Natural History of Salivary Gland Dysfunction and Sjogren's Syndrome
Saliva plays a major role in maintaining oral health and comfort. Saliva is needed to
moisten the mouth, to lubricate food for easier swallowing, to protect oral hard and soft
tissues, to modulate oral microbial populations, to provide enzymes necessary to begin food
breakdown for digestion, and to promote soft tissue repair and oral cleansing. Therefore,
salivary dysfunction may result in numerous clinical conditions affecting oral and systemic
health, comfort and quality of life. In particular, we will focus on individuals with
Sjogren's syndrome, an autoimmune exocrinopathy that primarily affects the salivary and
lacrimal glands. A number of unanswered questions remain concerning salivary involvement in
this disorder. These include the rate of progression of secretory dysfunction, and related
oral and systemic complications associated with xerostomia in autoimmune and non-autoimmune
diseases, and B-cell dysregulation. Also, more precise estimates of the incidence of the
lymphoma development are needed.
The purpose of this study is :1) to allow careful follow-up of patients with defined
salivary gland alterations so that the long term course and effects of Sjogren's syndrome
(SS) on the oral cavity and systemic health in SS may be delineated; 2) to follow the
development and progression of B-cell dysregulation in SS; 3) to follow subjects to
establish whether those initially manifesting incomplete criteria for SS progress toward
fully meeting the criteria.; 4) to refine diagnostic tests for SS, and to determine whether
those subjects who meet the criteria for SS continue to do so; and 5) to develop
intermediary outcome measures for SS based on long term outcomes (loss of tears and loss of
stimulated salivary flow).
Patients will return every two years from the baseline visit for a full oral examination,
salivary function assessment, clinical laboratory studies, and questionnaires concerning
signs and symptoms of salivary gland dysfunction. These individuals will be patients with
Sjogren's syndrome (SS), incomplete SS (patients who have some, but not all of the criteria
for SS) or radiation-induced salivary gland hypofunction. We anticipate that many of these
patients will also participate in therapeutic trials conducted within the branch.
Ilias G Alevizos, D.M.D.
National Institute of Dental and Craniofacial Research (NIDCR)
United States: Federal Government
|National Institutes of Health Clinical Center, 9000 Rockville Pike||Bethesda, Maryland 20892|