Candidate autoantibodies for primary Sjögren's syndrome: where are they now?

Although ANA, SSA and SSB antibody testing are universally accepted biomarkers for Sjögren's syndrome (SS) diagnosis, they do not occur in all patients. Up to 18% of SS patients are seronegative, with potential for delayed or missed diagnosis. There are no clinically available autoantibodies with predictive value for SS end-organ complications. Over the last three decades, novel autoantibodies for SS diagnosis and monitoring have been identified but few have transitioned from research studies to clinical use. We performed a literature review of candidate serum autoantibodies to examine their persistence in the literature and potential clinical utility. Of the nineteen autoantibodies we identified, AQP5, SP-1, CA6, and PSP Abs have the most promise. Larger cohort studies are needed to determine their potential contribution in SS management.