Infections increase the risk of developing Sjögren's syndrome

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Infections increase the risk of developing Sjögren's syndrome. / Mofors, Johannes; Arkema, Elizabeth V; Björk, Albin; Westermark, Linnea; Kvarnström, Marika; Forsblad-d'Elia, Helena; Magnusson Bucher, Sara; Eriksson, Per; Mandl, Thomas; Nordmark, Gunnel; Wahren-Herlenius, Marie.

In: Journal of Internal Medicine, Vol. 285, No. 6, 2019, p. 670-680.

Research output: Contribution to journalArticle

Harvard

Mofors, J, Arkema, EV, Björk, A, Westermark, L, Kvarnström, M, Forsblad-d'Elia, H, Magnusson Bucher, S, Eriksson, P, Mandl, T, Nordmark, G & Wahren-Herlenius, M 2019, 'Infections increase the risk of developing Sjögren's syndrome', Journal of Internal Medicine, vol. 285, no. 6, pp. 670-680. https://doi.org/10.1111/joim.12888

APA

Mofors, J., Arkema, E. V., Björk, A., Westermark, L., Kvarnström, M., Forsblad-d'Elia, H., ... Wahren-Herlenius, M. (2019). Infections increase the risk of developing Sjögren's syndrome. Journal of Internal Medicine, 285(6), 670-680. https://doi.org/10.1111/joim.12888

CBE

Mofors J, Arkema EV, Björk A, Westermark L, Kvarnström M, Forsblad-d'Elia H, Magnusson Bucher S, Eriksson P, Mandl T, Nordmark G, Wahren-Herlenius M. 2019. Infections increase the risk of developing Sjögren's syndrome. Journal of Internal Medicine. 285(6):670-680. https://doi.org/10.1111/joim.12888

MLA

Vancouver

Mofors J, Arkema EV, Björk A, Westermark L, Kvarnström M, Forsblad-d'Elia H et al. Infections increase the risk of developing Sjögren's syndrome. Journal of Internal Medicine. 2019;285(6):670-680. https://doi.org/10.1111/joim.12888

Author

Mofors, Johannes ; Arkema, Elizabeth V ; Björk, Albin ; Westermark, Linnea ; Kvarnström, Marika ; Forsblad-d'Elia, Helena ; Magnusson Bucher, Sara ; Eriksson, Per ; Mandl, Thomas ; Nordmark, Gunnel ; Wahren-Herlenius, Marie. / Infections increase the risk of developing Sjögren's syndrome. In: Journal of Internal Medicine. 2019 ; Vol. 285, No. 6. pp. 670-680.

RIS

TY - JOUR

T1 - Infections increase the risk of developing Sjögren's syndrome

AU - Mofors, Johannes

AU - Arkema, Elizabeth V

AU - Björk, Albin

AU - Westermark, Linnea

AU - Kvarnström, Marika

AU - Forsblad-d'Elia, Helena

AU - Magnusson Bucher, Sara

AU - Eriksson, Per

AU - Mandl, Thomas

AU - Nordmark, Gunnel

AU - Wahren-Herlenius, Marie

N1 - This article is protected by copyright. All rights reserved.

PY - 2019

Y1 - 2019

N2 - 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.

AB - 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.

U2 - 10.1111/joim.12888

DO - 10.1111/joim.12888

M3 - Article

VL - 285

SP - 670

EP - 680

JO - Journal of Internal Medicine

T2 - Journal of Internal Medicine

JF - Journal of Internal Medicine

SN - 1365-2796

IS - 6

ER -