Abstract
BackgroundSjögren’s Syndrome compromises the exocrine function, producing xerostomia and xerophthalmia. It can appear as an isolated condition or associated with other autoimmune diseases (polyautoimmunity). The Unstimulated Salivary Flow rate (UWSF) is used to quantify saliva production. There is no objective evidence to differentiate the values in patients with Sjögren’s versus healthy people or patients with non-Sjögren’s sicca. The objective of the present review was to evaluate the UWSF in patients with Sjögren’s syndrome in comparison to controls (healthy and non-Sjögren’s sicca patients).MethodsA systematic literature review was carried out (PRISMA guidelines). Analytical observational studies of cases and controls, cross-sectional studies, cohort studies and randomized clinical trials (including healthy controls) were considered. The Medline/OVID, Lilacs, Embase, and Cochrane/OVID databases were consulted. MeSH, DeCS, keywords, and Boolean operators were used. The meta-analysis (RevMan 5.2) was done through the random-effects model [mean difference (MD)]. Level and quality of evidence were evaluated by the Oxford Center Levels of Evidence and Joanna Brigs list respectively.ResultsThirty-two articles were included (20 were case-control studies, 6 were cross-sectional, 2 prospective cohort, 2 retrospective cohort, and 2 studies were abstracts) and 28 were meta-analyzed. The unstimulated whole salivary flow rate in the Sjögren’s group was lower than in controls (healthy and patients with non-Sjögren Sicca syndrome) (MD-0.18 ml/min; 95% CI, − 0.24 to − 0.13; chi2-P-value < 0.00001). Heterogeneity was 97% and there was publication bias (funnel plot). The level of evidence was mostly 3 or 4. The quality of evidence was met (97% of items valued).ConclusionFor the first time, the unstimulated whole salivary flow rate is found to be lower in patients with Sjögren’s syndrome compared to controls (healthy and non-SS sicca) through a meta-analysis.Trial registrationPROSPERO CRD42020211325.
Highlights
Sjögren’s Syndrome (SS) is a chronic autoimmune disease that compromises the function of the exocrine glands in the skin and mucosa of the eyes, mouth, etc. and it results in predominantly xerophthalmia and xerostomia [1]
For the first time, the difference in the values of the UWSF rate in patients with SS compared to controls was objectively demonstrated through a meta-analysis
The purpose behind this study is to challenge the different specialists in oral health and rheumatology regarding the importance of the use of UWSF, which has the same weight within the classification criteria [14] for SS as the Schirmer test or the ocular staining score test
Summary
Sjögren’s Syndrome (SS) is a chronic autoimmune disease that compromises the function of the exocrine glands in the skin and mucosa of the eyes, mouth, etc. and it results in predominantly xerophthalmia and xerostomia [1]. SS could appear as an isolated disease (Primary Sjögren Syndrome (pSS)), or associated with another autoimmune pathology (Secondary Sjögren Syndrome (sSS)) such as autoimmune thyroid disease (15– 30%), rheumatoid arthritis (4–31%), systemic lupus erythematosus (9–19%), and systemic sclerosis (14%). This association was named polyautoimmunity [2]. Sjögren’s Syndrome compromises the exocrine function, producing xerostomia and xerophthalmia. It can appear as an isolated condition or associated with other autoimmune diseases (polyautoimmunity). The objective of the present review was to evaluate the UWSF in patients with Sjögren’s syndrome in comparison to controls (healthy and non-Sjögren’s sicca patients)
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