Infections as Risk Factor of Sjogren's Syndrome

Purpose: Sjogren's syndrome (SS) is an autoimmune disease targeting exocrine glands, leading to low body fluids production, especially on the salivary and lacrimal glands. Due to the low saliva and tear production, the common symptoms of Sjogren's syndrome are dry eyes and dry mouth, later on leading to uncomfortable sensations on the eye surface, cornea destruction, dental caries, and oral cavity infections. Several infections are known to cause similar side-effects to Sjogren's syndrome symptoms, including low saliva flow; therefore, infection is hypothesized as one of the risk factors of Sjogren's syndrome. Results: Based on our literature research, there are several infectious agents which cause similar disease manifestations to Sjogren's syndrome, including infections of hepatitis C virus, Epstein-Barr virus, cytomegalovirus, and human T-lymphotropic virus-1 (HTLV-1), and these four agents are found to cause persistent infection on the salivary gland after the first infection and later lead to organ destruction, thus causing sicca syndrome in the oral cavity. Other findings show possible Heliobacter pylori infection might lead on the increasing level of anti-Ro/SSA and anti-La/SSB of infected individuals. Conclusion: Some research has shown persistent infection could trigger autoimmune disorders due to continuous T-cells and B-cells activation in an attempt of infected cells eradication, leading to autoimmune reaction and high autoreactive cells concentration around the healthy cells causing the immune cells to eradicate the healthy cells nearby. However, the results in this literature study found persistent infection is not the only risk factor of Sjogren's syndrome but there are various unknown factors that trigger infection to develop into Sjogren's syndrome.