Sjogren’s Syndrome: Dry Mouth and Dry Eye
The division is known for its research on Sjögren’s syndrome, an autoimmune disorder that affects between 1 and 4 million people in the United States, with nine times greater incidence in women than in men. It is characterized by a lymphocytic infiltration of salivary and lacrimal glands resulting in decreased tears and saliva, burning mouth, and the involvement of other organs and systems in the body.
Approximately 40% of patients have systemic involvement, which can include constitutional, lymphatic, cutaneous, pulmonary, muscular, CNS, PNS, hematologic and biologic. Patients experience long-term disease progression including lymphoma (5%), pulmonary fibrosis, and renal failure, resulting in increased morbidity.
Sjögren’s syndrome is a disease that attacks the body’s moisture-producing glands, causing tooth decay, gum disease, and other problems. Our research activities include the identification of biomarkers for the disease, research on the effect of omega 3 fatty acids on salivation, assessment of cognitive dysfunction associated with Sjögren’s syndrome, and we are conducting numerous FDA Phase II-IV clinical trials to identify potential therapeutic interventions.
Clinical Trial Participation
The division frequently recruits individuals for participation in its clinical trials. To learn about current trials:
Call 617-636-3931
Oral Medicine Clinic Appointments
Dry Eye and Dry Mouth Research Laboratory
Research Synopsis
Sjögren’s syndrome, a systemic inflammatory autoimmune disease which affects approximately 2 to 4 million American, mostly women, is the leading cause of aqueous-deficient dry eye and dry mouth syndromes. In Sjögren’s syndrome, cells of the immune system attack and destroy lacrimal and salivary gland acinar cells (the secretory cells), either directly or through the production of proinflammatory cytokines. To date, the mechanisms leading to acinar cell loss and the associated decline in lacrimal and salivary gland secretions leading to dry eye and dry mouth symptoms are still poorly understood.
Previous research from this laboratory investigated why the remaining acinar cells are not able to support normal exocrine functions during inflammation. The evidence gathered so far points to a pivotal role of proinflammatory cytokines, especially interleukin-1 (IL-1), in the impaired function of the lacrimal gland associated with inflammation. Specifically, it was found that IL-1 has a dual target in the lacrimal gland: the nerve endings (i.e., inhibition of neurotransmitter release) and the epithelial cells (i.e., inhibition of agonist-induced secretion) leading to insufficient secretion and symptoms of dry eye.
Recently, they discovered that myoepithelial cells in chronically inflamed lacrimal glands (from animal models of human Sjogren’s disease) are not able to contract in response to oxytocin stimulation thereby resulting in improper tears secretion. It was demonstrated, in vitro using cultured myoepithelial cells, that the addition of proinflammatory cytokines altered these cells’ structure and function, i.e., inhibited oxytocin-induced contraction.
Ongoing research in this laboratory aims to:
- Continue to elucidate the causes of insufficient production of tears and saliva with special emphasis on the autoimmune disease Sjögren’s syndrome.
- Characterize the intracellular mediators used by proinflammatory cytokines to alter myoepithelial cell’s structure and function.
- Study the impact of proinflammatory cytokines on the extracellular matrix produced by the myoepithelial cells.