Sjogren's Syndrome - 1st Edition - ISBN: 9780128036044, 9780128036327

Sjogren's Syndrome

1st Edition

Novel Insights in Pathogenic, Clinical and Therapeutic Aspects

Editors: Alessia Alunno Elena Bartoloni Roberto Gerli
eBook ISBN: 9780128036327
Hardcover ISBN: 9780128036044
Imprint: Academic Press
Published Date: 21st June 2016
Page Count: 344
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Description

Sjogren's Syndrome: Novel Insights in Pathogenic, Clinical and Therapeutic Aspects provides the reader with an overview of current knowledge about Sjogren's Syndrome. The book summarizes the huge amount of literature concerning related advances in genetic background, pathogenesis, clinical picture, and therapeutic approaches. It integrates basic immunology concepts, clinical aspects, and pharmacological issues.

Scientific progress has allowed us to unmask novel pathogenic mechanisms, to perform genome wide studies, and to identify clinical and serological features associated with different disease subsets and, eventually, different disease prognoses. In addition, the increasing knowledge about SS pathogenesis provides the rationale to employ targeted therapies in SS as has already occurred in rheumatoid arthritis and systemic lupus erythematosus.

Key Features

  • Discusses heterogeneity of topics and audience, from basic immunology to clinical aspects and therapeutics
  • Provides novel lines of investigation and supports the management of patients requiring novel therapeutic approaches
  • Presents a deeper knowledge on SS clinical management as well as on immunological aspects possibly leading to new lines of investigation
  • Offers a bridge between the clinician and the scientist, and vice versa
  • Provides the reader with most recent and relevant updates due to the novelty of topics

Readership

This book is primarily intended for people already aware of SS who would like to be updated on recent insights into this disease. Since this book integrates basic immunology concepts, clinical aspects and pharmacological issues, it can be of help both to scientists (graduate students/PhD/Post docs/lecturers) who focus their research on this field and to clinicians (graduate students, fellows and consultants) who care for SS patients.

