Childhood Sjogren syndrome: insights from adults and animal models.

PURPOSE OF REVIEW: Sjogren syndrome is a chronic autoimmune disease affecting lacrimal and salivary glands that often is accompanied by extraglandular disease manifestations. Although common in adults, the prevalence and prognosis of childhood Sjogren syndrome are unknown, in part due to lack of child-specific diagnostic and classification criteria. This review discusses difficulties in diagnosing childhood Sjogren syndrome and highlights recent findings in Sjogren syndrome treatment and pathogenesis from studies in adults and animal models over the past 18 months. RECENT FINDINGS: Studies of rituximab show some therapeutic potential in adult Sjogren syndrome, whereas newer modalities including gene therapy and mesenchymal stem cell transfer are promising. The pathogenesis of Sjogren syndrome is emerging, including roles of T and B lymphocytes, autoantibodies, interferons, and glandular epithelial cells. Specific recent notable findings in Sjogren syndrome pathogenesis include identification of a type II interferon signature in salivary glands of Sjogren syndrome patients, characterization of salivary gland-infiltrating T-cell subsets, and characterization of antimuscarinic acetylcholine receptor type 3 autoantibodies. SUMMARY: Childhood Sjogren syndrome is a poorly defined and underdiagnosed autoimmune disease that requires child-specific criteria in order to study disease burden and prognosis. Studies in adults and animal models continue to elucidate new potential diagnostic and therapeutic targets, which may be relevant for childhood Sjogren syndrome. VIDEO ABSTRACT: http://links.lww.com/COR/A3.