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Therapeutic Advances in Musculoskeletal... 2020To systematically review the diagnostic accuracy of salivary gland ultrasound in primary Sjögren's syndrome (pSS). (Review)
Review
BACKGROUND
To systematically review the diagnostic accuracy of salivary gland ultrasound in primary Sjögren's syndrome (pSS).
METHODS
PubMed, Embase, CINAHL, Cochrane Central and Scopus and ClinicalTrials.gov were searched to identify diagnostic or validation studies in patients with pSS meeting the diagnostic criteria. A diagnostic test meta-analysis was performed using a bivariate model to calculate the pooled sensitivity, specificity, positive/negative likelihood ratios, and the diagnostic odds ratio. Meta-regression analyses were done for several pSS covariates.
RESULTS
Sixty-five studies met our criteria for the qualitative review. Fifty-four studies with a total of 6087 patients were included in the meta-analysis. Pooled sensitivity for salivary gland ultrasound was 80% [95% confidence interval (CI): 77-83%; = 78%], and specificity was 90% (95% CI: 87-92%; = 76%). The pooled positive and negative likelihood ratios were 8 (95% CI: 6.4-10) and 0.22 (95% CI: 0.19-0.25), respectively. The corresponding pooled diagnostic odds ratio (DOR) was 37 (95% CI: 28-48). Separate meta-regression models resulted in similar diagnostic estimates: (a) adjusted for mean age: sensitivity 81% (95% CI:77-84%; = 99%) and specificity 90% (95% CI: 87-93%; I = 99%); (b) adjusted for mean disease duration, sensitivity 79% (95% CI:72-84%; = 99%), and specificity 90% (89-94%; = 99%). The diagnostic estimates were robust to sensitivity analyses by quality criteria, pSS diagnostic criteria and ultrasound scoring systems.
CONCLUSION
Salivary gland ultrasound is a valuable modality for the diagnosis of Sjögren's syndrome. It is plausible that salivary gland ultrasound can be used as an important criterion for the diagnosis of pSS.
PubMed: 33281953
DOI: 10.1177/1759720X20973560 -
International Journal of Chronic... 2015Both central (CNS) and peripheral nervous system (PNS) complications are frequent and varied in connective tissue diseases. A systematic review was conducted between... (Review)
Review
A Systematic Review of Peripheral and Central Nervous System Involvement of Rheumatoid Arthritis, Systemic Lupus Erythematosus, Primary Sjögren's Syndrome, and Associated Immunological Profiles.
Both central (CNS) and peripheral nervous system (PNS) complications are frequent and varied in connective tissue diseases. A systematic review was conducted between 1989 and 2014 in the databases Medline, Scopus, and Cochrane Library using the search terms, peripheral and central nervous complications and immunological profiles, to identify studies in specific connective tissue disorders such as rheumatoid arthritis, systemic lupus erythematosus, and primary Sjögren's syndrome. A total of 675 references were identified, of which 118 were selected for detailed analysis and 22 were included in the final review with a total of 2338 participants. Our search focused only on studies upon connective tissue disorders such as rheumatoid arthritis, systemic lupus erythematosus, and primary Sjögren's syndrome associated with seroimmunological data. The reported prevalence of CNS involvement ranges from 9 to 92% across the reported studies. However, the association between CNS and PNS manifestations and seroimmunological profiles remains controversial. Τo date, no laboratory test has been shown as pathognomonic neither for CNS nor for PNS involvement.
PubMed: 26688829
DOI: 10.1155/2015/910352 -
BMC Complementary and Alternative... Feb 2018Saliva is fundamental to our oral health and our well-being. Many factors can impair saliva secretion, such as adverse effects of prescribed medication, auto-immune... (Review)
Review
BACKGROUND
Saliva is fundamental to our oral health and our well-being. Many factors can impair saliva secretion, such as adverse effects of prescribed medication, auto-immune diseases (for example Sjögren's syndrome) and radiotherapy for head and neck cancers. Several studies have suggested a positive effect of acupuncture on oral dryness.
METHODS
Pubmed and Web of Science were electronically searched. Reference lists of the included studies and relevant reviews were manually searched. Studies that met the inclusion criteria were systematically evaluated. Two reviewers assessed each of the included studies to confirm eligibility and assessing the risk of bias.
RESULTS
Ten randomized controlled trials investigating the effect of acupuncture were included. Five trials compared acupuncture to sham/placebo acupuncture. Four trials compared acupuncture to oral hygiene/usual care. Only one clinical trial used oral care sessions as control group. For all the included studies, the quality for all the main outcomes has been assessed as low. Although some publications suggest a positive effect of acupuncture on either salivary flow rate or subjective dry mouth feeling, the studies are inconclusive about the potential effects of acupuncture.
