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Patients with Sjogren's syndrome may have a dysfunctional parasympathetic nervous system, which might explain why the disease causes decreased saliva and tear production. Sjogren's syndrome is characterized mostly by dry eyes and dry mouth.

The human T-cell lymphotropic virus type I (HTLV-I) may be associated with some cases of rheumatoid arthritis and Sjogren's syndrome. Sjogren's syndrome is an autoimmune disease characterized by inflammatory changes in salivary and other glands. Studies in Japan, where HTLV-I infection is widespread, show that people who tested positive for HTLV-I were more likely to have rheumatoid arthritis. People with Sjogren's syndrome were also more likely to test positive and they had antibodies against HTLV-I in their saliva. Viral DNA has also been found in the synovial fluid of joints in people with rheumatoid arthritis.

Epstein-Barr virus (EBV) causes infectious mononucleosis, a disease characterized by enlargement of the lymph nodes and spleen, and increased numbers of abnormal mononuclear leukocytes (white blood cells with a single nucleus). The virus infects the immune B cells and multiplies in the salivary glands and surface tissues of the nasal and throat passages. After the initial infection, the virus remains dormant in the host's body, that is, exists without being infective. EBV can stimulate the production of autoantibodies, which are abnormal immune proteins directed against the body's own tissues and cells. Various lines of evidence suggest that EBV may be involved in the development of two autoimmune disorders, rheumatoid arthritis and Sjogren's syndrome. Rheumatoid arthritis is an inflammatory joint disease characterized by the production of antibodies directed against the cell nucleus. Sjogren's syndrome is characterized by the accumulation of lymphocytes (immune cells), destruction of secretory cells in the salivary gland, and abnormal immune function. The role of EBV infection in rheumatoid arthritis and Sjogren's syndrome was assessed by measuring the levels of antibodies directed against specific EBV antigens, or elements of the virus that trigger an immune response. These viral antigens were components of the EBV nucleus and included Epstein-Barr nuclear antigens (EBNA)-1,-2,-3,-4, and -6. The type of antibody measured was immunoglobulin G (IgG). Increased levels of IgG antibodies to EBNAs were detected in patients with Sjogren's syndrome, but not in patients with rheumatoid arthritis. The relation between EBV infection and Sjogren's syndrome requires further investigation. (Consumer Summary produced by Reliance Medical Information, Inc.)

PURPOSE: To determine whether Epstein-Barr virus (EBV) could be involved in the pathogenesis Sjogren's syndrome (SS). PATIENTS AND METHODS. In situ hybridization using the BamHI-W fragment of EBV DNA was performed using labial salivary gland biopsy sPecimens from 14 patients with SS (eight with Primary SS and six with secondary SS) and 39 control subjects. Furthermore, labial salivary gland biopsy specimens from 12 patients with SS (seven with primary SS and rive with secondary SS) and 24 control subjects were submitted to the polymerase chain reaction to detect EBV DNA. RESULTS: In situ hybridization detected EBV DNA in epithelial cells of labial salivary gland bioPsy specimens from four of eight (50%) patients with primary SS, zero of six patients with secOndary SS, and three of 39 (8%) control subjects. The difference between patients with primary SS and control subjects was statistically significant p, Sjogren's syndrome (SS) is characterized by the accumulation of lymphocytes, a type of immune cell, in the salivary and lacrimal (tear) glands, and the production of abnormal immune proteins called autoantibodies. Several lines of evidence suggest that infection with the Epstein-Barr virus (EBV) may be involved in the development of SS. However, the role of EBV infection in the development of SS remains unclear. The presence of EBV was assessed in the salivary glands of patients with SS using molecular biology methods. The DNA of EBV was detected by in situ hybridization in the epithelial cells located on the surface of the salivary glands from: four of eight patients (50 percent) with primary SS, or SS unrelated to other medical conditions; none of six patients (0 percent) with secondary SS, or SS associated with another medical problem; and three of 39 subjects (8 percent) without SS. Another molecular biology technique, the polymerase chain reaction, was used to detect EBV DNA in six of seven patients (86 percent) with primary SS; three of five patients (60 percent) with secondary SS; and seven of 24 subjects (29 percent) without SS. These results show that the genetic material of EBV can be detected with a greater frequency in patients with SS than subjects without SS. The epithelial cells of the salivary glands appeared to be the major site of infection by EBV. These findings suggest that EBV infection plays a role in the pathogenesis of SS. However, it remains unclear whether the virus causes deterioration of the salivary glands or whether infection occurs after injury of the gland. (Consumer Summary produced by Reliance Medical Information, Inc.)

Part 3: Causes of dry eye and Sj?gren's syndrome In the third part of this series, ophthalmologists Mohammad Laiquzzaman and Sunil Shah describe Sj?gren's syndrome and the underlying causes of [...]

Angel Nunez, MD; H. Baier, MD; M. Saldana, MD--Jackson Memorial Hospital, University of Miami, Florida Introduction: Sjogren's syndrome may often be associated with a variety of pulmonary disorders. Chronic interstitial [...]

Sjogren-Larsson syndrome (SLS) is an inherited disease characterized by dry, scaly skin, mental retardation and spastic paralysis. Children born with SLS have white dots on the retina of the eye, speech problems, hump-like curvature of the spine and are short in height. Affected patients have a deficiency of an enzyme needed for the metabolism of fatty alcohol in the skin and for the cover of nerve fibers. To study the metabolism of fatty alcohol, the skin cells (fibroblasts) of eight patients with SLS were examined. The fibroblast cells had accumulations of fatty alcohol. It was found that the fatty alcohol oxidoreductase (FAO) enzyme deficiency was the main biochemical defect in these patients, which was not found in patients having other skin or neurological diseases. The measurement of FAO in infants born with apparent skin abnormalities will help in the diagnosis of SLS. Treatment with a low-fat diet to limit the amount of long-chain fatty acids which are essential for the production of fatty alcohols improved the skin manifestations in one patient.

FORT LAUDERDALE, FLA. -- Sjogren's syndrome is the second most common autoimmune disorder that affects the musculoskeletal system, and yet the average time to diagnosis is 6 years, Yvonne Sherrer, [...]