Table of Contents

  • Dedication
  • List of Contributors
  • Preface
  • Chapter 1. Introduction: History of Sjögren’s Syndrome
    • 1. Introduction
  • Chapter 2. Clinical Features
    • 1. Introduction
    • 2. The Many Facets of the Disease
    • 3. Glandular Manifestations
    • 4. Systemic Involvement
    • 5. Nonspecific Manifestations
    • 6. Periepithelial Manifestations
    • 7. Immune Complex–Mediated Manifestations
    • 8. Cardiovascular Manifestations
    • 9. Conclusions
  • Chapter 3. Management of Sjögren’s Syndrome
    • 1. Introduction
    • 2. Management of Glandular Complications
    • 3. Management of Systemic Complications
    • 4. Immune Complex–Mediated Disease
  • Chapter 4. Classification Criteria for Sjögren’s Syndrome
    • 1. General Concepts on Classification Criteria
    • 2. The Historical Sets of Classification Criteria Proposed Before the 1990s
    • 3. From the Preliminary European Criteria to the American–European Consensus Group Criteria
    • 4. The New Preliminary ACR Classification Criteria for Sjögren’s Syndrome
    • 5. Comparison of the New ACR Criteria With the AECG Classification Criteria
    • 6. The ACR-EULAR Initiative
  • Chapter 5. Imaging Procedures Useful for the Diagnosis of Sjögren’s Syndrome: Abnormalities of the Major Salivary Glands
    • 1. Sialography
    • 2. Sialoscintigraphy
    • 3. Ultrasonography
    • 4. Magnetic Resonance Imaging
    • 5. Elastometry
    • 6. FDG PET/CT Imaging
    • 7. Conclusion
  • Chapter 6. Sjögren’s Syndrome–Associated Lymphoma
    • 1. Introduction
    • 2. Epidemiology and Histological Subtypes of Lymphoma in Sjögren’s Syndrome
    • 3. Predictors of Lymphoma in Sjögren’s Syndrome
    • 4. Lymphomagenesis in Primary Sjögren’s Syndrome
    • 5. Biopsy and Imaging for an Improved Evaluation of Lymphoproliferation in Sjögren’s Syndrome
    • 6. Treatment
  • Chapter 7. Spontaneous and Inducible Animal Models of Sjögren’s Syndrome
    • 1. Spontaneous Models
    • 2. Inducible Models of SS-Like Sialadenitis and Autoimmunity
  • Chapter 8. Genetics, Genomics, Gene Expression Profiling, and Epigenetics in Sjögren’s Syndrome
    • 1. Historical Background
    • 2. Epidemiology, Prevalence, and Classification Criteria
    • 3. Immunopathology of Sjögren’s Syndrome
    • 4. “Traditional” Genetics: Human Leukocyte Antigens
    • 5. Candidate Gene Analysis
    • 6. Genome-Wide Association Studies
    • 7. Epigenetics
    • 8. Functional Genomics
    • 9. Conclusions
  • Chapter 9. Autoantigens and Autoantibodies in the Pathogenesis of Sjögren’s Syndrome
    • 1. Introduction
    • 2. Pathogenesis and Autoantigens
    • 3. Autoantibodies: Their Role in the Pathogenesis and Diagnosis
    • 4. Novel Proposed Autoantigens and Autoantibodies
    • 5. Conclusions
  • Chapter 10. Sjögren’s Syndrome and Environmental Factors
    • 1. Introduction
    • 2. Sjögren’s Syndrome and Infections
    • 3. Sjögren’s Syndrome and Vaccines
    • 4. Sjögren’s Syndrome and Silicone
    • 5. Sjögren’s Syndrome and ASIA Syndrome
    • 6. Sjögren’s Syndrome, Hormonal Factors, and Vitamin D
    • 7. Sjögren’s Syndrome, Stress, and Environmental Pollution
    • 8. Conclusions
  • Chapter 11. Histology of Sjögren’s Syndrome
    • 1. Introduction
    • 2. Salivary Gland Anatomy
    • 3. Histology of Normal Salivary Glands
    • 4. Salivary Gland Biopsy
    • 5. Histological Findings in Salivary Glands From Sjögren’s Syndrome Patients
    • 6. Differential Diagnosis
    • 7. Germinal Centers as Predictors of Lymphoma Development
    • 8. Lymphoma Histopathology
    • 9. The Value of Histopathological Assessment During Clinical Trials
    • 10. Conclusions
  • Chapter 12. Glandular Epithelium: Innocent Bystander or Leading Actor?
    • 1. Introduction
    • 2. Dysfunction of Glandular Epithelia in Sjögren’s Syndrome: “Innocent Bystanders”?
    • 3. The Clinical Expression of “Autoimmune Epitheliitis”
    • 4. Epithelium as the Leading Actor of Autoimmune Responses
    • 5. Summary
    • Abbreviations
  • Chapter 13. T Cells in the Pathogenesis of Sjögren’s Syndrome: More Than Just Th1 and Th2
    • 1. Introduction
    • 2. Regulatory T Cells in Sjögren’s Syndrome
    • 3. IL-17–Producing T Cells in Sjögren’s Syndrome
    • 4. Follicular T Helper Cells in Sjögren’s Syndrome
    • 5. T Helper 22 and T Helper 9 Cells
    • 6. Concluding Remarks
  • Chapter 14. B Lymphocytes in Primary Sjögren’s Syndrome
    • 1. B-Cell Hyperactivity Is a Hallmark of Primary Sjögren’s Syndrome
    • 2. B-Cell Classification According to Their Ontogenic State
    • 3. B Lymphocytes in Salivary Glands
    • 4. B Lymphocytes in Peripheral Blood
    • 5. Intrinsic B-Cell Defects
    • 6. Autoreactivity-Driven B Lymphocyte Proliferation
    • 7. B-Cell–Derived Cytokines
    • 8. Interconnections Between B- and T-Cell Cytokine Networks
    • 9. Epigenetic Dysregulations in Salivary Glands Is Ascribed to B Cells
    • 10. Conclusion
  • Chapter 15. Cytokines, Chemokines, and the Innate Immune System in Sjögren’s Syndrome
    • 1. Introduction
    • 2. Cytokines of the Innate Immune System in Primary Sjögren’s Syndrome
    • 3. Conclusion
  • Chapter 16. Autoantibodies and Autoantigens in Sjögren’s Syndrome
    • 1. Background of Autoantibodies SSA/B
    • 2. Methods of Detection of Antinuclear Antibodies and Ro/SSA and La/SSB
    • 3. Detection of Specific Antibodies to Ro/SSA and La/SSB
    • 4. Simple Model for the Role of Ro/SSA and La/SSB in Pathogenesis and as a Possible Target for Therapy
    • 5. Mapping of Antigenic Epitopes on Ro/SSA and La/SSB
    • 6. La/SSB Antibody
    • 7. Antibody to Ro/SSA and CHB
    • 8. Anti-Ro/SSA Antibodies Precede Development of Clinical Manifestations
    • 9. Other Autoantibodies Associated With SS
    • 10. Anti–α-Fodrin Antibodies
    • 11. Antibodies to NA14
    • 12. Nuclear Autoantigen 14kD
    • 13. Summary
    • Abbreviations
  • Chapter 17. Outcome Measures in Sjögren’s Syndrome and Perspectives in Clinical Trial Design
    • 1. Current Outcome Measures in Primary Sjögren’s Syndrome
    • 2. Perspectives in Clinical Trial Design
  • Chapter 18. Novel Therapeutic Strategies in Sjögren’s Syndrome: B-Cell Targeting
    • 1. Therapeutic Potential for B-Cell Modulation in Sjögren’s Syndrome
    • 2. Anti-CD20 Antibodies in pSS Treatment: The Role of Rituximab
    • 3. Epratuzumab, an Anti-CD22 Antibody in pSS Treatment
    • 4. Anti–B Lymphocyte Stimulator Therapy in pSS
    • 5. Future Perspectives and Personalized Therapy
    • 6. Conclusions
  • Chapter 19. Novel Therapeutic Strategies in Sjögren’s Syndrome: T-Cell Targeting
    • 1. Costimulation
    • 2. T-Cell Trafficking
    • 3. Cytokines
    • 4. Conclusion
  • Chapter 20. New Biological Avenues for Sjögren’s Syndrome
    • 1. New Biological Treatments for Autoimmune Disease
    • 2. The Interferon Signature
    • 3. Innate Inflammatory Cytokines
    • 4. T Cell Targeting
    • 5. Tertiary Lymphoid Organ Development and the Role of Chemokines
    • 6. Germinal Centers and Costimulatory Molecules
    • 7. Intracellular Cascade Targeting
    • 8. Regenerative Medicine for Sjögren’s Syndrome
    • 9. Conclusions
  • Index

