Abstract：
UNASSIGNED: Almost one-quarter of immune checkpoint inhibitor (ICI) recipients experience sicca syndrome, while Sjögren\'s disease (SjD) is estimated at 0.3-2.5%, possibly underreported.
UNASSIGNED: This narrative review (Medline/Embase until January/31/2024) addresses the pathophysiology, incidence, demographic/clinical features, biomarkers, labial salivary gland biopsy (LSGB), fulfillment of the idiopathic SjD (iSjD) classificatory criteria, differential diagnosis, and management of sicca syndrome/SjD associated with ICIs.
UNASSIGNED: SjD associated with ICIs is underdiagnosed, since studies that performed the mandatory SjD investigation identified that 40-60% of patients with sicca syndrome associated with ICIs meet the iSjD classificatory criteria. LSGB played a fundamental role in recognizing these cases, as most of them had negative anti-Ro/SS-A antibody. Despite the finding of focal lymphocytic sialoadenitis in LSGB samples mimicking iSjD, immunohistochemical analysis provided novel evidence of a distinct pattern for sicca syndrome/SjD associated with ICIs compared to iSjD. The former has scarcity of B lymphocytes, which are a hallmark of iSjD. Additionally, patients with sicca syndrome/SjD associated with ICIs have demographical/clinical/serological and treatment response dissimilarities compared to iSjD. Dryness symptoms are more acute in the former than in iSjD, with predominance of xerostomia over xerophthalmia, and partial/complete response to glucocorticoids. Dryness symptoms in ICI-treated patients warrant prompt SjD investigation.
UNASSIGNED: This narrative review (Medline/Embase until January/31/2024) addresses the pathophysiology, incidence, demographic/clinical features, biomarkers, labial salivary gland biopsy (LSGB), fulfillment of the idiopathic SjD (iSjD) classificatory criteria, differential diagnosis, and management of sicca syndrome/SjD associated with ICIs.
UNASSIGNED: SjD associated with ICIs is underdiagnosed, since studies that performed the mandatory SjD investigation identified that 40-60% of patients with sicca syndrome associated with ICIs meet the iSjD classificatory criteria. LSGB played a fundamental role in recognizing these cases, as most of them had negative anti-Ro/SS-A antibody. Despite the finding of focal lymphocytic sialoadenitis in LSGB samples mimicking iSjD, immunohistochemical analysis provided novel evidence of a distinct pattern for sicca syndrome/SjD associated with ICIs compared to iSjD. The former has scarcity of B lymphocytes, which are a hallmark of iSjD. Additionally, patients with sicca syndrome/SjD associated with ICIs have demographical/clinical/serological and treatment response dissimilarities compared to iSjD. Dryness symptoms are more acute in the former than in iSjD, with predominance of xerostomia over xerophthalmia, and partial/complete response to glucocorticoids. Dryness symptoms in ICI-treated patients warrant prompt SjD investigation.
摘要：
■近四分之一的免疫检查点抑制剂（ICI）接受者经历干燥综合征，而Sjögren病（SjD）估计为0.3-2.5％，可能被低估了。
■这篇叙述性综述（Medline/Embase至2024年1月31日）讨论了病理生理学，发病率,人口统计学/临床特征，生物标志物，唇腺活检（LSGB），实现特发性SjD(iSjD)分类标准，与ICIs相关的干燥综合征/干燥综合征的鉴别诊断和治疗。
■与ICI相关的SjD未被诊断，因为进行强制性SjD调查的研究发现,40-60%的与ICIs相关的干燥综合征患者符合iSjD分类标准.LSGB在识别这些案件方面发挥了基本作用，因为他们中的大多数具有阴性抗Ro/SS-A抗体。尽管在模仿iSjD的LSGB样本中发现了局灶性淋巴细胞唾液腺炎，与iSjD相比,免疫组织化学分析提供了与ICIs相关的干燥综合征/SjD不同模式的新证据。前者缺乏B淋巴细胞，这是iSjD的标志。此外,与iSjD相比,与ICIs相关的干燥综合征/SjD患者在人口统计学/临床/血清学和治疗反应方面存在差异.前者的干燥症状比iSjD更严重，口干症多于干眼症，和对糖皮质激素的部分/完全反应。ICI治疗患者的干燥症状需要迅速进行SjD调查。
■这篇叙述性综述（Medline/Embase至2024年1月31日）讨论了病理生理学，发病率,人口统计学/临床特征，生物标志物，唇腺活检（LSGB），实现特发性SjD(iSjD)分类标准，与ICIs相关的干燥综合征/干燥综合征的鉴别诊断和治疗。
■与ICI相关的SjD未被诊断，因为进行强制性SjD调查的研究发现,40-60%的与ICIs相关的干燥综合征患者符合iSjD分类标准.LSGB在识别这些案件方面发挥了基本作用，因为他们中的大多数具有阴性抗Ro/SS-A抗体。尽管在模仿iSjD的LSGB样本中发现了局灶性淋巴细胞唾液腺炎，与iSjD相比,免疫组织化学分析提供了与ICIs相关的干燥综合征/SjD不同模式的新证据。前者缺乏B淋巴细胞，这是iSjD的标志。此外,与iSjD相比,与ICIs相关的干燥综合征/SjD患者在人口统计学/临床/血清学和治疗反应方面存在差异.前者的干燥症状比iSjD更严重，口干症多于干眼症，和对糖皮质激素的部分/完全反应。ICI治疗患者的干燥症状需要迅速进行SjD调查。
