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Infections in Sjögren's disease: a clinical concern or not?

1, 2, 3, 4, 5

 

  1. Department of Pathophysiology, School of Medicine, National and Kapodistrian University of Athens, Greece.
  2. Department of Pathophysiology, School of Medicine, National and Kapodistrian University of Athens; and Laboratory of Immunobiology, Centre for Clinical, Experimental Surgery and Translational Research, Biomedical Research Foundation of the Academy of Athens, Greece. lukechatzis@gmail.com
  3. Department of Pathophysiology, School of Medicine, National and Kapodistrian University of Athens, Greece.
  4. Department of Pathophysiology, School of Medicine, National and Kapodistrian University of Athens, Greece.
  5. Department of Pathophysiology, School of Medicine, National and Kapodistrian University of Athens; and Laboratory of Immunobiology, Centre for Clinical, Experimental Surgery and Translational Research, Biomedical Research Foundation of the Academy of Athens, Greece.

CER18248
2024 Vol.42, N°12
PI 2531, PF 2541
Reviews

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PMID: 39661562 [PubMed]

Received: 21/10/2024
Accepted : 09/12/2024
In Press: 11/12/2024
Published: 19/12/2024

Abstract

Patients with autoimmune diseases are particularly prone to infections due to both the underlying immune dysfunction and the use of immunosuppressive therapies. Sjögren’s disease (SjD) serves as a valuable model for studying the complex interplay between autoimmunity and infections. This review focuses on the infection risks associated with SjD, emphasising key areas such as oral, respiratory, and urogenital infections, along with complications arising from systemic infections. The role of infections in SjD-associated lymphoma treatment complications is also addressed. Additionally, the recent COVID-19 pandemic has highlighted the vulnerability of autoimmune patients to severe viral infections, complicating disease management. While biologic therapies, including predominantly rituximab and belimumab have become increasingly utilised, they carry inherent risks of infections due to their immunosuppressive effects. Emerging therapies, such as ianalumab, iscalimab, dazodalibep, and remibrutinib, show efficacy in reducing disease activity but also present infection risks, with reports of upper respiratory infections and serious cases, including pneumonia and COVID-19. By exploring these infection-related challenges, this review underscores the importance of understanding the infection-autoimmunity relationship to improve outcomes for patients with SjD and similar autoimmune conditions.

DOI: https://doi.org/10.55563/clinexprheumatol/ekder7

Rheumatology Article