Details

No. of pages:
344
Language:
English
Copyright:
© Academic Press 2016
Published:
Imprint:
Academic Press
eBook ISBN:
9780128036327
Hardcover ISBN:
9780128036044

About the Editor

Alessia Alunno

Alessia Alunno

Alessia Alunno is Assistant Professor of Rheumatology at the Rheumatology Unit of the Department of Medicine, University of Perugia. She received her medical degree in 2007 at the University of Perugia, where she also obtained the Graduate diploma in Rheumatology in 2012. She is now completing her PhD in Medical Biotechnologies at the Department of Medicine of the University of Perugia with a thesis focused on stem cell therapy in Sjögren’s syndrome. During her training, she completed a one-year research fellowship at the Centre for Experimental Medicine and Rheumatology of the Queen Mary University of London. During the same period, she improved her skills in medical statistics through a series of training courses endorsed by the National Institute for Health Research (NHS) at the Guy’s & St Thomas NHS Foundation Trust and King’s College, London.

She is a member of the Italian Society of Rheumatology and also a member of the Scientific Committee of the Italian Federation for Research on Arthritis. Moreover, she has been a member of the Emerging EULAR Network (EMEUNET) since 2010 and currently leads the subgroup for Newsletters.

Her research activity has mainly focused on the interplay of T and B cells in the pathogenesis of Sjögren’s syndrome, systemic lupus erythematosus and rheumatoid arthritis, with particular interest in the identification of novel therapeutic targets. She has co-authored over 50 articles in international peer-reviewed journals on these subjects and presented her work at national and international congresses including EULAR Congress, where she was also invited to chair some sessions. She received four young investigator awards at the National Congress of the Italian Society of Rheumatology and three best abstract presentation awards at the International Congress on Controversies in Rheumatology and Autoimmunity. Dr. Alunno is associate editor of BMC Musculoskeletal Disorders journal and serves as a reviewer for several international rheumatology and immunology journals.

