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干燥综合征当前临床状况综述:地域差异、分类/诊断标准、诊断方法的最新进展以及分子靶向治疗

A Review of the Current Clinical Aspects of Sjögren's Disease: Geographical Difference, Classification/Diagnostic Criteria, Recent Advancements in Diagnostic Methods, and Molecular Targeted Therapy.

作者信息

Horai Yoshiro, Kurushima Shota, Shimizu Toshimasa, Nakamura Hideki, Kawakami Atsushi

机构信息

Department of Rheumatology, Sasebo City General Hospital, Sasebo 857-8511, Japan.

Department of Immunology and Rheumatology, Division of Advanced Preventive Medical Sciences, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki 852-8523, Japan.

出版信息

J Clin Med. 2025 Aug 7;14(15):5577. doi: 10.3390/jcm14155577.

Abstract

Sjögren's Disease (SjD) is an autoimmune disorder characterized by sicca symptoms arising from impaired salivary and lacrimal gland function and accompanying extraglandular involvement. SjD is recognized as an illness of female dominance for which the 2002 American-European Consensus Group Classification Criteria and the American College of Rheumatology/European Alliance of Associations for Rheumatology 2016 classification criteria are utilized for inclusion in clinical trials, and treatment recommendations from countries belonging to the American College of Rheumatology or the European Alliance of Associations for Rheumatology are globally recognized. It is presumed that there are geographical differences among female sufferers, and unique diagnostic criteria and recommendations are used in clinical practice in Japan. In addition to the items included in the classification criteria, several methods to measure saliva secretion, serum biomarkers, and artificial intelligence tools have recently been reported to be useful for the assessment of SjD. While symptomatic therapies including tear drops, artificial saliva, and muscarinic agonists are still the mainstay for treating SjD, several kinds of molecular targeted drugs, such as biological drugs and Janus kinase inhibitors, that are expected to improve the prognosis of SjD have been tested in recent clinical trials.

摘要

干燥综合征(SjD)是一种自身免疫性疾病,其特征是唾液腺和泪腺功能受损导致的口干症状以及伴有腺体外受累。SjD被认为是一种女性主导的疾病,2002年美欧共识小组分类标准以及美国风湿病学会/欧洲风湿病联盟2016年分类标准被用于临床试验纳入,并且美国风湿病学会或欧洲风湿病联盟所属国家的治疗建议在全球得到认可。据推测,女性患者存在地域差异,日本临床实践中使用独特的诊断标准和建议。除了分类标准中包含的项目外,最近有报道称,几种测量唾液分泌、血清生物标志物的方法以及人工智能工具对干燥综合征的评估很有用。虽然包括眼药水、人工唾液和毒蕈碱激动剂在内的对症治疗仍然是治疗干燥综合征的主要方法,但几种有望改善干燥综合征预后的分子靶向药物,如生物药物和Janus激酶抑制剂,最近已在临床试验中进行了测试。

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