An article from University of Oslo

Sometimes a sufferer’s mouth is so dry that the tongue sticks to the palate.

New insight into the cause of Sjögren’s syndrome

Patients with Sjögren’s syndrome have defects in their glandular cells that affect the cells’ function. These cells may be perceived as a danger by the body’s immune system and in order to defend itself, the body’s immune system attacks them.

University of Oslo

The University of Oslo is Norway's leading institution of research and higher education.

Imagine that your mouth is so dry that you are reluctant to kiss the person you love. You find that your tongue sticks to your palate and food is difficult to swallow. Mouth ulcers and dental cavities are a constantly recurring problem.

You are tired all the time, even though you have slept the whole night, you suffer from muscular and joint pain, and you cannot understand why it feels as though you permanently have a grain of sand in your eye.

These are common symptoms for people with Sjögren’s syndrome. At the Faculty of Dentistry at the University of Oslo, researcher Tone Berge Enger has been examining more closely what causes this disease.

What is Sjögren’s syndrome?

Sjögren’s syndrome is one of our most common autoimmune rheumatic diseases.  Unfortunately many people have never heard of the illness, which results in a number of people walking around with ailments they are unable to explain.

Tone Berge Enger has recently completed her PhD, during which she discovered that changes in a person’s own tissue may be the cause of the disease. (Photo: Jan Unneberg, UiO/OD)

In cases of autoimmune disease, the immune defence system starts to attack the body’s own organs. 

In Sjögren’s syndrome, primarily the salivary glands and lacrimal glands are attacked, and chronic inflammation results in dryness of the mouth and eyes. The great majority of those affected by Sjögren’s syndrome are women of menopausal age, but younger people can also acquire the disease.

A person’s own tissue ‒ the cause of the disease?

We currently know little about the cause of this disease, but various environmental, immunological and genetic factors have been put forward as explanations for why some individuals develop Sjögren’s syndrome.

A new, alternative explanatory model postulates that the reason why the immune system attacks its own tissue lies in the tissue itself. 

In the course of her studies, researcher Tone Berge Enger at the Faculty of Dentistry has examined whether changes in the function and structure of salivary gland cells may help to explain how the disease develops.

Defects in cell structure

What happens if the cell structure of the tissue changes? Can a change of this type in the glandular tissue explain why the disease occurs?

The results of Enger’s research indicate that patients with Sjögren’s syndrome have defects in their glandular cells that affect the cells’ function. These cells may be perceived as a danger by the body’s immune system and in order to defend itself, the body’s immune system attacks them, resulting in inflammation of the tissue and exacerbation of the symptoms.

Defects in the glandular cells may therefore partly help to explain the development of Sjögren’s syndrome.

Enger’s discovery came about through research on mice with a disease similar to Sjögren’s syndrome. Enger ascertained that these mice already had defects in the cell structure of the glandular tissue early in their foetal development. These defects were not found in healthy mice and, most interestingly, the same defects in cell structure were found in the salivary glands of humans with Sjögren’s syndrome.

These findings thus help to support the theory that defects in the body’s own tissue may be one of the causes of the disease.

The importance of diagnosis

“I have met patients whose quality of life is so reduced that a normal social life has become difficult,” says Enger.

“Since the disease is underdiagnosed, patients may look for other explanations to understand their own ailments. When there is uncertainty with regard to a diagnosis, there are many people who begin to wonder if there is something they may have done to cause their symptoms. Once it is determined that Sjögren’s syndrome is present, the patient will be liberated from personal responsibility and have an explanation for his/her symptoms. And even though there is no complete cure, various measures can be taken to alleviate these symptoms. This in turn can result in improved quality of life for the patient,” concludes Berge Enger.

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