RESEARCH - Progression of salivary gland dysfunction in patients with Sjoren's syndrome

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Ann Rheum Dis. 2007 Jan;66(1):107-12. Epub 2006 May 25.

Progression of salivary gland dysfunction in patients with Sjogren's

syndrome.

University Medical Center Groningen, University of Groningen, PO Box 30001,

9700 RB Groningen, The Netherlands.

BACKGROUND: Salivary gland dysfunction is one of the key manifestations of

Sjogren's syndrome. OBJECTIVES: (1) To assess prospectively loss of function

of individual salivary glands in patients with primary and secondary

Sjogren's syndrome in relation to disease duration and use of

immunomodulatory drugs. (2) To study changes in sialochemical and laboratory

values and subjective complaints over time. METHODS: 60 patients with

Sjogren's syndrome were included in this study. Whole and gland-specific

saliva (parotid and submandibular/sublingual (SM/SL)), samples were

collected at baseline and after a mean of 3.6 (SD 2.3) years of follow-up.

Disease duration was recorded for all patients. RESULTS: Patients with

Sjogren's syndrome with short disease duration had significantly higher

stimulated flow rates at baseline than those with longer disease duration

(p<0.05). When compared with healthy controls, the decrease in SM/SL flow

rates at baseline was more prominent than that in parotid flow rates

(p<0.05). Over time, there was a significant further decrease of stimulated

flow rates, especially of the parotid gland, accompanied by increasing

problems with swallowing dry food (p<0.05). The decrease was independent of

the use of corticosteroids or disease-modifying antirheumatic drugs

(DMARDs). Sialochemical variables remained stable. CONCLUSIONS: Early

Sjogren's syndrome is characterised by a decreased salivary gland function

(parotis>SM/SL), which shows a further decrease over time, regardless of the

use of DMARDs or steroids. Patients with Sjogren's syndrome with longer

disease duration are characterised by severely reduced secretions of both

the parotid and SM/SL glands. These observations are relevant for

identifying patients who would most likely benefit from intervention

treatment.

PMID: 16728458

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?itool=abstractplus & db=pubmed & cmd=R\

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