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Sjögren syndrome, a systemic autoimmune disease that is characterized by dry mouth and eyes, on which treatment decision remain challenging, while traditional Chinese medicine ( TCM) has advantages and is widely used in China. However, the lack of consensus on standardized TCM patterns diagnosis and treatment based on evidence-based evidence, limits the further improvement of clinical efficacy and scientific research level. Rheumatology Branch, Chinese Academy of Chinese Medicine organized more than 50 experts from 48 hospitals across the country to form Expert Consensus for TCM Patterns of Sjögren Syndrome: (ⅰ) pattern of yin deficiency and depletion of fluid; (ⅱ) pattern of deficiency of both qi and yin; (ⅲ) pattern of endogenous heat due to yin deficiency ( pattern of yin deficiency and heat-poison, included); (ⅳ) pattern of intermingled dryness and blood stasis; (ⅴ) pattern of intermingled dryness and dampness. According to the patterns, principles of treatment and prescriptions are also on the same page. The formation and promotion of this consensus is of importance in the TCM course of diagnosis and treatment of Sjögren syndrome. [ABSTRACT FROM AUTHOR]

Exposure to endocrine-disrupting chemicals (EDCs) has been linked to various immune deficiency disorders, including autoimmune diseases like Sjögren Syndrome (SjS). However, the detrimental effects of exposure to EDCs, including bisphenols, parabens, and triclosan (TCS), on SjS have been inadequately documented. Thus, we conducted a cross-sectional study that included both healthy individuals (controls) and patients with SjS (cases). We assessed serum concentrations of bisphenol A (BPA), bisphenol S (BPS), methyl parabens (MeP), ethyl parabens (EtP), and TCS. The relationship between the five EDCs levels and the risk of SjS was also explored. Additionally, we conducted an in-depth analysis of the collective influence of these EDCs mixtures on SjS, employing a weighted quantile sum regression model. Out of the five EDCs analyzed, EtP displayed the highest mean concentration (2.80 ng/mL), followed by BPA (2.66 ng/mL) and MeP (1.99 ng/mL), with TCS registering the lowest level (0.36 ng/mL). Notably, BPS exposure was significantly positively associated with the risk of being diagnosed with SjS (with an odds ratio [OR] of 1.17, p = 0.042). No statistically significant associations with SjS were observed for BPA, MeP, EtP, and TCS (p > 0.05). And we did not observe any significant effects of the EDCs mixture on SjS. To the best of our knowledge, this study is the first to suggest that BPS may potentially increase the risk of SjS. Although no significant effects were observed between other EDCs and SjS risk, we cannot disregard the potential harm of EDCs due to their non-monotonic dose response., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier B.V. All rights reserved.)

Organophosphate esters (OPEs) are widely used as flame retardants and plasticizers due to their excellent properties. The interference of OPEs on immune function has been proven, but the epidemiological data on OPEs exposure to related immune function diseases, such as sjögren syndrome (SjS), is limited. In cross-sectional study, 283 serum samples were collected from healthy individuals (n = 145) and patients with SjS (n = 138) in Hangzhou, China. Eight OPEs, triethyl phosphate (TEP), tributyl phosphate (TBP), tris (2-chloroethyl) phosphine (TCEP), triphenyl phosphate (TPHP), tri (1-chloro-2-propyl) phosphate (TCIPP), 2-ethylhexyldi-phenyl phosphate (EHDPP), tris (1,3-dichloro-2-propyl) phosphate (TDCIPP), and tri (2-butoxyethyl) phosphate (TBOEP), were frequently measured in serum samples. In addition, we explored the associations between the serum OPEs concentration and the risk of SjS. Results showed that TEP (mean controls 2.17 and cases 3.63 ng/mL) was the most abundant OPEs in the serum samples of the control and case groups, followed by TCIPP (mean controls 0.54 and cases 0.78 ng/mL). Serum TEP, TPHP, and EHDPP concentrations were positively correlated with SjS [odds ratio (OR): 1.97, 1.96, and 2.42, respectively; 95% confidence interval (CI):1.34–2.89, 1.34–2.87, and 1.34–2.87, respectively] in the adjusted model, and a negative correlation of TBP concentrations with SjS in the adjusted model (OR: 0.35, 95% CI: 0.17–0.70) was observed. Compared with the lowest quartile concentrations, the ORs of SjS at the highest quartile concentrations of TEP (OR: 4.93, 95% CI: 2.24–10.82) and TPHP (OR: 4.75, 95% CI:1.89–11.94) were significantly higher. This study suggests that human exposure to OPEs may increase the risk of SjS. [Display omitted] • Distribution of OPEs in serum of Hangzhou population in China was studied. • TEP was the major OPE in all serum samples. • TEP, TPHP, and EHDPP levels were significantly associated with risk of SjS. • We firstly found that human exposure to OPEs may increase the risk of SjS. [ABSTRACT FROM AUTHOR]