Affiliations and Expertise

Rheumatology Unit, Department of Medicine, University of Perugia, I-06126 Perugia, Italy

Elena Bartoloni

Elena Bartoloni

Elena Bartoloni is Assistant Professor of Rheumatology at the Rheumatology Unit of the Department of Medicine, University of Perugia. She achieved her medical degree in 1999 at University of Perugia and completed postgraduate training in Internal Medicine in 2004 and in Rheumatology in 2008, both at the University of Perugia. Currently, she is University Professor of Rheumatology for the Degree Course in Terni, part of the School of Medicine of the University of Perugia.

She is a member of the Italian Society of Rheumatology and she received two young investigator awards for her presentations at the National Congress of the Italian Society of Rheumatology in 2003 and in 2006.

She has been working at the Rheumatology Unit of University of Perugia since soon after her medical degree, thus acquiring a great experience in clinical management of rheumatic diseases, in particular of chronic inflammatory and autoimmune disorders. Her research activity has mainly addressed the study of clinical, diagnostic and therapeutic aspects of immune-mediated and chronic inflammatory rheumatic diseases with particular attention to the investigation of the mechanisms involved in the pathogenesis of autoimmune diseases, the cardiovascular involvement in rheumatic disorders and the effects of technobiological therapies. This research activity has led to the publication of over 80 full papers in international journals. Many of these studies focused on Sjögren’s syndrome, in particular on clinical and pathogenic aspects of accelerated atherosclerosis and cardiovascular manifestations in this disorder.

She acts as a reviewer for a number of international journals in the field of Rheumatology.

Affiliations and Expertise

Rheumatology Unit, Department of Medicine, University of Perugia, I-06126 Perugia, Italy

Roberto Gerli

Roberto Gerli

Roberto Gerli is Full Professor of Rheumatology and Director of the Rheumatology Unit of the Department of Medicine at the University of Perugia. He received his medical degree in 1980 from the same institution, completing postgraduate training in Internal Medicine in 1985 (University of Perugia), Rheumatology in 1988 (University of Pisa), and Experimental Medicine in 1990 (National Research Council).

In 1989 and in 1990 he received a young investigator award for his presentations on Sjögren’s syndrome at the European Workshop for Rheumatologic Research in Vienna and Copenhagen, respectively.

In 1994, after an experience at the Rheumatology Unit of the Guy’s Hospital, London, directed by Prof. Gabriel Panayi, he started a number of collaborative studies with Prof. C. Pitzalis, in particular on the pathogenesis of rheumatoid arthritis.

From 2001 to 2006 he was Associate Professor of Rheumatology at the University of Perugia and became Professor of Rheumatology at the same University in 2006.

He is a member of the Italian Society of Rheumatology and the American College of Rheumatology.

Professor Gerli has a long-standing experience in clinical management of chronic inflammatory and autoimmune disorders and his Unit is a 3rd referral rheumatological Center covering a vast area of central Italy. Since the ‘80s, he has been primarily involved in the study of chronic inflammatory and systemic autoimmune rheumatic diseases from a point of view of basic and clinical research, with particular attention to the investigation of primary Sjögren’s syndrome. In this field, he has published over 270 original papers in international journals, such as Journal of Clinical Investigation, Blood, Circulation, Annals of Internal Medicine, Archives of Internal Medicine, Journal of Immunology, Trends in Immunology, Annals of the Reumatic Diseases, Arthritis & Rheumatism. Many of these papers focused on Sjögren’s syndrome, in particular on the immunopathogenesis of this disorder, and several of these have been the result of collaborative studies with prominent international Rheumatology and Clinical Immunology Centers. In the last decade, moreover, his research group, in collaboration with Prof. Yehuda Shoenfeld, produced a number of studies based on the role of inflammation and autoimmune derangement in favouring cardiovascular complications in chronic rheumatic and systemic autoimmune conditions and it described for the first time the impact of accelerated atherosclerosis in primary Sjögren’s syndrome.

Affiliations and Expertise

Professor of Rheumatology, Department of Medicine, University of Perugia, Italy