Taking Charge of Your Health

Sjogren’s syndrome, named after Dr. Henrik
Sjogren who first identified it, is a common autoimmune disorder, typically occurring in
women. In Sjogren’s syndrome, the body’s immune
cells go rogue and start attacking various exocrine glands, which are glands that pour
their secretions into a duct; most commonly the salivary glands and the lacrimal, or tear,
glands. Normally, the cells of the immune system are
ready to spot and destroy anything foreign pathogens that could cause the body harm. Immune cells called antigen-presenting cells,
which include macrophages and dendritic cells, latch onto pathogens and engulf them – literally
swallowing them up. Pieces of the pathogen called antigens are
then presented on a major histocompatibility complex class II molecule, or MHC-class II
molecule – which is like a serving platter for antigens. An antigen presenting cell then searches for
a T cell that can bind to the antigen. Once found, binding to the antigen helps activate
this T cell, which then releases proinflammatory cytokines, or signaling molecules, that recruit
more immune cells – ultimately leading to inflammation. The exact cause for Sjogren’s syndrome is
unknown, but it seems to be related to both genetic and environmental factors. Genetic factors include genes which code for
specific types of MHC class II molecules, called human leukocyte antigen, or HLA genes. Specifically HLA- DRW52, HLA- DQA1, or HLA-
DQB1. Environmental factors include an infection
of exocrine glands like the salivary and lacrimal glands. Infections can damage the cells of the salivary
gland, and expose their cell components, including their DNA, RNA, and histones to circulating
immune cells. These cell components get picked up by antigen-presenting
cells, and presented to T-cells. In individuals with Sjogren’s syndrome, a
T cell gets inappropriately activated by these nuclear components, and considers them to
be foreign nuclear antigens. The T-cells then activate B-cells, which start
producing anti-nuclear antibodies, or ANAs, which are antibodies against the nuclear antigens. Two types of ANA formed in Sjogren’s syndrome
are anti- SS-A and anti- SS-B antibodies, which are formed against the ribonucleoproteins
SS-A and SS-B. Then, both T-cells and antibodies enter the circulation and reach the exocrine
glands, where the T-cells secrete cytokines to recruit more immune cells and promote inflammation
of the exocrine gland tissue. The cytokines also activate fibroblasts in
the tissue, which then produce fibrous tissue that replaces the damaged tissue. The end result is a loss secretory cells in
the glands. Sjogren syndrome can be primary and occur
alone – and in that situation it’s called sicca syndrome. Alternatively it can be secondary, which is
when it occurs along with other autoimmune diseases like rheumatoid arthritis. Symptoms of Sjogren’s syndrome usually present
in middle aged women, and are due to dryness of various body surfaces. When the lacrimal gland is involved, it leads
to keratoconjunctivitis, which is the inflammation and ulceration of the cornea and conjunctiva. This causes dryness of eyes, leading to blurring
of vision, itching, redness and burning of the eyes. When the salivary glands are involved, it
leads to xerostomia, or dryness of mouth, difficulty in tasting and swallowing, and
cracks and fissures in the mouth. In the nose and respiratory passages, it causes
ulceration and perforation of the nasal septum, which can lead to crusting and bleeding. When it affects the larynx, it can lead to
difficulty speaking. In some people there may also be dryness of
the skin and vagina. There’s also swelling of the glands, which
can compress nearby structure like nerves, and cause pain. Finally, the dryness of epithelial linings
can also make infections more likely. Diagnosis of Sjogren’s syndrome is based
on a decrease in exocrine glands secretions, for example, sialometry can be done to measure
the saliva flow. Blood tests often show the presence of anti-
SS-A and anti- SS-B antibodies. A confirmatory test is a lip biopsy to examine
the minor salivary glands, which will show extensive lymphocytic infiltrate, especially
CD4+ T- cells, plasma cells, and macrophages; and thickening of the inner duct wall. Treatment of Sjogren’s syndrome typically
involves medications to suppress the immune response, like corticosteroids; and also medications
which increase the exocrine secretions like pilocarpine. All right, as a quick recap, Sjogren’s syndrome
is caused by autoimmune destruction of the exocrine glands, most commonly the salivary
and lacrimal glands, often following an infection. Antinuclear antibodies, typically anti- SSA
and anti- SSB antibodies cause destruction of the secretory cells in the exocrine glands,
resulting in dry eyes and mouth.

57 thoughts on “Sjogren’s syndrome

  1. hate to ask but if you do take certain requests, may you help explain psoriasis?

    anyways, i loved the video and helped broaden my horizon on pathology and medical knowledge.

  2. Great vid! I thought the immmune introduction was a bit too drawn out and had to skip ahead to half the video before even knowing what this syndrome can cause. Perhaps it would be better to give an idea what it can cause in the first board where you introduced what it affects and its autoimmune nature. Great video, love how you guys are contributing to science communication! (:

  3. I'd like to see him explain chronic fatigue syndrome. It's something I have and it's hard to explain to people because the symptoms are vague but also because it's not something medical professionals really think of.

