Abstract
The diagnostic work-up of primary Sjögren’s syndrome (pSS) includes quantifying saliva and tear production, evaluation of autoantibodies in serum and histopathological analysis of minor salivary glands. Thus, the potential for further utilizing these fluids and tissues in the quest to find better diagnostic and therapeutic tools should be fully explored. Ten samples of saliva and tears from female patients diagnosed with pSS and ten samples of saliva and tears from healthy females were included for lipidomic analysis of tears and whole saliva using high-performance liquid chromatography coupled to time-of-flight mass spectrometry. In addition, lipidomic analysis was performed on minor salivary gland biopsies from three pSS and three non-SS females. We found significant differences in the lipidomic profiles of saliva and tears in pSS patients compared to healthy controls. Moreover, there were differences in individual lipid species in stimulated saliva that were comparable to those of glandular biopsies, representing an intriguing avenue for further research. We believe a comprehensive elucidation of the changes in lipid composition in saliva, tears and minor salivary glands in pSS patients may be the key to detecting pSS-related dry mouth and dry eyes at an early stage. The identified differences may illuminate the path towards future innovative diagnostic methodologies and treatment modalities for alleviating pSS-related sicca symptoms.
Highlights
Sjögren’s syndrome (SS) is a chronic, progressive, systemic autoinflammatory disease defined by lymphocytic infiltration of exocrine glands, predominantly the salivary and lacrimal glands [1]
The etiology of SS is an ongoing matter of debate; it is currently believed to result from a combination of genetic, epigenetic, environmental and immunologic factors [4]
The ten patients from whom saliva was analyzed had a mean number of 24 teeth and mean DMFT of 17
Summary
Sjögren’s syndrome (SS) is a chronic, progressive, systemic autoinflammatory disease defined by lymphocytic infiltration of exocrine glands, predominantly the salivary and lacrimal glands [1]. The resultant secretory decrease in saliva and tears often leads to symptoms of dryness in the mouth and eyes (xerostomia and xerophthalmia). SS is considered primary (pSS) when it presents independently, or secondary (sSS) should it occur as part of a previously diagnosed rheumatic disease [2]. SS patients may develop caries, oral fungal infections and systemic symptoms such as fatigue and arthralgia. They are at increased risk of acquiring non-Hodgkin’s lymphoma [3]. Primary Sjögren’s syndrome affects approximately 10 females for every male [6]
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