Sjögren’s Syndrome, or autoimmune epithelitis, as it is known, is a chronic, autoimmune disease that mainly affects the exocrine glands. The main exocrine glands affected are salivary glands and lacrimal glands. This syndrome, with difficult pronunciation, is an autoimmune disease. It derives from an abnormal immune response which is directed against healthy tissues of the body itself.
Diagnosis of Real Causes & Treatment of Sjögren Syndrome
- Gradual restoration of cellular function
- Personalized therapeutic protocols, without chemical residues and excipients
- Treating the real causes
- Therapeutic formulas that work alone or in combination with any other medication
- Adopting a Molecular / Therapeutic Nutrition Plan
Sjögren’s Syndrome is divided into primary and secondary. It is characterized as primary when it occurs alone and as secondary when it occurs along with other diseases, such as Systemic Lupus Erythematosus, Rheumatoid Arthritis, Scleroderma, etc.
The disease can affect people of all ages. However, it is more common in middle-aged women, with the female-to-male ratio being 9: 1. It is a fairly common disease, as it is estimated to affect 1% of adult women. In the US, about 4 million people suffer from Sjögren’s Syndrome. In Greece, the first epidemiological study on rheumatic diseases, conducted by the Hellenic Institute of Rheumatology, revealed that the incidence of the disease in the Greek population is 1%.
What are the symptoms of Sjögren’s Syndrome?
The diagnosis of Sjögren’s Syndrome can be difficult to diagnose, as symptoms of the disease may vary from patient to patient, but may even change over time or be associated with non-specific symptoms (e.g. fever, fatigue). Symptoms of Sjögren’s Syndrome include:
- Dry eyes – Feeling a foreign body in the eyes
- Dry mouth – Difficulty swallowing
- Dryness of skin and / or appearance of rashes
- Change in the sense of taste
- Ulcers in the mouth or trachea
- Fatigue
- Joint pains
- Vaginal dryness and pain during intercourse
- Swelling of salivary glands
How to diagnose Sjögren’s Syndrome
Every physician who observes a patient with some of the above symptoms should thoroughly investigate the possibility that this patient has Sjögren’s Syndrome. The two most are dry mouth and dry eyes.
In the case of dry mouth, the doctor in charge is the Otolaryngologist, who will evaluate the dryness of the oral cavity and the possible swelling of the parotid glands or salivary glands. Malignant gland dysfunction can be confirmed by biopsy, which is performed under local anesthesia, and is subsequently assessed microscopically by a diagnostic laboratory.
The Ophthalmologist is the one who will examine the eyes, may detect the dry eyes and through special painless tests (Schirmer test, Rose Bengal dye test) will assess the potential damage from prolonged ocular dryness.
Blood tests can help diagnose the syndrome. Indicators commonly checked are the following:
- Anti-nuclear antibodies (ANA)
- Rheumatoid Factor
- Anti-SSA (Ro) antibodies
- Anti-SSB antibodies (La)
- Erythrocyte Sedimentation Rate (ESR)
Classical Therapeutic Treatment
The treatment regimen applied to each patient depends on their symptoms and their severity. In this context, your doctor may recommend:
- Artificial tears and ocular lubricant ointments
- Non-steroidal anti-inflammatory drugs
- Medicines that promote salivary secretion (eg pilocarpine)
- Glucocorticoids (eg cortisone)
- Immunomodulators – immunosuppressive drugs (eg azathioprine, methotrexate)
- Biological agents (eg rituximab)
It is important to note that these therapeutic regimens are intended to alleviate symptoms and do not address the underlying cause of the disease.
The Modern Medical Approach
A key point of a modern Medical Approach is the detection and identification of any dysfunctions, at the Molecular and Cellular level. This is achieved through Hematological/ Hormonological tests as well as innovative specialized diagnostic tests, which reveal any deviations from normal to the cell metabolism. At the same time, all those deficiencies of Micro- and Macronutrients that have contributed to the development of the disease are identified.
After a thorough analysis of the medical history and lab test results and based on medical algorithms, a personalized treatment regimen is determined for each patient.
The patient does not need to change anything in his daily life and gradually observes the overall improvement of his health levels.
The duration of the follow-up depends on the overall clinical condition of the patient and ranges from 6 to 18 months.
This personalized treatment does not contradict another parallel drug and / or homeopathic treatment.
Dr. Nikoleta Koini, M.D.
Doctor of Functional, Preventive, Anti-ageing and Restorative Medicine.
Diplomate and Board Certified in Anti-aging, Preventive, Functional and Regenerative Medicine from A4M (American Academy in Antiaging Medicine).
References:
- Moutsopoulos HM. Sjögren’s syndrome: autoimmune epithelitis. Clin Immunol Immunopathol (1994) 72(2):162–
5.10.1006/clin.1994.1123 [PubMed] [CrossRef] [Google Scholar] - Ramos-Casals M, Brito-Zerón P, Kostov B, Sisó-Almirall A, Bosch X, Buss D, et al. Google-driven search for big data in autoimmune geoepidemiology: analysis of 394,827 patients with systemic autoimmune diseases. Autoimmun Rev (2015) 14(8):670–9.10.
