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Sjogren's Syndrome

An autoimmune disorder in which immune cells attack and destroy the glands that produce tears and saliva.

PubMed Health Glossary
(Source: NIH - National Institute of Neurological Disorders and Stroke)

About Sjogren's Syndrome

Sjögren's (SHOW-griens) syndrome is a disease that affects the glands that make moisture. It most often causes dryness in the mouth and eyes. It can also lead to dryness in other places that need moisture, such as the nose, throat, and skin.

Who Gets Sjögren's Syndrome?

Most people with Sjögren's syndrome are women. It can occur at any age and in any race. But it is rare in children and most often shows up after age 40.

What Causes Sjögren's Syndrome?

Sjögren's syndrome is an autoimmune disease. The immune system is supposed to fight disease by killing off harmful viruses and bacteria. But with autoimmune diseases, your immune system attacks parts of your own body by mistake.

In Sjögren's syndrome, your immune system attacks the glands that make tears and saliva (spit). The damage keeps these glands from working right and causes dry eyes and dry mouth.

Doctors don't know the exact cause of Sjögren's syndrome. They think it may be caused by a combination of two things:

NIH - National Institute of Arthritis and Musculoskeletal and Skin Diseases

What works? Research summarized

Evidence reviews

The accuracy of the anti-alpha-fodrin antibody test for diagnosis of Sjogren's syndrome: a meta-analysis

OBJECTIVE: To evaluate the diagnostic value of anti-α-fodrin in patients with Sjögren's syndrome (SS).

Treatment of primary Sjogren's syndrome with anti-CD20 therapy (rituximab). A feasible approach or just a starting point?

INTRODUCTION: In vitro and in vivo experimental data have suggested new immunopathogenic mechanisms in primary Sjögren's syndrome (pSS). The availability of targeted treatment modalities has opened new ways to selectively target these mechanistic pathways in vivo. Amongst these new treatment modalities, monoclonal antibodies specific for the B-cell surface molecule CD20 have been shown to be the most promising treatment option to date.

Chinese herbal medicine in treating primary Sjogren's syndrome: a systematic review of randomized trials

Background. There is no curative treatment for primary Sjögren's syndrome (PSS). Chinese herbal medicine (CHM) is widely used in the treatment of PSS in China. Objective. To evaluate the effectiveness and safety of CHM for PSS. Methods. PubMed, Cochrane Library, China Knowledge Resource Integrated Database, Chinese Biomedical Database, Wanfang Data, and the Database for Chinese Technical Periodicals were searched for randomized controlled trials (RCTs) of CHM or CHM plus conventional medicine for PSS compared with placebo or conventional medicine. RevMan 5.0.17 was employed to conduct data analyses and assess homogeneity. Statistical models were chosen according to heterogeneity. Results. A total of 52 RCTs were included. The overall methodological quality of included trials was low. 49 trials reported response rates, of which 32 found significant improvements favoring CHM treatment against controls; 20 trials reported lacrimal function by Schirmer test scores, of which 16 trials reported a significant difference favoring CHM treatment. 21 trials reported salivary function by salivary flow rate, of which 10 reported significant favorable effects of CHM treatment. Other trials found no difference. The reported adverse effects of CHM included nausea, diarrhea, and other minor digestive symptoms, but more frequent adverse effects occurred in conventional medicine groups. Conclusions. Preliminary evidence from RCTs suggests the effect of CHM is promising for relieving symptoms, improving lacrimal and salivary function in PSS. However, the poor methodological quality of the included trials means that further well-designed, multicentered, larger trials are needed.

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Summaries for consumers

Non‐drug treatments for dry mouth symptoms

This review, carried out by authors of the Cochrane Oral Health Group, has been produced to assess the effects of non‐drug treatments used to stimulate saliva production for the relief of dry mouth (xerostomia) symptoms.

