Non-Conventional and Emerging Autoantibodies in Sjögren's Disease

Area of Science:

• Immunology
• Rheumatology
• Autoimmune Diseases

Background:

• Sjögren's disease (SjD) is a chronic autoimmune disorder defined by dryness, joint pain, systemic illness, and B-cell hyperactivity.
• Serum autoantibodies are critical pathological markers in SjD, with anti-Ro52, anti-Ro60, and anti-La antibodies being well-established and present in up to 70% of patients.
• Rheumatoid factors, found in about 50% of patients, offer prognostic insights into B-cell lymphoma development.

Purpose of the Study:

• To provide an updated review of autoantibodies associated with Sjögren's disease.
• To discuss the potential clinical utility and current limitations of both established and emerging autoantibodies in SjD diagnosis and patient stratification.
• To highlight the need for further research to validate the diagnostic and clinical value of these biomarkers.

Main Methods:

• This is a narrative review article.
• The review synthesizes current literature on autoantibodies in Sjögren's disease.
• It discusses established autoantibodies (anti-Ro52, anti-Ro60, anti-La, rheumatoid factors) and emerging ones (anti-fodrin, anti-muscarinic acetylcholine receptor 3).

Main Results:

• Established autoantibodies like anti-Ro52/60/La are crucial for SjD classification.
• Emerging autoantibodies show potential for identifying specific clinical features and aiding diagnosis in seronegative patients.
• Current limitations include poor diagnostic sensitivity, inconsistent findings, and heterogeneous study designs, hindering routine clinical application.

Conclusions:

• While numerous autoantibodies are linked to SjD, their routine clinical use is currently limited by diagnostic challenges.
• Further large-scale, multicenter studies with harmonized testing are essential to validate the utility of these autoantibodies.
• Validated autoantibodies could improve Sjögren's disease diagnosis and patient management in the future.