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Izzetti R, Carli E, Gennai S, Graziani F, Nisi M. OHIP-14 Scores in Patients with Sjögren's Syndrome Compared to Sicca Syndrome: A Systematic Review with Meta-Analysis. Int J Dent 2024; 2024:9277636. [PMID: 38756383 PMCID: PMC11098607 DOI: 10.1155/2024/9277636] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2023] [Revised: 04/03/2024] [Accepted: 04/25/2024] [Indexed: 05/18/2024] Open
Abstract
Objectives Primary Sjögren's syndrome (pSS) is a chronic autoimmune disorder characterized by dryness of mucous membranes, predominantly the eyes and mouth, following glandular tissue substitution. The onset of oral dryness constitutes a significant source of discomfort that negatively affects overall quality of life. This systematic review aimed at investigating the differences in Oral Health Impact Profile-14 (OHIP-14) questionnaire scores in patients diagnosed with Sjögren's syndrome compared to sicca syndrome, to assess the influence of the two conditions on oral health. Study Design. A systematic electronic and manual search was performed up to December 2023 for studies reporting OHIP-14 questionnaire scores in pSS patients versus sicca syndrome. Two authors independently reviewed, selected, and extracted the data. The outcome was the assessment of OHIP-14 scores in studies comparing pSS- and sicca syndrome-affected patients. Meta-analysis was conducted on available quantitative data. Results Literature search retrieved 30 articles, and 3 articles met the criteria for inclusion in the review. Meta-analysis revealed significantly higher scores in patients with sicca syndrome compared to pSS, although salivary flow was markedly reduced in pSS. Conclusions While offering supplementary information to standard tests and supporting the assessment of pSS and sicca syndrome patients, further validation is necessary to establish OHIP-14 validity in determining the impact of pSS and sicca syndrome on patients' quality of life.
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Affiliation(s)
- Rossana Izzetti
- Department of Surgical, Medical and Molecular Pathology and Critical Care Medicine, University of Pisa, Pisa, Italy
| | - Elisabetta Carli
- Unit of Dentistry and Oral Surgery, University Hospital of Pisa, Pisa, Italy
| | - Stefano Gennai
- Department of Surgical, Medical and Molecular Pathology and Critical Care Medicine, University of Pisa, Pisa, Italy
| | - Filippo Graziani
- Department of Surgical, Medical and Molecular Pathology and Critical Care Medicine, University of Pisa, Pisa, Italy
| | - Marco Nisi
- Department of Surgical, Medical and Molecular Pathology and Critical Care Medicine, University of Pisa, Pisa, Italy
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Villarinho LN, Só BB, Schuch LF, Loureiro FJA, Martins MAT, Martins MD. Impact of the oral repercussions of Sjogren's Syndrome on patient's quality of life: a systematic review and meta-analysis. Oral Surg Oral Med Oral Pathol Oral Radiol 2024:S2212-4403(24)00120-2. [PMID: 38594096 DOI: 10.1016/j.oooo.2024.03.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2023] [Revised: 03/04/2024] [Accepted: 03/07/2024] [Indexed: 04/11/2024]
Abstract
This study aimed to perform a systematic review to evaluate the impact of the oral repercussions of Sjogren's Syndrome (SS) on the quality of life (QoL) of patients living with this disease. To conduct this work, we followed the PRISMA guidelines. The included studies evaluated oral repercussions of SS and their correlation with QoL. The risk of bias was assessed with the JBI tools for each type of study design. Our findings resulted in 26 articles met the eligibility criteria. Seventeen articles (65.3%) used the OHIP-14 questionnaire to evaluate oral health-related QoL (OHRQoL) and showed that the oral repercussions of SS had a negative impact. Ten studies applied other QoL instruments, in which 5 found a correlation between oral repercussions of SS and poorer OHRQoL, 3 showed no correlation, and 2 were unclear. Due to significant heterogeneity, the meta-analysis was limited to 8 of the 17 studies that used the OHIP-14. The results showed statistically significant poorer OHRQoL in individuals with SS compared to healthy controls. In conclusion, oral repercussions of SS negatively affect QoL. However, future studies should focus on standardized methodology to provide more homogenous and comparable evidence.
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Affiliation(s)
- Lauren Neumann Villarinho
- Department of Oral Pathology, School of Dentistry, Federal University of Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Bruna Barcelos Só
- Department of Oral Pathology, School of Dentistry, Federal University of Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Lauren Frenzel Schuch
- Department of Pathology and Oral Medicine Diagnosis, School of Dentistry, Universidad de la República, Montevideo, Uruguay
| | | | | | - Manoela Domingues Martins
- Department of Oral Pathology, School of Dentistry, Federal University of Rio Grande do Sul, Porto Alegre, RS, Brazil.
