Cytokines as therapeutic targets in primary Sjögren syndrome

Primary Sjögren syndrome (SjS) is a systemic autoimmune disease that may affect 1 in 1000 people (overwhelmingly women) and that can be a serious disease with excess mortality due to severe organ-specific involvements and the development of B cell lymphoma; systemic involvement clearly marks the disease prognosis, and strongly suggests the need for closer follow-up and more robust therapeutic management. Therapy is established according to the organ involved and severity. As a rule, the management of systemic SjS should be organ-specific, with glucocorticoids and immunosuppressive agents limited to potentially-severe involvements; unfortunately, the limited evidence available for these drugs, together with the potential development of serious adverse events, makes solid therapeutic recommendations difficult. The emergence of biological therapies has increased the therapeutic armamentarium available to treat primary SjS. Biologics currently used in SjS patients are used off-label and are overwhelmingly agents targeting B cells, but the most recent studies are moving on into the evaluation of targeting specific cytokines involved in the SjS pathogenesis. The most recent etiopathogenic advances in SjS are shedding some light in the search for new highly-selective biological therapies without the adverse effects of the standard drugs currently used (corticosteroids and immunosuppressant drugs). This review summarizes the potential pharmacotherapeutic options targeting the main cytokine families involved in the etiopathogenesis of primary SjS and analyzes potential insights for developing new therapies. Fil: Retamozo, Maria Soledad. Laboratory of Autoimmune Diseases Josep Font; España. Hospital Privado Universitario de Córdoba; Argentina. Hospital Clínic de Barcelona; España. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Córdoba; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Córdoba. Instituto de Investigaciones en Ciencias de la Salud. Universidad Nacional de Córdoba. Instituto de Investigaciones en Ciencias de la Salud; Argentina Fil: Flores Chavez, Alejandra. Laboratory of Autoimmune Diseases Josep Font; España. Mexican Institute for Social Security; México. Universidad de la Colima; México. Hospital Clínic de Barcelona; España Fil: Consuegra Fernández, Marta. Institut D'Investigacions Biomèdiques August Pi I Sunyer; España Fil: Lozano, Francisco. Institut D'Investigacions Biomèdiques August Pi I Sunyer; España. Hospital Clínic de Barcelona; España. Universidad de Barcelona; España Fil: Ramos Casals, Manuel. Laboratory of Autoimmune Diseases Josep Font; España. Universidad de Barcelona; España. Hospital Clínic de Barcelona; España Fil: Brito Zerón, Pilar. Laboratory of Autoimmune Diseases Josep Font; España. Hospital CIMA-Sanitas; España. Hospital Clínic de Barcelona; España