1016/j.autrev.2015.03.008 [PubMed] [CrossRef] [Google Scholar] - Humphreys-Beher MG, Brinkley L, Purushotham KR, Wang PL, Dusek D, Nakagawa Y, et al. Characterization of antinuclear autoantibodies present in the serum from nonobese diabetic (NOD) mice. Clin Immunol Immunopathol (1993) 68:350–6.
10.1006/clin.1993.1137 [PubMed] [CrossRef] [Google Scholar] - Humphreys-Beher MG, Hu Y, Nakagawa Y, Wang PL, Purushotham KR. Utilization of the non-obese diabetic (NOD) mouse as an animal model for the study of secondary Sjogren’s syndrome. Adv Exp Med Biol (1994) 350:631–6.10.1007/
978-1-4615-2417-5_105 [PubMed] [CrossRef] [Google Scholar] - Robinson CP, Yamamoto H, Peck AB, Humphreys-Beher MG. Genetically programmed development of salivary gland abnormalities in the NOD (nonobese diabetic)-scid mouse in the absence of detectable lymphocytic infiltration: a potential trigger for sialoadenitis of NOD mice. Clin Immunol Immunopathol (1996) 79:50–9.
10.1006/clin.1996.0050 [PubMed] [CrossRef] [Google Scholar] - de Paiva CS, Jones DB, Stern ME, Bian F, Moore QL, Corbiere S, et al. Altered mucosal microbiome diversity and disease severity in Sjögren syndrome. Sci Rep (2016) 6:23561.10.1038/
srep23561 [PMC free article] [PubMed] [CrossRef] [Google Scholar] - Spachidou MP, Bourazopoulou E, Maratheftis CI, Kapsogeorgou EK, Moutsopoulos HM, Tzioufas AG. Expression of functional toll-like receptors by salivary gland epithelial cells: increased mRNA expression in cells derived from patients with primary Sjogren’s syndrome. Clin Exp Immunol (2007) 147:497–503.10.
1111/j.1365-2249.2006.03311.x [PMC free article] [PubMed] [CrossRef] [Google Scholar] - Garcia-Carrasco M, Fuentes-Alexandro S, Escarcega RO, Salgado G, Riebeling C, Cervera R. Pathophysiology of Sjogren’s syndrome. Arch Med Res (2006) 37:921–32.10.1016/
j.arcmed.2006.08.002 [PubMed] [CrossRef] [Google Scholar] - Daridon C, Devauchelle V, Hutin P, Berre RL, Martins-Carvalho C, Bendaoud B. Aberrant expression of BAFF by B lymphocytes infiltrating the salivary glands of patients with primary Sjögren’s syndrome. Arthritis Rheum (2007) 56:1134–44.10.
1002/art.22458 [PubMed] [CrossRef] [Google Scholar] - Groom J, Kalled SL, Cutler AH, Olson C, Woodcock SA, Schneider P. Association of BAFF/BLyS overexpression and altered B cell differentiation with Sjogren’s syndrome. J Clin Invest (2002) 109:59–68.10.
1172/JCI0214121 [PMC free article] [PubMed] [CrossRef] [Google Scholar] - Vlachogiannis NI, Nezos A, Tzioufas AG, Koutsilieris M, Moutsopoulos HM, Mavragani CP. Increased frequency of the PTPN22W* variant in primary Sjogren’s Syndrome: association with low type I IFN scores. Clin Immunol (2016) 173:157–60.10.
1016/j.clim.2016.10.015 [PubMed] [CrossRef] [Google Scholar] - Johnsen SJ, Gudlaugsson E, Skaland I, Janssen EA, Jonsson MV, Helgeland L, et al. Low protein A20 in minor salivary glands is associated with lymphoma in primary Sjögren’s Syndrome. Scand J Immunol (2016) 83(3):181–7.10.
1111/sji.12405 [PubMed] [CrossRef] [Google Scholar] - Williams AEG, Choi K, Chan AL, Lee YJ, Reeves WH, Bubb MR, et al. Sjögren’s syndrome-associated microRNAs in CD14+ monocytes unveils targeted TGFβ signaling. Arthritis Res Ther (2016) 18:95.10.1186/
s13075-016-0987-0 [PMC free article] [PubMed] [CrossRef] [Google Scholar] - Cole MB, Quach H, Quach D, Baker A, Taylor KE, Barcellos LF, et al. Epigenetic signatures of salivary gland inflammation in Sjögren’s syndrome. Arthritis Rheumatol (2016) 68(12):2936–
44.10.1002/art.39792 [PMC free article] [PubMed] [CrossRef] [Google Scholar] - Wang J, Peng H, Tian J, Ma J, Tang X, Rui K, et al. Upregulation of long noncoding RNA TMEVPG1 enhances T helper type 1 cell response in patients with Sjögren syndrome. Immunol Res (2016) 64(2):489.10.1007/
s12026-015-8715-4 [PubMed] [CrossRef] [Google Scholar] - Nair JJ, Singh TP. Sjogren’s syndrome: review of the aetiology, pathophysiology & potential therapeutic interventions. J Clin Exp Dent (2017) 9(4):e584–9.10.
4317/jced.53605 [PMC free article] [PubMed] [CrossRef] [Google Scholar] - Sardu C, Cocco E, Mereu A, et al. Population based study of 12 autoimmune diseases in Sardinia, Italy: prevalence and comorbidity. PLoS One. 2012;7(3):e32487. doi:10.1371/journal.pone.
0032487.