Emerging Trends and Management for Sjögren Syndrome-Related Dry Eye Corneal Alterations
Background: Sjögren’s syndrome (SS) is a systemic autoimmune condition marked by significant dry eye disease (DED), leading to considerable corneal changes. These modifications, encompassing punctate epithelial erosions, chronic epithelial abnormalities, and corneal ulcers, significantly impact eyes...
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MDPI AG
2025-05-01
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| author | Maria Letizia Salvetat Francesco Pellegrini Fabiana D’Esposito Mutali Musa Daniele Tognetto Rosa Giglio Roberta Foti Caterina Gagliano Marco Zeppieri |
| author_facet | Maria Letizia Salvetat Francesco Pellegrini Fabiana D’Esposito Mutali Musa Daniele Tognetto Rosa Giglio Roberta Foti Caterina Gagliano Marco Zeppieri |
| author_sort | Maria Letizia Salvetat |
| collection | DOAJ |
| description | Background: Sjögren’s syndrome (SS) is a systemic autoimmune condition marked by significant dry eye disease (DED), leading to considerable corneal changes. These modifications, encompassing punctate epithelial erosions, chronic epithelial abnormalities, and corneal ulcers, significantly impact eyesight and quality of life. Progress in comprehending the corneal pathophysiology associated with SS has prompted innovative diagnostic and treatment approaches. Aim: This narrative review aims to examine developing trends in the pathogenesis, diagnostic methods, and treatment strategies for Sjögren’s syndrome-associated corneal changes. Methods: The study was based on a narrative review of the current literature available on PubMed and Cochrane from Jan 2000 to December 2024. Results: Corneal changes associated with Sjögren’s syndrome result from a multifactorial interaction of ocular surface inflammation, tear film instability, and epithelium degradation. Recent research underscores the significance of immune-mediated pathways, such as T-cell-induced inflammation and cytokine dysregulation, as crucial factors in corneal disease. Innovations in diagnostic instruments, including in vivo confocal microscopy and tear proteomics, provide earlier and more accurate identification of subclinical alterations in the corneal epithelium and stroma. Therapeutic developments concentrate on meeting the specific requirements of SS-related DED. Biological treatments, especially tailored inhibitors of interleukin-6 and tumor necrosis factor-alpha, show potential in mitigating inflammation and facilitating epithelial repair. Moreover, regenerative approaches, such as autologous serum tears and mesenchymal stem cell therapies, provide innovative methods to repair ocular surface integrity. Advanced drug delivery technologies, including nanoparticle-loaded eye drops, enhance bioavailability and therapeutic efficacy. Conclusion: Recent developments in comprehending SS-related corneal changes have transformed the management approach to precision medicine. The combination of improved diagnostics and innovative therapy approaches offers potential for reducing disease progression, maintaining corneal health, and enhancing patient outcomes. Subsequent investigations ought to concentrate on enhancing these tactics and examining their long-term safety and effectiveness. Clinicians and researchers must adopt these developments to successfully tackle the difficulties of SS-related corneal illness, providing hope for improved care and higher quality of life for those affected. |
| format | Article |
| id | doaj-art-dde7d5293c2440a6b1bbc835088bf131 |
| institution | OA Journals |
| issn | 2076-3417 |
| language | English |
| publishDate | 2025-05-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Applied Sciences |
| spelling | doaj-art-dde7d5293c2440a6b1bbc835088bf1312025-08-20T01:49:24ZengMDPI AGApplied Sciences2076-34172025-05-01159507610.3390/app15095076Emerging Trends and Management for Sjögren Syndrome-Related Dry Eye Corneal AlterationsMaria Letizia Salvetat0Francesco Pellegrini1Fabiana D’Esposito2Mutali Musa3Daniele Tognetto4Rosa Giglio5Roberta Foti6Caterina Gagliano7Marco Zeppieri8Department of Ophthalmology, Azienda Sanitaria Friuli Occidentale, Via Montereale 24, 33170 Pordenone, ItalyDepartment of Ophthalmology, Azienda Sanitaria Friuli Occidentale, Via Montereale 24, 33170 Pordenone, ItalyImperial College Ophthalmic Research Group (ICORG) Unit, Imperial College, London NW1 5QH, UKDepartment of Optometry, University of