Abstract
Sjogrens syndrome (SS) is a chronic autoimmune disease that mainly affects the exocrine glands and usually presents with sicca symptoms of the main mucosal surfaces. The prevalence and the type of central nervous system (CNS) tissue damage caused by SS are debatable. The wide spectrum of CNS manifestations, different classification criteria used and unclear inclusion or exclusion criteria pose some difficulty reviewing these studies. Careful examination of the SS patients and to be aware of neurological findings which may be associated with suspicious CNS involvement is highly important. Central nervous system may also hypothetically have a role in the pathophysiology of SS. The wide spectrum of CNS involvement includes focal (sensorial and motor deficits, brain stem, cerebellar lesions, seizure, migraine etc.) or non-focal (encephalomyelitis, aseptic meningitis, neuropsychiatric dysfunctions), spinal cord (myelopathy, transverse myelitis, motor neuron disease etc.) findings or multiple sclerosis-like illness and optic neuritis. Evolving imaging techniques such as single photon emission computed tomography (SPECT), magnetic resonance spectroscopy or magnetization transfer imaging are promising for better understanding the nature of CNS involvement in SS. Treatments usually comprise symptomatic approach in milder cases however, pulse cyclophosphamide and steroids or other immunosuppressants (chlorambucil or azathioprine) are required in cases with progressive symptoms leading to neurological impairment. Anti-TNF agents (infliximab and etanercept) and B cell targeted therapies (rituximab and epratuzumab) are used in primary SS however their efficacy on CNS manifestation is still unclear. Randomized, multicenter studies are warranted to confirm the efficacy of treatment regimes which were reported to be effective in anecdotal reports or in small uncontrolled series. This article reviews the clinical approach to current therapy of CNS involvement in patients with primary SS.
Keywords: Sjogren syndrome, central nervous system, immunosuppressant, treatment
Current Pharmaceutical Design
Title: Treatment of Central Nervous System Involvement Associated with Primary Sjogrens Syndrome
Volume: 14 Issue: 13
Author(s): Salih Ozgocmen and Ali Gur
Affiliation:
Keywords: Sjogren syndrome, central nervous system, immunosuppressant, treatment
Abstract: Sjogrens syndrome (SS) is a chronic autoimmune disease that mainly affects the exocrine glands and usually presents with sicca symptoms of the main mucosal surfaces. The prevalence and the type of central nervous system (CNS) tissue damage caused by SS are debatable. The wide spectrum of CNS manifestations, different classification criteria used and unclear inclusion or exclusion criteria pose some difficulty reviewing these studies. Careful examination of the SS patients and to be aware of neurological findings which may be associated with suspicious CNS involvement is highly important. Central nervous system may also hypothetically have a role in the pathophysiology of SS. The wide spectrum of CNS involvement includes focal (sensorial and motor deficits, brain stem, cerebellar lesions, seizure, migraine etc.) or non-focal (encephalomyelitis, aseptic meningitis, neuropsychiatric dysfunctions), spinal cord (myelopathy, transverse myelitis, motor neuron disease etc.) findings or multiple sclerosis-like illness and optic neuritis. Evolving imaging techniques such as single photon emission computed tomography (SPECT), magnetic resonance spectroscopy or magnetization transfer imaging are promising for better understanding the nature of CNS involvement in SS. Treatments usually comprise symptomatic approach in milder cases however, pulse cyclophosphamide and steroids or other immunosuppressants (chlorambucil or azathioprine) are required in cases with progressive symptoms leading to neurological impairment. Anti-TNF agents (infliximab and etanercept) and B cell targeted therapies (rituximab and epratuzumab) are used in primary SS however their efficacy on CNS manifestation is still unclear. Randomized, multicenter studies are warranted to confirm the efficacy of treatment regimes which were reported to be effective in anecdotal reports or in small uncontrolled series. This article reviews the clinical approach to current therapy of CNS involvement in patients with primary SS.
