Efficient diagnosis of Sjögren's syndrome to reduce the burden on patients.

OBJECTIVE: The purpose of this study was to investigate the procedures for efficiently diagnosing Sjögren's syndrome to reduce patient burden. METHODS: This study analyzed data from 254 Japanese patients diagnosed with Sjögren's syndrome out of 4967 who visited our clinic complaining of xerostomia. RESULTS: Of the 254 Sjögren's syndrome patients, 140 fulfilled the criteria proposed by the Committee on Sjögren's Syndrome of the Ministry of Health and Welfare of Japan, 228 fulfilled the criteria proposed by the American-European Consensus Group, and 69 fulfilled the criteria proposed by the American College of Rheumatology. Numbers of definitive cases varied with each set of criteria. Logistic regression analysis was used to analyze useful examination items for definitive diagnosis of Sjögren's syndrome, demonstrating that anti-Ro/SSA (odds ratio (OR), 7.165), lip biopsy (OR, 4.273), sialography (OR, 2.402), and ANA (OR, 0.678) correlated significantly with definitive diagnosis of Sjögren's syndrome. CONCLUSIONS: These results suggest that the following diagnostic procedure for Sjögren's syndrome would reduce burden on patients. When clinicians choose examination items for diagnosing Sjögren's syndrome, they should first select which criteria to use. Then, to minimize the number of examination items, examinations should be performed in order of anti-SSA antibody, lip biopsy, and parotid gland sialography.

Inhibition of pilocarpine-induced saliva secretion by adrenergic agonists in ICR mice.

The aim of the present study was to clarify the effects of the adrenoceptor agonist isoproterenol (IPR) on saliva secretion stimulated by the muscarinic receptor agonist pilocarpine (PILO) in mice. Mice were injected with either 0.5 mg/kg, i.p. PILO alone or simultaneously with 2 mg/kg, i.p., IPR to evaluate the inhibitory effects of adrenoceptor agonists on saliva secretion. The mechanisms underlying changes in saliva flow rate were evaluated by histological examination of aquaporin 5 (AQP5) and saliva flow rate using the adenylate cyclase (AC) inhibitor SQ22536 (0.25 mg per mouse, s.c.), which was administered 30 min prior to PILO and/or IPR. Saliva volume decreased significantly in the mice treated simultaneously with PILO + IPR compared with that in mice treated with PILO alone. Changes in the intracellular localization of AQP5 were seen in PILO + IPR-treated mice, and those changes were reversed by SQ22536 pretreatment. In addition, the decreased salivary flow rate in the PILO + IPR-treated mice was partially restored by SQ22536 pretreatment. There were no significant changes in intracellular calcium or ATP levels among the groups. The results of the present study suggest the existence of an inhibitory effect of the sympathetic nervous system on parasympathetic-stimulated salivary secretion from the salivary gland.