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Wu KY, Serhan O, Faucher A, Tran SD. Advances in Sjögren's Syndrome Dry Eye Diagnostics: Biomarkers and Biomolecules beyond Clinical Symptoms. Biomolecules 2024; 14:80. [PMID: 38254680 PMCID: PMC10812982 DOI: 10.3390/biom14010080] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2023] [Revised: 01/04/2024] [Accepted: 01/06/2024] [Indexed: 01/24/2024] Open
Abstract
Sjögren's syndrome dry eye (SSDE) is a subset of Sjögren's syndrome marked by dry eye symptoms that is distinct from non-Sjögren's syndrome dry eye (NSSDE). As SSDE can lead to severe complications, its early detection is imperative. However, the differentiation between SSDE and NSSDE remains challenging due to overlapping clinical manifestations. This review endeavors to give a concise overview of the classification, pathophysiology, clinical features and presentation, ocular and systemic complications, clinical diagnosis, and management of SSDE. Despite advancements, limitations in current diagnostic methods underscore the need for novel diagnostic modalities. Thus, the current review examines various diagnostic biomarkers utilized for SSDE identification, encompassing serum, salivary, and tear analyses. Recent advancements in proteomic research and exosomal biomarkers offer promising diagnostic potential. Through a comprehensive literature review spanning from 2016 to 2023, we highlight molecular insights and advanced diagnostic modalities that have the potential to enhance our understanding and diagnosis of SSDE.
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Affiliation(s)
- Kevin Y. Wu
- Division of Ophthalmology, Department of Surgery, University of Sherbrooke, Sherbrooke, QC J1G 2E8, Canada; (K.Y.W.); (A.F.)
| | - Olivia Serhan
- Faculty of Medicine, University of Sherbrooke, Sherbrooke, QC J1G 2E8, Canada
| | - Anne Faucher
- Division of Ophthalmology, Department of Surgery, University of Sherbrooke, Sherbrooke, QC J1G 2E8, Canada; (K.Y.W.); (A.F.)
| | - Simon D. Tran
- Faculty of Dental Medicine and Oral Health Sciences, McGill University, Montreal, QC H3A 1G1, Canada
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Freguia CF, Pascual DW, Fanger GR. Sjögren's Syndrome Treatments in the Microbiome Era. ADVANCES IN GERIATRIC MEDICINE AND RESEARCH 2023; 5:e230004. [PMID: 37323129 PMCID: PMC10270702 DOI: 10.20900/agmr20230004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/17/2023]
Abstract
Sjögren's syndrome (SS) is a chronic autoimmune disease characterized by inflammatory cell infiltration of the salivary and lacrimal glands, resulting in acinar epithelial cell atrophy, cell death, and loss of exocrine function. At least half of SS patients develop extraglandular inflammatory disease and have a wide range of systemic clinical manifestations that can affect any organ system, including connective tissues. As many as 3.1 million people in the U.S. suffer from SS, a disease that causes severe impairment. Women are nine times more likely than men to be affected by this condition. Unfortunately, there is currently no effective treatment for SS, and the available options only provide partial relief. Treatment involves using replacement therapies such as artificial saliva and eye lubricants, or immunosuppressive agents that have limited efficacy. The medical community recognizes that there is a significant need for more effective treatments for SS. Increasing evidence demonstrates the links between the dysfunction of the human microbial community and the onset and development of many human diseases, signifying the potential use of microorganisms as an alternative strategy to conquer these issues. The role of the microbiome in controlling immune function of the human host in the context of autoimmune diseases like SS is now becoming better understood and may help to enable new drug development strategies. Natural probiotics and synthetic biology applications hold promise for novel treatment approaches to solve the encryption of many complex and multifactorial immune disorders, like SS.
