New frontiers in precision medicine for Sjogren’s syndrome

ABSTRACT

Introduction: Sjögren’s syndrome is a unique systemic autoimmune disease, placed in the center of systemic autoimmunity and at the crossroads of autoimmunity and lymphoproliferation. The diverse clinical picture of the disease, the inefficacy of current biologic treatments, and the co-existence with lymphoma conferring to the patients’ morbidity and mortality force the scientific community to review disease pathogenesis and reveal the major implicated cellular and molecular elements.

Areas covered: Biomarkers for early diagnosis, prediction, stratification, monitoring, and targeted treatments can serve as a tool to interlink and switch from the clinical phenotyping of the disease into a more sophisticated classification based on the underlying critical molecular pathways and endotypes. Such a transition may define the establishment of the so-called precision medicine era in which patients’ management will be based on grouping according to pathogenetically related biomarkers. In the current work, literature on Sjogren’s syndrome covering several research fields including clinical, translational, and basic research has been reviewed.

Expert opinion: The perspectives of clinical and translational research are anticipated to define phenotypic clustering of high-risk pSS patients and link the clinical picture of the disease with fundamental molecular mechanisms and molecules implicated in pathogenesis.

KEYWORDS:

• Sjogren’s syndrome
• biomarkers
• precision medicine
• lymphoma

Article highlights

• Sjogren Syndrome is a complex and systemic autoimmune disease with clinical unmet needs.

• Clinical and histopathologic heterogeneity of the disease points out the need for discovering novel biomarkers.

• Previous biomarkers for risk stratification include clinical serological and histological components.

• Data-driven approaches and high throughput technologies have revealed several newly proposed biomarkers.

• Novel biomarkers will facilitate the transition from clinical to molecular phenotyping and promote precision medicine.

• Future research perspectives are expected to link clinical manifestations with important underlying molecular pathways.

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Declaration of interest

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

Reviewer disclosures

Peer reviewers in this manuscript have no relevant financial or other relationships to disclose.

Additional information

Funding

The project was funded by the European Union under the Horizon H2020-EU.3.1.1. - Understanding health, wellbeing and disease – Grant Agreement: 731944.