CONCLUSIONS
Insufficient evidence is available to conclude whether acupuncture is an evidence-based treatment option for xerostomia/hyposalivation. Further well-designed, larger, double blinded trials are required to determine the potential benefit of acupuncture. Sample size calculations should be performed before before initiating these studies.
Topics: Acupuncture Therapy; Humans; Randomized Controlled Trials as Topic; Saliva; Treatment Outcome; Xerostomia
PubMed: 29439690
DOI: 10.1186/s12906-018-2124-x -
Eye (London, England) Dec 2021Dry eye disease (DED) is one of the most common conditions presenting to eye care providers and is increasingly recognized to have poor outcomes on quality of life,... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Dry eye disease (DED) is one of the most common conditions presenting to eye care providers and is increasingly recognized to have poor outcomes on quality of life, activities of daily living, and social and emotional well-being. Here, we aim to understand the association between dry eye symptoms and workplace productivity experienced by patients with non-Sjögren's dry eye and Sjögren's Syndrome.
METHODS
MEDLINE, PubMed, Embase, Cochrane Library, CINAHL, Healthstar, and PsycINFO were searched from inception to May 2019.
RESULTS
Thirty-one studies consisting of 50,446 study participants from 14 countries were included in this systematic review. Among non-Sjögren's dry eye patients, there was significant absenteeism (ES = 0.19; 95% CI: [0.04, 0.35]), presenteeism (ES = 0.25; 95% CI: [0.15. 0.35]), productivity impairment (ES = 0.24; 95% CI: [0.20, 0.27]), activity impairment (ES = 0.30; 95% CI: [0.21, 0.38]), and subjective difficulties at work (ES = 0.58; 95% CI: [0.40, 0.75]). Patients with Sjögren's Syndrome demonstrated significant absenteeism (ES = 0.13, 95% CI: [0.10, 0.17]), presenteeism (ES = 0.28, 95% CI: [0.24, 0.32]), productivity impairment (ES = 0.31, 95% CI: [0.27, 0.35]), and activity impairment (ES = 0.39, 95% CI: [0.32, 0.47]) in the workplace. In addition, patients with Sjögren's Syndrome demonstrated significantly lower employment rate (ES = 0.42, 95% CI: [0.34, 0.50]), decreased number of hours worked (SMD = -0.21, 95% CI: [-0.39, -0.02]), and increased work disability (ES = 0.18; 95% CI: [0.09, 0.27]).
CONCLUSIONS
This is the first systematic review and meta-analysis to demonstrate the negative association between DED and several work productivity measures.
Topics: Activities of Daily Living; Dry Eye Syndromes; Humans; Quality of Life; Sjogren's Syndrome
PubMed: 33479487
DOI: 10.1038/s41433-020-01282-3 -
Oral Diseases May 2023The association of OLP with other autoimmune processes points to the possibility that OLP-affected patients are actually developing an autoimmune status that predisposes... (Meta-Analysis)
Meta-Analysis Review
OBJECTIVES
The association of OLP with other autoimmune processes points to the possibility that OLP-affected patients are actually developing an autoimmune status that predisposes them to autoaggression against different targets. This systematic review and meta-analysis aim to evaluate the current evidence on the prevalence of autoimmune disorders in patients with OLP and their magnitude of association.
METHODS
We searched PubMed, Embase, Web of Science, Scopus databases for the studies published before May 2021, with no limitation in regards to their publication date or language. We evaluated the quality of studies, carried out meta-analyses and performed heterogeneity, subgroups, meta-regression, and small-study effects analyses.
RESULTS
Inclusion criteria were met by 153 studies (23,327 patients). Our results indicate the existence of high prevalence and a frequent association between OLP and some autoimmune disorders, especially in regards to thyroid disease (PP = 7.96%, 95% CI = 6.32-9.75; OR = 1.99, 95% CI = 1.60-2.49, p < 0.001) and diabetes mellitus (PP = 9.41%,95% CI = 8.16-10.74; OR = 1.64, 95% CI = 1.34-2.00, p < 0.001).
CONCLUSIONS
Our study demonstrates the existence of a comorbidity between autoimmune thyroid diseases as well as between diabetes mellitus and OLP respectively. Quality of evidence should be upgraded on other autoimmune diseases (fibromyalgia, gastrointestinal disorders, rheumatic diseases, Sjogren's syndrome, lupus erythematosus, and dermatological diseases) for which the current data do not allow us to know whether they are really associated with OLP.