Export Options
About this article
Cite this article as:
Ozgocmen Salih and Gur Ali, Treatment of Central Nervous System Involvement Associated with Primary Sjogrens Syndrome, Current Pharmaceutical Design 2008; 14 (13) . https://dx.doi.org/10.2174/138161208799316366
DOI https://dx.doi.org/10.2174/138161208799316366 |
Print ISSN 1381-6128 |
Publisher Name Bentham Science Publisher |
Online ISSN 1873-4286 |
Call for Papers in Thematic Issues
"Tuberculosis Prevention, Diagnosis and Drug Discovery"
The Nobel Prize-winning discoveries of Mycobacterium tuberculosis and streptomycin have enabled an appropriate diagnosis and an effective treatment of tuberculosis (TB). Since then, many newer diagnosis methods and drugs have been saving millions of lives. Despite advances in the past, TB is still a leading cause of infectious disease mortality ...read more
Current Pharmaceutical challenges in the treatment and diagnosis of neurological dysfunctions
Neurological dysfunctions (MND, ALS, MS, PD, AD, HD, ALS, Autism, OCD etc..) present significant challenges in both diagnosis and treatment, often necessitating innovative approaches and therapeutic interventions. This thematic issue aims to explore the current pharmaceutical landscape surrounding neurological disorders, shedding light on the challenges faced by researchers, clinicians, and ...read more
Emerging and re-emerging diseases
Faced with a possible endemic situation of COVID-19, the world has experienced two important phenomena, the emergence of new infectious diseases and/or the resurgence of previously eradicated infectious diseases. Furthermore, the geographic distribution of such diseases has also undergone changes. This context, in turn, may have a strong relationship with ...read more
Melanoma and Non-Melanoma Skin Cancer Treatment: Standard of Care and Recent Advances
In this thematic issue, we aim to provide a standard of care of the diagnosis and treatment of melanoma and non-melanoma skin cancer. The editor will invite authors from different countries who will write review articles of melanoma and non-melanoma skin cancers. The Diagnosis, Staging, Surgical Treatment, Non-Surgical Treatment all ...read more
- Author Guidelines
- Graphical Abstracts
- Fabricating and Stating False Information
- Research Misconduct
- Post Publication Discussions and Corrections
- Publishing Ethics and Rectitude
- Increase Visibility of Your Article
- Archiving Policies
- Peer Review Workflow
- Order Your Article Before Print
- Promote Your Article
- Manuscript Transfer Facility
- Editorial Policies
- Allegations from Whistleblowers
- Announcements
Related Articles
-
The Role of Growth Factors in the Prevention and Treatment of Chemotherapy-Induced Peripheral Neurotoxicity
Current Drug Safety Metalloproteinases and Metalloproteinase Inhibitors in Age-Related Diseases
Current Pharmaceutical Design The Need for Physiologically Relevant Peroxisome Proliferator-Activated Receptor-gamma (PPAR-γ) Ligands
Endocrine, Metabolic & Immune Disorders - Drug Targets The Role of Melatonin in Multiple Sclerosis, Huntington's Disease and Cerebral Ischemia
CNS & Neurological Disorders - Drug Targets Novelty in Treatment of Pulmonary Fibrosis: Pulmonary Hypertension Drugs and Others
Cardiovascular & Hematological Agents in Medicinal Chemistry Leptin: The Prototypic Adipocytokine and its Role in NAFLD
Current Pharmaceutical Design Reyess Syndrome, Encephalopathy, Hyperammonemia and Acetyl Salicylic Acid Ingestion in a City Hospital of Buenos Aires, Argentina
Current Drug Safety Therapeutic Indications and Action Mechanisms of Bilirubin: Suggestions from Natural Calculus Bovis
Current Signal Transduction Therapy MicroRNAs: Key Players in Microglia and Astrocyte Mediated Inflammation in CNS Pathologies
Current Medicinal Chemistry Redox Regulation and the Autistic Spectrum: Role of Tryptophan Catabolites, Immuno-inflammation, Autoimmunity and the Amygdala
Current Neuropharmacology Nanoparticle- and Liposome-carried Drugs: New Strategies for Active Targeting and Drug Delivery Across Blood-brain Barrier
Current Drug Metabolism Tetramethoxyluteolin for the Treatment of Neurodegenerative Diseases
Current Topics in Medicinal Chemistry Design, Synthesis, and Anti-Neuroinflammatory Activity of Amide- Containing Dithiolethiones
Medicinal Chemistry Using Small Molecule GSK3β Inhibitors to Treat Inflammation
Current Medicinal Chemistry Transmissibility and Epidemicity of COVID-19 in India: A Case Study
Recent Advances in Anti-Infective Drug Discovery Editorial [Hot Topic: Anti-Neuroinflammatory Effects of Psychopharmaceuticals: Further than Monoamine Modulators (Guest Editor: Sadayuki Hashioka)]
Mini-Reviews in Medicinal Chemistry Therapeutic Options for the Treatment of 2019-Novel Coronavirus in India: A Review
Coronaviruses Proline-Rich Peptides: Multifunctional Bioactive Molecules as New Potential Therapeutic Drugs
Current Protein & Peptide Science Biological Nitration of Arachidonic Acid
Current Vascular Pharmacology Physically Cross-linked Hydrogels of β -cyclodextrin Polymer and Poly(ethylene glycol)-cholesterol as Delivery Systems for Macromolecules and Small Drug Molecules
Current Drug Delivery