  4. OK, I have never heard of this before now and don't known anyone who has suffered from this particular syndrome; I just found this mentioned here on Youtube; by someone afflicted by this, on a thread regarding a vid about Chernobyl. Anyway, I appreciate the simple educational animation style; very informative. I do suffer from a different form of autoimmune disorder, however, and I know of many people who suffer from other forms as well. There has been a drastic rise in these disorders since 1980; perhaps there are environmental factors triggering or exacerbating these issues? I know that this time is when mod-gen food products first began to be introduced into public consumption; but of course -that ship has already sailed…

  5. I liked the video as soon as I started watching it. By the end where the nice guy introduced the others thanking them, I looked around on the page wondering whether there is a way to express a super-like. I had that in my head seriously for around 2 seconds before I notice how weird was this. Thank you guys.

  6. I wanna get answers

    My patoid glands swell when eating pizza dough sometimes

    Insomnia fatigue

    Dry eyes
    Dry nose
    Dry skin rashes dry scalp
    Mouth only dry waking or anxious

    Ana speckled
    Igg4 elevated
    Schriemers positive no tears
    Ssa ssb negative
    Lip biopsy 1 negative
    Second one negative but low grade inflammation now wanna do another one more tissue

    I hate this I took accutane a decade ago it did all this
    So idk if it’s poison or sjorgens

  7. I have Sjogren's. It's a horrible disease. There is far more to it than just dry eyes and mouth. This disease also likes to eat hearts, lungs and livers. Joint pain and swelling. Chronic gut issues from stomach to toilet. Not to mention the huge increase in non-hodgkins b-cell lymphoma. There is a lot of info left out of this video and it's all the stuff that I usually have to educate MD's on in the emergency room or doctors office. It would be nice to see these autoimmune diseases explained a little more thoroughly. It's exhausting explaining to medical professionals the disease I have.

  8. I've had Sjogren's Syndrome for about 15 years. Was only diagnosed about 5 years ago. You can follow my story on my channel.

  9. Haven’t come to mention Schirmer’s test which is a good diagnostic tool and; can be an area of questions in different exams!

  10. Please, correct that sicca syndrome is not the same as primary sjorgrens syndrome (big difference). Sicca syndrome just means dry and there is no evidence of autoinmune response.

  11. I have suffered with chronic dry eyes as a result of Sjögren syndrome and have been on several prescription meds, nearly every over the counter eyedrops that I could get my hands on as well as lots of home remedies. I am on Restasis and Xiidra one of each drop in the morning and at night and because of several eye infections due to dry eye, I was on Lotomax for a month at a time and 1 a day Apo-Doxy 100 ml Doxycycline Hyclate for months. I recently found an over the counter night time eye drop that I'm using with the Restasis and Xiidra and the one a day antibiotic andI am having amazing success. TheraTears Nighttime Dry Eye Therapy- Lubricant Eye Gel- Preservative Free. I have not yet spoke with my optometrist about my success but I'm hoping that this eye drop with alleviate the reoccurring eye infection and that I will not need the one a day antibiotic.

    If you have dry eye, give TheraTears Nighttime Dry Eye Therapy- Lubricant Eye Gel- Preservative Free a try. I pray they give you relief.

  12. Sjogrens is so much more than this!! It can affect the major organs. I wish you would have included this in your video. Us Sjogrens sufferes are so tired of it being referred to as just dry eyes, mouth, and vagina.

  13. my wife was diagnosed with Sjogren syndrome last year. of all the horrible symptoms Joint

    pain, swelling and stiffness, Swollen salivary glands, Skin rashes, dry skin, Rheumatoid Arthritis, lupus, was also diagnosed of Asthma And lots more, she was given Hydroxychloroquine but wasn't helping her situation. it becomes worst each day. while surfing the internet, i saw people testifying about Dr Jude Herbal formula on how it helped them cure their sjogren disease. i quickly copied his email and whatsApp number. i contacted him and made my orders. it was delivered to us in three days. she was on his Herbal medication for three weeks after which she went for test, to our greatest surprised it came out negative. it been 9 months now, up till now she haven't gotten any symptoms. she went for another varieties of test last three months ago and the result came out to be negative again. all thanks to Dr JUDE HERBAL FORMULA. Visit DR JUDE NATURAL HERBS on [drjudenaturalherbs. blogspot. com]. or you can reach him via email [[email protected]] or reach him via whatsApp on 1860-532-0721.

  14. Sicca syndrome should be associated with other rheumatic disease such as Rheumatoid arthritis which falls in secondary SS but not as primary SS which is not connected with another rheuamtic disease!

  15. Great to see this video, and I love your style of presenting the information. After seeing how much detail you went into regarding cell biology, I was really disappointed that the only effect you covered was dryness. Unfortunately, Sjogren's Syndrome can cause a lot more problems than dryness alone. It would be great to see an update to this video covering the extreme fatigue, damage to internal organs and neuropathy too.

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