness of salivary scintigraphy for screening TD in addition to diagnosis of SS.