Editing Sjögren's disease (section)

== Research ==
[[File:Carrie Ann Inaba.jpg|thumb| Singer-actress [[Carrie Ann Inaba]] is the national awareness ambassador and spokesperson for the Sjögren's Syndrome Foundation.]]
Research into multifactorial autoimmune diseases such as SS focuses on expanding the knowledge surrounding the disorder, improving diagnostic tools and finding ways to prevent, manage and cure the disorder. The [[United Kingdom]] Primary Sjögren's Syndrome Registry, a tissue [[biobank]] of samples taken for research, supported by the [[Medical Research Council (United Kingdom)|Medical Research Council, UK]], was established in 2010. It supports [[clinical trials]] and genetic studies of Sjögren's syndrome and is open to those wishing to participate in research studies and to researchers studying the disease.<ref name="ng">{{cite journal|last1=Ng|first1=W.-F.|last2=Bowman|first2=S. J.|last3=Griffiths|first3=B.|date=January 2011|title=United Kingdom Primary Sjogren's Syndrome Registry—a united effort to tackle an orphan rheumatic disease|journal=Rheumatology (Oxford)|volume=50|issue=1|pages=32–9|doi=10.1093/rheumatology/keq240|pmid=20693261|doi-access=free}}</ref>

As with other autoimmune diseases, susceptibility to Sjögren's disease is greatly influenced by the human leukocyte antigen.<ref name="ice">{{cite journal  |title=Genetics of Sjögren's syndrome in the genome-wide association era |journal=J. Autoimmun. |volume=39 |issue=1–2 |pages=57–63 |date=August 2012 |pmid=22289719 |doi=10.1016/j.jaut.2012.01.008 |pmc=3518871 |last1=Ice |first1=John A. |last2=Li |first2=He |last3=Adrianto |first3=Indra |last4=Lin  |first4=Paul Chee |last5=Kelly |first5=Jennifer A. |last6=Montgomery |first6=Courtney G. |last7=Lessard  |first7=Christopher J.  |last8=Moser  |first8=Kathy L.}}</ref> DQA1*05:01, DQB1*02:01, and DRB1*03:01 alleles were identified as [[risk factors]], while DQA1*02:01, DQA1*03:01 and DQB1*05:01 alleles were found to be protective factors for the disease.<ref>{{cite journal  |title=HLA and Sjögren's syndrome susceptibility. A meta-analysis of worldwide studies |journal=Autoimmun Rev |volume=11 |issue=4 |pages=281–7 |date=February 2012 |pmid=22001416 |doi=10.1016/j.autrev.2011.10.002 |last1=Cruz-Tapias |first1=Paola |last2=Rojas-Villarraga |first2=Adriana |last3=Maier-Moore |first3=Shannon |last4=Anaya |first4=Juan-Manuel}}</ref> The relationship between alleles and specific race was also established.<ref name="peri">{{cite journal |title=Sjögren's syndrome, the old and the new |journal=Best Pract Res Clin Rheumatol |volume=26 |issue=1 |pages=105–17 |date=February 2012 |pmid=22424197 |doi=10.1016/j.berh.2012.01.012 |last1=Peri |first1=Yogev |last2=Agmon-Levin |first2=Nancy |last3=Theodor |first3=Emanuel |last4=Shoenfeld |first4=Yehuda}}</ref> [[HLA-DQ2]] and [[HLA-B8]] are generally found in [[Caucasian race|Caucasian]] patients, while [[HLA-DR5]] is related to [[Greek people|Greek]] and [[Israelis|Israeli]] patients.<ref name="peri" /> Multiple [[genome-wide association study|genome-wide association scans]] may be conducted in the future to identify key risk variants.<ref name="ice" />