Interventions for the management of dry mouth: topical therapies

Dry mouth is a common problem with a range of causes. The symptom may be due to a reduction in the quantity of saliva produced, or a change in the composition of saliva, but a feeling of dry mouth may also be present in people with normal saliva production. Radiotherapy or chemotherapy for head and neck cancers, and diseases such as Sjögren's Syndrome, may result in reduced saliva production. Many commonly prescribed medications are associated with a feeling of dry mouth, despite normal saliva production. As well as difficulty in speaking, chewing and swallowing, prolonged dry mouth may result in increased risk of tooth decay and reduced quality of life. In many sufferers dry mouth cannot be cured, but effective ways for people to manage dry mouth symptoms are available. Many topical treatments (applied directly to the inside of the mouth) such as sprays, lozenges, mouthrinses, gels, oils, chewing gum or toothpastes have been evaluated in this review, but there is no strong evidence that any topical treatment is effective for relieving the sensation of dry mouth. Oxygenated glycerol triester (OGT) saliva substitute spray is more effective than a water based electrolyte spray. A gel‐releasing device worn in the mouth, or a mouthcare system might be effective but more research is needed. Chewing gum increases saliva production but there is no evidence that gum is better or worse than saliva substitutes. Acidic products and those containing sugar should be avoided.

Eyedrops made from autologous serum as a treatment for dry eye

We conducted a wide range of searches for relevant trials in April 2013. We identified four randomized controlled trials with a total of 72 participants with dry eye from Chile, Australia and Japan. The trials compared autologous serum eye drops to traditional artificial tears for the treatment of dry eye. The results from the four trials could not be combined in analysis due to the variation in participant populations, follow‐up intervals, and incomplete reporting of treatment outcomes. None of the included trials reported outcomes for the primary outcome of this review, the change in participant‐reported symptoms after one month of treatment. Some improvements in participant‐reported outcomes and tear film stability were seen in two trials after two weeks, but not in the other two trials or at longer follow‐up periods. Autologous serum eye drops did not provide a benefit based on other clinical assessments of the surface of the eye compared to traditional artificial tears. Outcomes for quality or life and costs were not reported in any of the trials. One study reported that no serious harms were related to using autologous serum eye drops while the other studies did not discuss whether any adverse events occurred. Overall the results from these studies do not provide consistent information as to whether autologous serum eye drops are safe and effective for the treatment of dry eye. Future trials are needed using appropriate study designs to address participant‐centered outcomes, to determine the effects of autologous serum eye drops in the treatment of dry eye.

Terms to know

Autoimmune Disease
Disease that results when the immune system mistakenly attacks the body's own tissues. Examples include multiple sclerosis, type 1 diabetes, rheumatoid arthritis, and systemic lupus erythematosus.
Dry Eye
A syndrome characterized by dryness of the cornea and conjunctiva. It is usually caused by a deficiency in tear production. Symptoms include a feeling of burning eyes and a possible foreign body presence in the eye.
Exocrine Glands
An organ that makes one or more substances, such as sweat, tears, saliva, or milk. Exocrine glands release the substances into a duct or opening to the inside or outside of the body.
Glands
A group of cells that secrete substances. Endocrine glands secrete hormones. Exocrine glands secrete salt, enzymes, and water.
Immune System
The body's system for protecting itself from viruses and bacteria or any foreign substances.
Lacrimal Glands
A gland that secretes tears. The lacrimal glands are found in the upper, outer part of each eye socket.
Rheumatologist
Doctors who diagnose and treat diseases of the bones, joints, muscles, and tendons, including arthritis and collagen diseases.
Salivary Glands
A gland in the mouth that produces saliva.
Xerostomia (Dry Mouth)
Occurs when the body is not able to make enough saliva.

More about Sjogren's Syndrome

Photo of an adult woman

Also called: Sjogren syndrome, Sjogren's disease, Sjögren's disease, Sjögren's syndrome, Sjögren syndrome, Sicca syndrome

Other terms to know: See all 9
Autoimmune Disease, Dry Eye, Exocrine Glands

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