Fox R I
Department of Rheumatology, Scripps Clinic and Research Foundation, La Jolla, CA 92037, USA.
Curr Opin Rheumatol. 1995 Sep;7(5):409-16. doi: 10.1097/00002281-199509000-00008.
The literature published over the past year on Sjögren's syndrome is reviewed, including epidemiology, genetic, environmental, and clinical features. The criteria for the classification of Sjögren's syndrome remain controversial, potentially leading to confusion in clinical practice and in research publications. Dryness of the eyes and mouth can result from either interruption of the neurovascular innervation of the glands or from any infiltrative process that affects the ability of the glands to secrete. Recent studies have demonstrated that sicca symptoms also can result from autonomic neuropathy in patients with diabetes, multiple sclerosis, or systemic lupus erythematosus. It is suggested that the term Sjögren's syndrome be used to describe one subset of patients with sicca symptoms who exhibit particular major histocompatibility complex antigens, the presence of T cell lymphoid infiltrates on glandular biopsy, and specific autoantibodies in their sera. Even using these restrictive criteria for classification, no single environmental factor has been shown as necessary or sufficient for pathogenesis. Recent studies on Epstein-Barr virus have indicated a novel deleted virus in some Chinese Sjögren's syndrome patients. Other patients with sicca symptoms and autoimmune features may have infections with HIV or hepatitis C virus.
本文回顾了过去一年发表的关于干燥综合征的文献，包括流行病学、遗传学、环境因素和临床特征。干燥综合征的分类标准仍存在争议，这可能导致临床实践和研究出版物中的混乱。眼睛和口腔干燥可能是由于腺体神经血管支配中断，或任何影响腺体分泌能力的浸润性过程所致。最近的研究表明，糖尿病、多发性硬化症或系统性红斑狼疮患者的自主神经病变也可导致口干症状。建议使用干燥综合征这一术语来描述具有特定主要组织相容性复合体抗原、腺体活检显示T细胞淋巴浸润以及血清中存在特定自身抗体的口干症状患者的一个子集。即使使用这些严格的分类标准，也没有单一的环境因素被证明对发病机制是必要或充分的。最近关于爱泼斯坦-巴尔病毒的研究表明，一些中国干燥综合征患者中存在一种新型缺失病毒。其他有口干症状和自身免疫特征的患者可能感染了HIV或丙型肝炎病毒。
