Department of Clinical Internal, Anesthesiological and Cardiovascular Sciences, Rheumatology Unit, Sapienza University of Rome, Italy.
Clin Exp Rheumatol. 2020 Jul-Aug;38 Suppl 126(4):237-244. Epub 2020 Oct 23.
Glucocorticoids (GCs) are involved in several physiological processes such as metabolism, water and electrolyte balance, growth, cardiovascular and cognitive functions, reproduction. Furthermore, they exert different effects on innate and adaptive immune cells. Due to their anti-inflammatory and immunosuppressive functions, these drugs are largely used for the treatment of inflammatory and autoimmune diseases. In comparison to other autoimmune rheumatic diseases, such as rheumatoid arthritis (RA) and systemic lupus erythematosus (SLE), to date no reliable evidence is available for the use of systemic GCs in Sjögren's syndrome (SS), which is still based on case reports, case studies, retrospective or prospective studies and a small number of randomised controlled trials (RCTs). Despite this gap in our knowledge, GCs are commonly used in SS for glandular, joint, cutaneous, lung, haematological, renal, neurological involvement. More recently, some sets of recommendations for the management of SS have provided a few pieces of advice regarding the use of GCs in this condition. Future studies should not neglect the role of GCs, as this traditional therapeutic weapon can still have a role in the management of SS. Accordingly, this review will address and discuss the use of systemic GCs in isolated or primary SS.
糖皮质激素（GCs）参与多种生理过程，如代谢、水和电解质平衡、生长、心血管和认知功能、生殖。此外，它们对先天和适应性免疫细胞有不同的作用。由于其抗炎和免疫抑制功能，这些药物被广泛用于治疗炎症性和自身免疫性疾病。与其他自身免疫性风湿病，如类风湿关节炎（RA）和系统性红斑狼疮（SLE）相比，迄今为止，尚无可靠证据支持在干燥综合征（SS）中使用全身性 GCs，目前仍基于病例报告、病例研究、回顾性或前瞻性研究和少数随机对照试验（RCT）。尽管我们对这一疾病的认识存在差距，但 GCs 仍常用于治疗 SS 的腺体、关节、皮肤、肺、血液、肾脏、神经受累。最近，一些关于 SS 管理的建议集就 GCs 在这种情况下的使用提供了一些建议。未来的研究不应忽视 GCs 的作用，因为这种传统的治疗武器在 SS 的管理中仍然可以发挥作用。因此，本综述将讨论和讨论在孤立性或原发性 SS 中使用全身性 GCs。
