Open Access Rheumatology: Research and Reviews (Nov 2020)
Infections as Risk Factor of Sjögren’s Syndrome
Abstract
Suyud Warno Utomo,1,2 Jemima Fajarin Putri2 1Environmental Science Programme, Universitas Indonesia, Central Jakarta 10430, Indonesia; 2Department of Environmental Health Studies, Faculty of Public Health Universitas Indonesia, Depok, IndonesiaCorrespondence: Suyud Warno UtomoEnvironmental Science Programme, Universitas Indonesia, Building C (FKG UI), Fl. V-VI Jl. Salemba Raya No. 4, Central Jakarta 10430, IndonesiaTel +62 812 8788 0304Email [email protected]: Sjögren’s syndrome (SS) is an autoimmune disease targeting exocrine glands, leading to low body fluids production, especially on the salivary and lacrimal glands. Due to the low saliva and tear production, the common symptoms of Sjögren’s syndrome are dry eyes and dry mouth, later on leading to uncomfortable sensations on the eye surface, cornea destruction, dental caries, and oral cavity infections. Several infections are known to cause similar side-effects to Sjögren’s syndrome symptoms, including low saliva flow; therefore, infection is hypothesized as one of the risk factors of Sjögren’s syndrome.Results: Based on our literature research, there are several infectious agents which cause similar disease manifestations to Sjögren’s syndrome, including infections of hepatitis C virus, Epstein–Barr virus, cytomegalovirus, and human T-lymphotropic virus-1 (HTLV-1), and these four agents are found to cause persistent infection on the salivary gland after the first infection and later lead to organ destruction, thus causing sicca syndrome in the oral cavity. Other findings show possible Heliobacter pylori infection might lead on the increasing level of anti-Ro/SSA and anti-La/SSB of infected individuals.Conclusion: Some research has shown persistent infection could trigger autoimmune disorders due to continuous T-cells and B-cells activation in an attempt of infected cells eradication, leading to autoimmune reaction and high autoreactive cells concentration around the healthy cells causing the immune cells to eradicate the healthy cells nearby. However, the results in this literature study found persistent infection is not the only risk factor of Sjögren’s syndrome but there are various unknown factors that trigger infection to develop into Sjögren’s syndrome.Keywords: autoimmune diseases, Sjögren’s syndrome, infections, pathogens