Objective. SS is an autoimmune disease characterized by salivary and lacrimal gland dysfunction leading to dry mouth (xerostomia) and dry eyes (xerophthalmia). Anti-muscarinic acetylcholine type-3 receptor (anti-M3R) autoantibodies have been shown to be a good serum marker in primary SS (pSS). The aim of this study was to assess the clinical correlations of anti-M3R-derived peptide antibodies in patients with pSS.Methods. Sequences of the first to fourth cycle-M3R (c1M3R–c4M3R)-derived peptide was synthesized by a solid-phase technique on an Applied Biosytems Peptide Synthesizer. Synthesized cM3R peptide (cM3RP) was used as substrate in an ELISA to detect IgG anti-cM3RP antibodies in serum samples of patients and controls. The clinical and biological parameters of the diseases were also evaluated. The EULAR SS disease activity index (ESSDAI) score was used to measure disease activity in patients with primary SS.Results. (i) Anti-c2M3RP antibodies were highly prevalent in pSS patients, and the titre is much higher than anti-c1,3,4M3RP antibodies. (ii) The prevalence of anti-c2M3RP antibodies in pSS, SLE, RA and healthy controls was 62.2, 7.1, 5.3 and 1.6%, respectively. The prevalence of anti-linear-2-M3RP antibodies in pSS, SLE and RA patients and healthy controls were 56.1, 20.0, 14.7 and 9.4%. (iii) The specificity of anti-c2M3RP antibodies was 95.1%, much higher than that of linear polypeptide (84.7%) for pSS diagnosis. (iv) In pSS patients, anti-c2M3RP positivity had significantly increased frequency in patients who were RF or ANA positive, and had several haematological abnormalities, such as leucopenia, anaemia and thrombocytopenia. Furthermore, the ESSDAI score was significantly higher in anti-c2M3RP-positive pSS patients (P < 0.05).Conclusion. Anti-c2M3RP antibody was highly specific for patients with pSS. The presence of anti-c2M3RP antibody in pSS indicates that c2M3RP may act as an autoantigen that may play a role in the pathogenesis of pSS. [ABSTRACT FROM PUBLISHER]

This study aims to investigate the clinical and laboratory features of systemic lupus erythematosus (SLE) patients associated with Sjögren syndrome (SS) in China, as well as its similarities to and differences from SLE patients without SS. A group of 542 consecutive unselected SLE patients was recruited. Diagnosis of SLE was made according to 1997 revised American College of Rheumatology SLE criteria; SS was diagnosed using the American–European classification criteria. Clinical and laboratory parameters in SLE patients with SS (SLE-SS) were compared with those in SLE patients without SS (SLE-no SS). Overall, SS was identified in 35 SLE patients (6.5%); the onset of SS preceded the development of SLE in 17 of them (48.6%). Compared with the SLE-no SS group (35.8 ± 10.5 years), patients with SLE-SS (41.3 ± 11.6 years) were significantly older ( P = 0.003), had a higher frequency of anti-Ro/SSA, anti-La/SSB, and anti-dsDNA antibodies, but had a significantly lower frequency of renal involvement. This study demonstrates that SLE-SS may be a subgroup of patients with characteristic clinical and laboratory features. To improve the treatment outcomes in SLE-SS patients, more specific treatment should be applied based on those factors. [ABSTRACT FROM AUTHOR]