Topics: Humans; Lichen Planus, Oral; Autoimmune Diseases; Sjogren's Syndrome; Lupus Erythematosus, Systemic; Databases, Factual
PubMed: 35000260
DOI: 10.1111/odi.14127 -
Clinical Rheumatology Sep 2022CXCL13 levels have been reported to be elevated in primary Sjögren's syndrome (pSS) patients. This study investigated alterations involving the CXCL13/CXCR5 axis in pSS... (Meta-Analysis)
Meta-Analysis
OBJECTIVES
CXCL13 levels have been reported to be elevated in primary Sjögren's syndrome (pSS) patients. This study investigated alterations involving the CXCL13/CXCR5 axis in pSS patients and explored the correlation between CXCL13 expression and disease severity.
METHODS
Six databases, including PubMed, Web of Science, Embase, Ovid Medline, China National Knowledge Infrastructure, and Wanfang, were searched. The quality of the included studies was assessed using the Newcastle-Ottawa Scale criteria. We analyzed CXCL13 concentrations in the serum and saliva of pSS patients and healthy controls (HCs). Next, we analyzed the percentage of CXCR5CD4 T cells among CD4 T cells in pSS patients and HCs. Correlations between CXCL13 levels and serological, clinical, and histological parameters of patients were also assessed. Publication bias was determined using funnel plots and Egger's test.
RESULTS
Twenty-three articles were included; of these, 14 studies reported CXCL13 levels, and 5 reported CXCR5CD4 T cell count of pSS patients and HCs. Nine articles covering 32 studies reported correlations between serum CXCL13 levels and serological, clinical, and histological parameters in pSS patients. Expressions of CXCL13 and CXCR5CD4 T cell count were significantly increased in pSS patients compared with those in HCs. There was a positive correlation between CXCL13 levels and serum IgG levels, disease activity indices, and focus score in minor salivary gland biopsy of patients.
CONCLUSIONS
CXCL13 abundance was evidently elevated in pSS patients and correlated with disease activity and can therefore probably be employed as a robust biomarker to monitor and diagnose pSS. Key Points • Serum CXCL13 is significantly elevated in primary Sjögren's syndrome patients. • CXCL13 level correlates with disease severity and activity of primary Sjögren's syndrome. • CXCL13 can probably be used as a robust biomarker to monitor and diagnose primary Sjögren's syndrome.
Topics: Biomarkers; Chemokine CXCL13; China; Humans; Saliva; Salivary Glands, Minor; Sjogren's Syndrome
PubMed: 35616754
DOI: 10.1007/s10067-022-06210-2 -
Frontiers in Immunology 2023Sjögren's syndrome (SS) is a systemic autoimmune disease, which affects the exocrine glands leading to glandular dysfunction and, particularly, symptoms of oral and...
INTRODUCTION
Sjögren's syndrome (SS) is a systemic autoimmune disease, which affects the exocrine glands leading to glandular dysfunction and, particularly, symptoms of oral and ocular dryness. The aetiology of SS remains unclear, and the disease lacks distinctive clinical features. The current diagnostic work-up is complex, invasive and often time-consuming. Thus, there is an emerging need for identifying disease-specific and, ideally, non-invasive immunological and molecular biomarkers that can simplify the diagnostic process, allow stratification of patients, and assist in monitoring the disease course and outcome of therapeutic intervention in SS.
METHODS
This systematic review addresses the use of proteomics and miRNA-expression profile analyses in this regard.
RESULTS AND DISCUSSION
Out of 272 papers that were identified and 108 reviewed, a total of 42 papers on proteomics and 23 papers on miRNA analyses in saliva, blood and salivary gland tissue were included in this review. Overall, the proteomic and miRNA studies revealed considerable variations with regard to candidate biomarker proteins and miRNAs, most likely due to variation in sample size, processing and analytical methods, but also reflecting the complexity of SS and patient heterogeneity. However, interesting novel knowledge has emerged and further validation is needed to confirm their potential role as biomarkers in SS.
Topics: Humans; Sjogren's Syndrome; MicroRNAs; Proteomics; Saliva; Biomarkers
PubMed: 37275849
DOI: 10.3389/fimmu.2023.1183195 -
The Laryngoscope Jul 2021This study is a systematic review of the literature which seeks to estimate the expected treatment outcomes of a patient with Sjogren's syndrome (SS) undergoing... (Meta-Analysis)
Meta-Analysis
OBJECTIVES/HYPOTHESIS
This study is a systematic review of the literature which seeks to estimate the expected treatment outcomes of a patient with Sjogren's syndrome (SS) undergoing therapeutic sialendoscopy.
STUDY DESIGN
Systematic Review.
METHODS
PubMed, Scopus, and Cochrane library databases were used to search for studies published as of August 2020 regarding the treatment outcomes of SS with sialendoscopy. The key search terms included "Sjogren's syndrome" and "sialendoscopy." Only studies in the English language involving more than one human patient were included. PRISMA guidelines were followed in study inclusion and data extraction. The primary outcome assessed was improvement in patient symptoms.
