Infections increase the risk of developing Sjögren's syndrome
(2019) In Journal of Internal Medicine 285(6). p.670-680- Abstract
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=9,048) 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 analyzed 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... (More)
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=9,048) 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 analyzed 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 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), while skin and urogenital infections only significantly associated with 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. This article is protected by copyright. All rights reserved.
(Less)
- author
- organization
- publishing date
- 2019-03-20
- type
- Contribution to journal
- publication status
- published
- subject
- in
- Journal of Internal Medicine
- volume
- 285
- issue
- 6
- pages
- 670 - 680
- publisher
- Wiley-Blackwell
- external identifiers
-
- pmid:30892751
- scopus:85064556267
- ISSN
- 1365-2796
- DOI
- 10.1111/joim.12888
- language
- English
- LU publication?
- yes
- additional info
- This article is protected by copyright. All rights reserved.
- id
- 145b39fb-fbee-48f3-bc46-1db03b7e1765
- date added to LUP
- 2019-03-22 16:44:37
- date last changed
- 2024-04-01 22:14:03
@article{145b39fb-fbee-48f3-bc46-1db03b7e1765,
abstract = {{<p>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).</p><p>METHODS: Patients with pSS in Sweden (n=945) and matched controls from the general population (n=9,048) 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 analyzed using conditional logistic regression models. Sensitivity analyses were performed by varying exposure definition and adjusting for previous health care consumption.</p><p>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 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), while skin and urogenital infections only significantly associated with 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.</p><p>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. This article is protected by copyright. All rights reserved.</p>}},
author = {{Mofors, Johannes and Arkema, Elizabeth V and Björk, Albin and Westermark, Linnea and Kvarnström, Marika and Forsblad-d'Elia, Helena and Magnusson Bucher, Sara and Eriksson, Per and Mandl, Thomas and Nordmark, Gunnel and Wahren-Herlenius, Marie}},
issn = {{1365-2796}},
language = {{eng}},
month = {{03}},
number = {{6}},
pages = {{670--680}},
publisher = {{Wiley-Blackwell}},
series = {{Journal of Internal Medicine}},
title = {{Infections increase the risk of developing Sjögren's syndrome}},
url = {{http://dx.doi.org/10.1111/joim.12888}},
doi = {{10.1111/joim.12888}},
volume = {{285}},
year = {{2019}},
}