Current and future challenges in primary Sjögren's syndrome.

Area of Science:

• Immunology
• Rheumatology
• Oral Medicine

Background:

• Sjögren's syndrome (SS) is an autoimmune inflammatory disorder primarily affecting exocrine glands, notably lacrimal and salivary glands.
• Common symptoms include dry eyes and dry mouth, but systemic symptoms like fatigue, purpura, polyneuropathy, and arthritis are also prevalent.
• A significant concern is the increased risk of lymphoma, particularly marginal zone B-cell lymphomas, in approximately 7.5% of patients.

Purpose of the Study:

• To review recent breakthroughs in salivary diagnostics for Sjögren's syndrome.
• To explore the potential of salivary proteomics, genomics, and systems biology in understanding SS pathophysiology.
• To discuss the promise of biological therapies, especially B cell depletion, and personalized treatment selection in SS.

Main Methods:

• Review of recent scientific literature on Sjögren's syndrome.
• Analysis of advancements in salivary diagnostics for disease detection and monitoring.
• Examination of emerging insights from salivary -omics and systems biology approaches.

Main Results:

• Salivary diagnostics are evolving for SS diagnosis, disease activity monitoring, and treatment response assessment.
• Salivary proteomics, genomics, and systems biology provide deep insights into SS pathophysiology.
• B cell depletion therapy shows promise for a subset of SS patients, enabling personalized treatment strategies.

Conclusions:

• Salivary diagnostics, combined with disease activity assessment tools, can help identify SS patients who will respond to specific biological therapies.
• Future research holds promise for improved diagnostic and therapeutic interventions for Sjögren's syndrome.
• Understanding SS mechanisms through -omics and systems biology is crucial for developing effective biological treatments.