RESULTS
Six studies met criteria and were analyzed in this review, including 125 patients undergoing sialendoscopy of parotid and/or submandibular glands as well as 25 controls. Of these patients, 90% were female with an age range of 18 to 79 years. There was significant diversity in outcome reporting tools. The outcomes of symptom improvement were pooled qualitatively based on improvement noted in each study. Outcomes were defined as partial improvement if the measured outcomes improved and complete improvement if measured outcomes resolved entirely. Despite the limited number of studies on this topic, this meta-analysis suggests that a similar study of therapeutic sialendoscopy could expect to provide at least temporary improvement of symptoms 90% to 99% of the time.
CONCLUSIONS
This review provides support for the application of sialendoscopy in the treatment of SS salivary disease. Larger studies with consistent outcome reporting tools and control groups are needed to validate these results and provide a consistent therapy protocol. Laryngoscope, 131:1474-1481, 2021.
Topics: Case-Control Studies; Endoscopy; Humans; Salivary Glands; Severity of Illness Index; Sialadenitis; Sjogren's Syndrome; Treatment Outcome
PubMed: 33141438
DOI: 10.1002/lary.29233 -
Scandinavian Journal of Immunology Apr 2018The aberrant expression of interleukin-17 (IL-17) has been reported in primary Sjögren's syndrome (pSS). Abnormalities in IL-17 can promote the production of... (Meta-Analysis)
Meta-Analysis Review
The aberrant expression of interleukin-17 (IL-17) has been reported in primary Sjögren's syndrome (pSS). Abnormalities in IL-17 can promote the production of pro-inflammatory cytokines and aggravate autoimmune disorders. The aim of this study was to investigate alterations of IL-17 in patients with pSS and explore the correlation between IL-17 and disease severity. Eight databases were searched for original studies reporting the expression of IL-17 in patients with pSS and controls. Eligible reports were included in the pooled analysis, and subgroup evaluations were performed according to different types of controls and IL-17 measurement methods. Newcastle-Ottawa Scale criteria were used to assess the risk of bias of the included studies. In total, 45 articles are included in the meta-analysis. The expression of IL-17 is significantly increased in patients with pSS compared to controls. Furthermore, patients with pSS without immunosuppressive treatment show markedly higher IL-17 levels. In addition, patients with pSS with positive rheumatoid factors tend to express a higher level of IL-17 than patients with negative rheumatoid factors. Negative correlations between IL-17 levels and ocular parameters are also found in patients with pSS. The results are similar after adjustment by "trim and fill" methods. In conclusion, the expression of IL-17 is obviously increased in patients with pSS, especially among those without immunosuppressive treatment. In addition, IL-17 level correlates with the disease severity of pSS. These findings demonstrate the significance of IL-17 overexpression in patients with pSS and may provide insights for the development of therapeutic interventions targeting IL-17 for pSS.
Topics: Humans; Immunosuppression Therapy; Interleukin-17; Rheumatoid Factor; Saliva; Salivary Glands; Sjogren's Syndrome; Tears
PubMed: 29476557
DOI: 10.1111/sji.12649 -
Clinical and Experimental Rheumatology 2015Several chronic inflammatory disorders, such as rheumatoid arthritis and systemic lupus erythematosus, have been linked to an increased risk of venous thromboembolism... (Meta-Analysis)
Meta-Analysis Review
OBJECTIVES
Several chronic inflammatory disorders, such as rheumatoid arthritis and systemic lupus erythematosus, have been linked to an increased risk of venous thromboembolism (VTE). However, the data on Sjögren's syndrome (SS) remain unclear. This study aimed to investigate this association.
METHODS
We conducted a systematic review and meta-analysis of observational studies that reported odds ratio, relative risk, hazard ratio or standardised incidence ratio comparing risk of VTE in patients with SS versus non-SS subjects. Pooled risk ratio and 95% confidence intervals were calculated using a random-effect, generic inverse variance method of DerSimonian and Laird.
RESULTS
Out of 306 potentially relevant articles, four eligible studies were identified and included in the data analysis. The pooled risk ratio of VTE in patients with SS was 2.05 (95% CI, 1.86-2.27). The statistical heterogeneity of this study was insignificant with an I2 of 0%.
CONCLUSIONS
Our study demonstrated a statistically significant increased VTE risk among patients with SS.
Topics: Chi-Square Distribution; Humans; Odds Ratio; Prognosis; Risk Assessment; Risk Factors; Sjogren's Syndrome; Venous Thromboembolism
PubMed: 26087815
DOI: No ID Found