Benin, Benin City 300238, Edo State, NigeriaDepartment of Medicine, Surgery and Health Sciences, University of Trieste, 34127 Trieste, ItalyDepartment of Medicine, Surgery and Health Sciences, University of Trieste, 34127 Trieste, ItalyDivision of Rheumatology, A.O.U. “Policlinico-San Marco”, 95123 Catania, ItalyDepartment of Medicine and Surgery, University of Enna “Kore”, Piazza dell’Università, 94100 Enna, ItalyDepartment of Medicine, Surgery and Health Sciences, University of Trieste, 34127 Trieste, ItalyBackground: Sjögren’s syndrome (SS) is a systemic autoimmune condition marked by significant dry eye disease (DED), leading to considerable corneal changes. These modifications, encompassing punctate epithelial erosions, chronic epithelial abnormalities, and corneal ulcers, significantly impact eyesight and quality of life. Progress in comprehending the corneal pathophysiology associated with SS has prompted innovative diagnostic and treatment approaches. Aim: This narrative review aims to examine developing trends in the pathogenesis, diagnostic methods, and treatment strategies for Sjögren’s syndrome-associated corneal changes. Methods: The study was based on a narrative review of the current literature available on PubMed and Cochrane from Jan 2000 to December 2024. Results: Corneal changes associated with Sjögren’s syndrome result from a multifactorial interaction of ocular surface inflammation, tear film instability, and epithelium degradation. Recent research underscores the significance of immune-mediated pathways, such as T-cell-induced inflammation and cytokine dysregulation, as crucial factors in corneal disease. Innovations in diagnostic instruments, including in vivo confocal microscopy and tear proteomics, provide earlier and more accurate identification of subclinical alterations in the corneal epithelium and stroma. Therapeutic developments concentrate on meeting the specific requirements of SS-related DED. Biological treatments, especially tailored inhibitors of interleukin-6 and tumor necrosis factor-alpha, show potential in mitigating inflammation and facilitating epithelial repair. Moreover, regenerative approaches, such as autologous serum tears and mesenchymal stem cell therapies, provide innovative methods to repair ocular surface integrity. Advanced drug delivery technologies, including nanoparticle-loaded eye drops, enhance bioavailability and therapeutic efficacy. Conclusion: Recent developments in comprehending SS-related corneal changes have transformed the management approach to precision medicine. The combination of improved diagnostics and innovative therapy approaches offers potential for reducing disease progression, maintaining corneal health, and enhancing patient outcomes. Subsequent investigations ought to concentrate on enhancing these tactics and examining their long-term safety and effectiveness. Clinicians and researchers must adopt these developments to successfully tackle the difficulties of SS-related corneal illness, providing hope for improved care and higher quality of life for those affected.https://www.mdpi.com/2076-3417/15/9/5076Sjögren’s syndromeautoimmune eye diseasesdry eye diseasekeratoconjunctivitis siccaocular surfacecornea |
| spellingShingle | Maria Letizia Salvetat Francesco Pellegrini Fabiana D’Esposito Mutali Musa Daniele Tognetto Rosa Giglio Roberta Foti Caterina Gagliano Marco Zeppieri Emerging Trends and Management for Sjögren Syndrome-Related Dry Eye Corneal Alterations Applied Sciences Sjögren’s syndrome autoimmune eye diseases dry eye disease keratoconjunctivitis sicca ocular surface cornea |
| title | Emerging Trends and Management for Sjögren Syndrome-Related Dry Eye Corneal Alterations |
| title_full | Emerging Trends and Management for Sjögren Syndrome-Related Dry Eye Corneal Alterations |
| title_fullStr | Emerging Trends and Management for Sjögren Syndrome-Related Dry Eye Corneal Alterations |
| title_full_unstemmed | Emerging Trends and Management for Sjögren Syndrome-Related Dry Eye Corneal Alterations |
| title_short | Emerging Trends and Management for Sjögren Syndrome-Related Dry Eye Corneal Alterations |
| title_sort | emerging trends and management for sjogren syndrome related dry eye corneal alterations |
| topic | Sjögren’s syndrome autoimmune eye diseases dry eye disease keratoconjunctivitis sicca ocular surface cornea |
| url | https://www.mdpi.com/2076-3417/15/9/5076 |
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