Sjogren's Roundup from 2021: GIVING US HOPE

GIVING US HOPE is a feature that we do in the Sjogren's Syndrome Info Newsletter explaining what many people are doing around the world to help further the knowledge and treatment of Sjogren's syndrome.  Here is a Roundup from 2021. 

It is always good to remember that there are many researchers and scientists and organizations working to help us. There may be many more researchers working on Sjogren's around the world. These were just the ones highlighted in our newsletter in 2021. 

At NIDCR, Tussiwand is working to investigate what her earlier findings in mice can tell us about immunity in humans. Dendritic cells may also play a pivotal role in autoimmunity, and her research could shed light on autoimmune diseases like Sjögren's syndrome.

At the University of Wisconsin Hospitals and Clinics research was conducted to learn more about Sjögren’s syndrome to develop new treatments. They studied: 

• Sjögren’s syndrome and mesenchymal stromal cells (e.g. stem cells)
• New autoantibody targets to improve diagnosis and treatment of Sjögren’s syndrome 
• The role of sex hormones in Sjögren’s syndrome

They are building a patient registry to allow doctors to track the success of treatments.

At the Wilmer Eye Institute, Johns Hopkins University Dr. Sezen Karakus assistant professor of ophthalmology studies "the association between dry eye and systemic diseases and the role of the novel autoantibodies in the early diagnosis of Sjögren's syndrome."

At the Sjögren’s Research Clinic Kathy (Moser) Sivils, Ph.D and her team are trying to understand what causes Sjogren’s syndrome and to develop new ways to treat the disease. 

Texas Tech University Health Sciences Center researchers have used new technology, derived from corneal epithelial stem cells, to treat dry eye disease.

At the National Institute of Biomedical Imaging and Bioengineering studies were done into swallowing:

1. Pioneering Gene Therapy for Dry Mouth: Ongoing clinical trial explores saliva-restoring gene transfer. 

2. Mimicking Mother Nature to Grow an Artificial Gland: video where researchers describe how they've achieved the first key step in growing a replacement gland.

The Garvan Institute continues to investigate the multiple factors that inform Sjögren’s syndrome and autoimmunity.

The British Society for Rheumatology is publishing new guidelines for the management of Sjögren’s syndrome. 

This guideline aims to address management in both adults and children and focuses specifically on the healthcare setting in the UK. It advises on best practice standard of care within the UK and covers the patient journey from initial presentation to diagnosis and long-term management, taking into account specifics such as UK access to drugs.

The Sjögren’s Foundation awarded four U.S. research projects focused on improving treatments for Sjögren’s syndrome.

The United Kingdom Primary Sjogren's Syndrome Registry (UKPSSR) is a national research biobank of patients diagnosed with Primary Sjogren's Syndrome.

The aim of this biobank is to facilitate clinical trials and academic research studies to improve our understanding of what causes Primary Sjogren's Syndrome and to find better, more effective treatment for patients with this condition.

The project is an initiative of the United Kingdom Sjogren's Interest Group (UKSIG) and funded by the Medical Research Council. FIND OUT MORE  HERE

Multiple clinical trials are currently being carried out testing the efficacy of different agents directed towards B-cells and T-cells as well as a variety of other topics. 

New therapeutic approaches and many drugs in the pipeline may provide hope for patients with Sjögren’s syndrome, according to a presenter at the 2021 Congress of Clinical Rheumatology-East.

“We are at a pretty exciting time for systemic Sjögren’s,”  Nancy L. Carteron, MD, associate clinical professor of rheumatology at the University of California, San Francisco, said in her presentation.

“The Sjögren’s field is behind lupus and RA with regard to understanding all the predisposing factors,” she said

“A lot of research is going on in understanding epithelial cells,” she added. Regarding autoantibodies, SSA (Ro), SSB (La), ANA (speckled), rheumatoid factor and muscarinic all may play a part in Sjögren’s syndrome.

Patients with this syndrome can have “a whole range of manifestations,” with roughly half of patients experiencing arthritis, arthralgias, skin or gastrointestinal involvement, according to Carteron. Raynaud’s phenomenon is “not uncommon,” occurring in up to 30% of patients, while a similar proportion of patients may experience pulmonary complications like interstitial lung disease, pericarditis or peripheral or small fiber neuropathy.

As for treatments for the broader systemic manifestations of Sjögren’s syndrome, Carteron highlighted the complicated story of rituximab. “It has not panned out in formal clinical trials, so it is not formally approved” in the U.S., she said. However, both EULAR and the British Society for Rheumatology support is use. “Internationally, this is a mainstay.”

Inhibiting T cell activation with drugs like abatacept may be the “next wave” of Sjögren’s treatment, according to Carteron. However, further data on this approach are needed.

Looking deeper into the pipeline, Carteron noted that the janus kinase (JAK)/signal transducer and activator of transcription (STAT) pathway is “on the radar,” as is Bruton's tyrosine kinase (BTK) signaling.

Researchers are also investigating various cytokines, according to Carteron. “There is a lot of activity in this area,” she said.

As for hydroxychloroquine, Carteron offered a realistic perspective. “It is an old drug, but don’t throw it out of your toolbox yet,” she said.

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