Research progress of biomarkers in Sjögren disease

Sjögren disease is a chronic autoimmune disorder characterized by immune-mediated dysregulation that leads to exocrine gland destruction, impaired tissue repair, and frequent co-occurrence with other connective tissue diseases. Current internationally accepted diagnostic criteria rely predominantly on a combination of characteristic clinical manifestations, autoantibody profiles, and histopathological findings from minor salivary gland biopsy. In early-stage disease, when immune-driven glandular injury has not yet caused evident structural damage, or when histopathological alterations are delayed compared to clinical symptoms, the conventional "gold standard" method may produce false-negative outcomes, leading to diagnostic delays or overlooked diagnoses. In recent years, advances in multi-omics platforms, single-cell technologies, and artificial intelligence-driven data analysis have enabled the discovery of a growing number of promising biomarkers, including proteases, metabolites, microRNAs, and novel autoantibody epitopes detectable in serum, saliva, and tears. Several of these candidates have already undergone translational validation and are beginning to impact clinical decision-making. This review highlights recent advancements in biomarker research for Sjögren disease, evaluating their diagnostic utility, prognostic relevance, and therapeutic implications.