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Infections increase the risk of developing Sjögren's syndrome
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2019 (English)In: Journal of Internal Medicine, ISSN 0954-6820, E-ISSN 1365-2796, Vol. 285, no 6, p. 670-680Article in journal (Refereed) Published
Abstract [en]

Objective: Environmental factors have been suggested in the pathogenesis of rheumatic diseases. We here investigated whether infections increase the risk of developing primary Sjögren's syndrome (pSS).

Methods: Patients with pSS in Sweden (n = 945) and matched controls from the general population (n = 9048) were included, and data extracted from the National Patient Register to identify infections occurring before pSS diagnosis during a mean observational time of 16.0 years. Data were analysed using conditional logistic regression models. Sensitivity analyses were performed by varying exposure definition and adjusting for previous health care consumption.

Results: A history of infection associated with an increased risk of pSS (OR 1.9, 95% CI 1.6–2.3). Infections were more prominently associated with the development of SSA/SSB autoantibody‐positive pSS (OR 2.7, 95% CI 2.0–3.5). When stratifying the analysis by organ system infected, respiratory infections increased the risk of developing pSS, both in patients with (OR 2.9, 95% CI 1.8–4.7) and without autoantibodies (OR 2.1, 95% CI 1.1–3.8), whilst skin and urogenital infections only significantly associated with the development of autoantibody‐positive pSS (OR 3.2, 95% CI 1.8–5.5 and OR 2.7, 95% CI 1.7–4.2). Furthermore, a dose–response relationship was observed for infections and a risk to develop pSS with Ro/SSA and La/SSB antibodies. Gastrointestinal infections were not significantly associated with a risk of pSS.

Conclusions: Infections increase the risk of developing pSS, most prominently SSA/SSB autoantibody‐positive disease, suggesting that microbial triggers of immunity may partake in the pathogenetic process of pSS.

Place, publisher, year, edition, pages
Wiley-Blackwell, 2019. Vol. 285, no 6, p. 670-680
Keywords [en]
autoantibodies, infection, La, SSB, Ro, SSA, Sjögren's syndrome
National Category
Rheumatology and Autoimmunity
Identifiers
URN: urn:nbn:se:umu:diva-161599DOI: 10.1111/joim.12888ISI: 000473089500007PubMedID: 30892751OAI: oai:DiVA.org:umu-161599DiVA, id: diva2:1337963
Funder
Swedish Research CouncilSwedish Rheumatism AssociationKing Gustaf V Jubilee FundSwedish Heart Lung FoundationStockholm County CouncilAvailable from: 2019-07-18 Created: 2019-07-18 Last updated: 2019-07-18Bibliographically approved

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Forsblad-d'Elia, Helena

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