Sjögren’s, an autoimmune disease that affects up to 4 million Americans, is notoriously tricky to diagnose.
An Oklahoma Medical Research Foundation physician-scientist hopes to change that.
Backed by a new two-year, $234,000 grant from the National Institutes of Health, Hal Scofield, M.D., is working toward a saliva test that would lead to a quicker and more accurate diagnosis of Sjögren’s and a related condition called sicca.
Both are autoimmune conditions in which the body mistakenly attacks its moisture-producing glands, causing painful dry eyes and dry mouth. While those two symptoms form the extent of sicca, Sjögren’s also can involve profound fatigue, skin rash and chronic joint pain or swelling.
“Some people have sicca but not Sjogren’s, at least by the current definitions,” Scofield said. “Clearly something is going on in these people, and some may have early Sjogren’s or perhaps an offshoot of Sjogren’s that hasn’t yet been fully defined.”
Sjögren’s predominantly affects women. People with the disease can go years without a proper diagnosis, in part because it mimics other conditions: Sjögren’s often is misdiagnosed as fibromyalgia, rheumatoid arthritis, lupus, multiple sclerosis or menopause.
Sjögren’s has no known cure, and current treatments address only the symptoms. Over time, it can result in lung disease, organ damage and neurological problems, and it can increase the risk of certain cancers.
To diagnose the disease, a physician asks questions, then orders a lip biopsy and a series of blood tests. Each test can be indicative of the disease, but none is definitive.
“Traditionally we’ve looked for Sjögren’s antibodies in the blood,” Scofield said. “What we’ve found is that there is a significant number of people with sicca or Sjögren’s whose antibodies show up in their saliva, but not in their blood.”
Using existing saliva samples, Scofield will collaborate on the project with two researchers at the University of California-Los Angeles School of Dentistry.
“This may seem like an odd disease to interest dental scientists, but the salivary glands are critical to the overall health of our teeth and gums,” said Scofield, who also serves as associate chief of staff for research at the Oklahoma City VA Medical Center. “Our saliva is a natural antibacterial, so without saliva it’s much easier to develop cavities and tooth and gum disease.”
Scofield believes the saliva test could help scientists and physicians better understand and define sicca. It could also reduce the time between symptom onset and diagnosis of both sicca and Sjögren’s.
The new research could represent a major step forward for patients and healthcare providers, said OMRF Executive Vice President and Chief Medical Officer Judith James, M.D., Ph.D.
“Dr. Scofield’s work could lead to a test that more definitively detects Sjögren’s and sicca,” said James. “In that sense, his research has the potential to be truly groundbreaking.”
The grant, No. 1R21DE033901-01A1, was awarded by the National Institute of Dental and Craniofacial Research, part of the NIH.