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Affiliation(s)
| | - David W. Pascual
- Department of Infectious Diseases & Immunology, College of Veterinary Medicine, University of Florida, P.O. Box 110880, Gainesville, FL 32611, USA
| | - Gary R. Fanger
- Rise Therapeutics, 1405 Research Blvd., Rockville, MD 20850, USA
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Chen B, Zhou J, Mao T, Cao T, Hu S, Zhang W, Li X, Qin X, Liu X, Watanabe N, Li J. The Critical Biomarkers Identification of Insulin Signaling Involved in Initiating cAMP Signaling Mediated Salivary Secretion in Sjogren Syndrome: Transcriptome Sequencing in NOD Mice Model. Biol Proced Online 2022; 24:26. [PMID: 36575389 PMCID: PMC9793606 DOI: 10.1186/s12575-022-00189-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2022] [Accepted: 12/14/2022] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND Sjogren's syndrome (SS) is an autoimmune disorder characterized by the destruction of exocrine glands, resulting in dry mouth and eyes. Currently, there is no effective treatment for SS, and the mechanisms associated with inadequate salivary secretion are poorly understood. METHODS In this study, we used NOD mice model to monitor changes in mice's salivary secretion and water consumption. Tissue morphology of the submandibular glands was examined by H&E staining, and Immunohistochemical detected the expression of AQP5 (an essential protein in salivary secretion). Global gene expression profiling was performed on submandibular gland tissue of extracted NOD mice model using RNA-seq. Subsequently, a series of bioinformatics analyses of transcriptome sequencing was performed, including differentially expressed genes (DEGs) identification, Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment analysis, PPI network construction, hub gene identification, and the validity of diagnostic indicators using the dataset GSE40611. Finally, IFN-γ was used to treat the cells, the submandibular gland tissue of NOD mice model was extracted, and RT-qPCR was applied to verify the expression of hub genes. RESULTS We found that NOD mice model had reduced salivary secretion and increased water consumption. H&E staining suggests acinar destruction and basement membrane changes in glandular tissue. Immunohistochemistry detects a decrease in AQP5 immunostaining within acinar. In transcriptome sequencing, 42 overlapping DEGs were identified, and hub genes (REN, A2M, SNCA, KLK3, TTR, and AZGP1) were identified as initiating targets for insulin signaling. In addition, insulin signaling and cAMP signaling are potential pathways for regulating salivary secretion and constructing a regulatory relationship between target-cAMP signaling-salivary secretion. CONCLUSION The new potential targets and signal axes for regulating salivary secretion provide a strategy for SS therapy in a clinical setting.
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Affiliation(s)
- Bo Chen
- grid.410737.60000 0000 8653 1072Guangdong Engineering Research Center of Oral Restoration and Reconstruction, Affiliated Stomatology Hospital of Guangzhou Medical University, #195 Dongfeng West Road, Guangzhou, 510140 Guangdong China
| | - Jiannan Zhou
- grid.410737.60000 0000 8653 1072Guangdong Engineering Research Center of Oral Restoration and Reconstruction, Affiliated Stomatology Hospital of Guangzhou Medical University, #195 Dongfeng West Road, Guangzhou, 510140 Guangdong China
| | - Tianjiao Mao
- grid.410737.60000 0000 8653 1072Guangdong Engineering Research Center of Oral Restoration and Reconstruction, Affiliated Stomatology Hospital of Guangzhou Medical University, #195 Dongfeng West Road, Guangzhou, 510140 Guangdong China
| | - Tingting Cao
- grid.410737.60000 0000 8653 1072Guangdong Engineering Research Center of Oral Restoration and Reconstruction, Affiliated Stomatology Hospital of Guangzhou Medical University, #195 Dongfeng West Road, Guangzhou, 510140 Guangdong China
| | - Shilin Hu
- grid.410737.60000 0000 8653 1072Guangdong Engineering Research Center of Oral Restoration and Reconstruction, Affiliated Stomatology Hospital of Guangzhou Medical University, #195 Dongfeng West Road, Guangzhou, 510140 Guangdong China
| | - Wenqi Zhang
- grid.410737.60000 0000 8653 1072School of Basic Medicine, Guangzhou Medical University, Guangzhou, Guangdong China
| | - Xueyang Li
- grid.410737.60000 0000 8653 1072Guangdong Engineering Research Center of Oral Restoration and Reconstruction, Affiliated Stomatology Hospital of Guangzhou Medical University, #195 Dongfeng West Road, Guangzhou, 510140 Guangdong China
| | - Xiuni Qin
- Guangzhou Concord Cancer Center, Guangzhou, Guangdong China
| | - Xintong Liu
- grid.509461.f0000 0004 1757 8255Chemical Biology Research Group, RIKEN Center for Sustainable Resource Science, Wako, Saitama, 351-0198 Japan ,grid.509461.f0000 0004 1757 8255Bio-Active Compounds Discovery Unit, RIKEN Center for Sustainable Resource Science, Wako, Saitama, 351-0198 Japan
| | - Nobumoto Watanabe
- grid.509461.f0000 0004 1757 8255Chemical Biology Research Group, RIKEN Center for Sustainable Resource Science, Wako, Saitama, 351-0198 Japan ,grid.509461.f0000 0004 1757 8255Bio-Active Compounds Discovery Unit, RIKEN Center for Sustainable Resource Science, Wako, Saitama, 351-0198 Japan
| | - Jiang Li
- grid.410737.60000 0000 8653 1072Guangdong Engineering Research Center of Oral Restoration and Reconstruction, Affiliated Stomatology Hospital of Guangzhou Medical University, #195 Dongfeng West Road, Guangzhou, 510140 Guangdong China
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