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干燥综合征:我们在寻找什么以及在哪里寻找?

Sjögren syndrome: what and where are we looking for?

作者信息

de Paiva Cintia S, Rocha Eduardo Melani

机构信息

aDepartment of Ophthalmology, Baylor College of Medicine, Houston, Texas, USA bDepartment of Ophthalmology, Otorhinolaryngology and Head & Neck Surgery, School of Medicine at Ribeirao Preto, University of Sao Paulo, Ribeirao Preto, Sao Paulo, Brazil.

出版信息

Curr Opin Ophthalmol. 2015 Nov;26(6):517-25. doi: 10.1097/ICU.0000000000000208.

Abstract

PURPOSE OF REVIEW

Sjögren's syndrome affects exocrine glands leading to a dry mouth and dry eyes. Dry eye manifestations can precede the diagnosis of Sjögren's syndrome by many years. Innumerous spontaneous and inducible Sjögren's syndrome models have been used to study the pathogenesis of Sjögren's syndrome. This review focuses on recent human data, ocular and extraglandular manifestations of animal models, what is known, what is still unknown and how we need to look, and their correlation correspondence to human disease.

RECENT FINDINGS

Hallmarks of dry eye in Sjögren's syndrome include increased corneal staining, goblet cell loss and low tear volume. Confocal microscopy and impression cytology are able to clarify new markers of the ocular disease. Extraglandular manifestations should be an alert more severe complications in the eye. Some models have strong sex and exocrine gland predilection, whereas aging generally worsens the disease phenotype. Although most models do not display a significant increase in corneal staining or tear secretion impairment, conjunctival infiltration and decrease in goblet cells are frequently seen.

SUMMARY

We have seen great advances in the role of inflammation in ocular, oral and extra-glandular manifestations of Sjögren's syndrome. Several mechanisms and mediators of Sjögren's syndrome have been elucidated in animal model studies.

摘要

综述目的

干燥综合征会影响外分泌腺,导致口干和眼干。干眼表现可能在干燥综合征诊断前数年就已出现。众多自发和诱导性干燥综合征模型已被用于研究干燥综合征的发病机制。本综述聚焦于近期的人类数据、动物模型的眼部和腺体外表现、已知和未知的内容、我们需要如何观察,以及它们与人类疾病的相关性。

最新发现

干燥综合征干眼的特征包括角膜染色增加、杯状细胞丢失和泪液量减少。共聚焦显微镜检查和印片细胞学能够明确眼部疾病的新标志物。腺体外表现应警示眼部出现更严重的并发症。一些模型具有强烈的性别和外分泌腺偏好,而衰老通常会使疾病表型恶化。尽管大多数模型的角膜染色或泪液分泌受损没有显著增加,但结膜浸润和杯状细胞减少却很常见。

总结

我们已经看到炎症在干燥综合征的眼部、口腔和腺体外表现中的作用取得了巨大进展。动物模型研究已经阐明了干燥综合征的几种机制和介质。

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