Antifodrin antibodies in Sjogren's syndrome: a review

Establishing the diagnosis of Sjögren's syndrome has been difficult in light of its nonspecific symptoms (dry eyes and mouth) and lack of both sensitive and specific laboratory markers. Recently, antibodies against alpha-fodrin have been characterized: first in animal models of Sjögren's syndrome, and later in humans. Antibodies against alpha-fodrin have been shown to be present in up to 98% of untreated patients. These antibodies are directed against an apoptotic cleavage product of alpha-fodrin. Anti-alpha-fodrin is clearly involved in the pathogenesis of murine models of Sjögren's syndrome. However, in humans, conflicting data have recently been generated with regard to the prevalence of antibodies against alpha-fodrin in the disease. These differences may be caused by interference of treatment with antibody concentrations, but may also reflect varying methods of patient selection. Further studies on untreated patients are needed to establish the diagnostic efficiency of antibodies against alpha-fodrin in Sjögren's syndrome, which may be a potential diagnostic marker in addition to antibodies against Ro. In this review, the potential of antifodrin antibodies as laboratory markers of Sjögren's syndrome is discussed.