[[Virus]]es that have been associated with Sjögren's disease include human T-lymphotropic virus type 1 ([[HTLV-1]]), [[Epstein-Barr virus]] (EBV), [[human immunodeficiency virus]] (HIV), [[Hepatitis D|hepatitis delta virus]] (HDV) and [[hepatitis C virus]] (HCV).<ref name="peri" /><ref>{{cite journal |last1=Igoe |first1=Ann |last2=Scofield |first2=R. Hal |title=Autoimmunity and infection in Sjögren's syndrome |journal=Current Opinion in Rheumatology |date=July 2013 |volume=25 |issue=4 |pages=480–487 |doi=10.1097/BOR.0b013e32836200d2 |pmid=23719365 |pmc=4410971 }}</ref><ref>{{cite journal |last1=Weller |first1=Melodie L. |last2=Gardener |first2=Matthew R. |last3=Bogus |first3=Zoe C. |last4=Smith |first4=Michael A. |last5=Astorri |first5=Elisa |last6=Michael |first6=Drew G. |last7=Michael |first7=Donald A. |last8=Zheng |first8=Changyu |last9=Burbelo |first9=Peter D. |last10=Lai |first10=Zhennan |last11=Wilson |first11=Paul A. |last12=Swaim |first12=William |last13=Handelman |first13=Beverly |last14=Afione |first14=Sandra A. |last15=Bombardieri |first15=Michele |last16=Chiorini |first16=John A. |title=Hepatitis Delta Virus Detected in Salivary Glands of Sjögren's Syndrome Patients and Recapitulates a Sjögren's Syndrome-Like Phenotype in Vivo |journal=Pathogens and Immunity |date=23 May 2016 |volume=1 |issue=1 |pages=12–40 |doi=10.20411/pai.v1i1.72 |pmid=27294212 |pmc=4902173 |s2cid=13763999 |doi-access=free }}</ref>

Some research has shown that a paucity of [[vitamin A]] and [[vitamin D]] are associated with the disease.<ref name="peri" /> [[Vitamin D deficiency]] was found to be related to neurological manifestations and the presence of [[lymphoma]] among patients, but vitamin A levels were [[Inverse function|inversely]] associated with extraglandular manifestations of the disease.<ref name="peri" />

Saliva is a potential diagnostic tool for Sjögren's disease because the salivary component is changed after the onset of the disease.<ref name="liu">{{cite journal |title=Saliva: a potential media for disease diagnostics and monitoring |journal=Oral Oncol. |volume=48 |issue=7 |pages=569–77 |date=July 2012 |pmid=22349278 |doi=10.1016/j.oraloncology.2012.01.021 |last1=Liu |first1=Jingyi |last2=Duan |first2=Yixiang}}</ref> With the new [[miniaturization]] technology, called [[lab on a chip]], the diagnosis can be more convenient.<ref name="liu" />

Concerning therapeutics, multiple [[monoclonal antibodies]] were under investigation in 2007.<ref name="meijer">{{cite journal |title=The future of biologic agents in the treatment of Sjögren's syndrome |journal=Clin Rev Allergy Immunol |volume=32 |issue=3 |pages=292–7 |date=June 2007 |pmid=17992596 |pmc=2071970 |doi=10.1007/s12016-007-8005-6 |last1=Meijer |first1=Jiska M. |last2=Pijpe |first2=Justin |last3=Bootsma |first3=Hendrika |last4=Vissink |first4=Arjan |last5=Kallenberg |first5=Cees G. M.}}</ref> The most promising seemed to be the anti-[[CD20]] [[rituximab]] and the anti-[[CD22]] [[epratuzumab]], while the anti-[[TNF-α]] and [[IFN-α]] seemed less effective.<ref name="meijer" />

In 2014, the Sjögren's Foundation (previously the Sjögren's Syndrome Foundation) announced a five-year goal to halve the disease's average time to diagnosis.<ref>{{cite web |url=https://www.sjogrens.org/home/about-the-foundation/breakthrough-goal- |publisher=Sjögren's Syndrome Foundation |title="Breakthrough Goal" SSF Launches 5-Year Breakthrough Goal/"To shorten the time to diagnose Sjögren's by 50% in 5 years!" |date=August 2016 |url-status=live |archive-url=https://web.archive.org/web/20140813143225/https://www.sjogrens.org/home/about-the-foundation/breakthrough-goal- |archive-date=13 August 2014 }}</ref>