- •Preface
- •Contents
- •Contributors
- •1 Introduction
- •1.1 Historical Background
- •1.2 Pitfalls in Diagnosis and Methodology
- •1.3 Methods to Assess Disease Activity
- •1.4 Summary
- •References
- •2.1 Introduction
- •2.4 Pearls of Wisdom
- •References
- •3.1 Background: Overall Approach to Patient Care
- •3.1.1 Pearl
- •3.1.2 Pearl
- •3.2 Diagnosis Criteria and Laboratory Tests
- •3.2.1 Myth
- •3.2.2 Pearl
- •3.2.3 Myth
- •3.2.4 Myth
- •3.2.5 Pearl
- •3.2.6 Pearl
- •3.2.7 Pearl
- •3.3 Myths and Pearls About Clinical Presentations
- •3.3.1 Pearl
- •3.3.2 Myth
- •3.3.3 Pearl
- •3.3.4 Pearl
- •3.3.5 Pearl
- •3.3.6 Pearl
- •3.3.7 Pearl
- •3.3.8 Pearl
- •3.3.9 Pearl
- •3.3.10 Pearl
- •3.3.11 Pearl
- •3.3.12 Pearl
- •3.3.13 Myth
- •3.3.14 Pearl
- •3.3.15 Pearl
- •3.3.16 Myth
- •3.4 Myths and Pearls About Pathogenesis
- •3.4.1 Myth
- •3.4.2 Pearl
- •3.4.3 Pearl
- •3.4.4 Myth
- •3.4.5 Pearl
- •3.5 Myths and Pearls About Treatment
- •3.5.1 Myth
- •3.5.2 Pearl
- •3.5.3 Pearl
- •3.5.4 Pearl
- •3.5.5 Pearl
- •3.5.6 Pearl
- •3.5.7 Pearl
- •References
- •4.1 Background and Overview
- •4.1.1 Need for Written Information
- •4.1.2 Use of Internet as a Method to Provide Information
- •4.1.3 Patient Access to Computers
- •4.1.4 Types of Information Supplied to Patients and Referring Physicians
- •4.2.1 Background: The Confusion Surrounding Criteria for Autoimmune Disorders
- •4.2.5 Criteria for Fibromyalgia
- •4.3 Laboratory Results for ANA Often Drive Clinical Diagnosis
- •4.5 Status of Biologic Drugs in SS Patients
- •4.6 Ocular Treatment
- •4.6.2 Blepharitis
- •4.7 Therapy of Oral Manifestations
- •4.7.1 Prevention of Dental Caries
- •4.7.2 Oral Candida Prevention and Treatment
- •4.8 Summary
- •References
- •5.1 Introduction
- •5.4 Outcome Measures in SS
- •5.4.1 Outcome Measures in SS: A Brief History
- •5.6 Outcome Measures in SS: The Italian Study
- •References
- •6.1 Introduction
- •6.2 Benign Lymphoepithelial Lesion in Salivary Glands
- •6.3.1.2 Ectopic Germinal Center Formation
- •6.3.1.3 Clinical Implications of Ectopic Germinal Center Formation
- •6.4 Late Breaking Update
- •References
- •7.1 Conventional Radiographs
- •7.1.1 Sialography
- •7.2 Computer Tomography
- •7.3 Ultrasound
- •7.4 Magnetic Resonance Imaging
- •7.5 Nuclear Medicine
- •7.5.1 Scintigraphy
- •7.6 Comparison of Nuclear Medicine, Ultrasound, and MRI
- •References
- •8.1 Introduction
- •8.2 Evidence Supporting a Genetic Component in SS
- •8.4 Lessons from SLE and Other Autoimmune Diseases
- •8.5 Genes Implicated in SS
- •8.7 Insights from Genomic and Proteomic Studies
- •8.8 Conclusion
- •References
- •9.1 Introduction
- •9.2.4 Antibodies to Nuclear Protein NA14
- •9.3.1 Initiation Phase
- •9.3.2 Recognition Phase
- •9.3.3 Establishment Phase: Autoreactive T and B Lymphocytes Dysregulation and Aberrant Cytokines Production
- •9.3.5 Effector Phase
- •References
- •10.1 Introduction
- •10.2.1 Ro/La RNP Particles
- •10.2.3 The Ro60 Autoantigen
- •10.2.4 The Ro52 Autoantigen
- •10.2.5 The Multifunctional Chaperone Calreticulin
- •10.4.2 Early Epitope Recognition in Autoimmune Diseases and Epitope Spreading
- •References
- •11.2 Acinar Cell
- •11.3 Neuropeptides
- •11.3.1 Acinotrophic Neurogenic Stimuli
- •11.4 Sex Steroids
- •11.4.1 Steroidogenesis in Adrenal Glands
- •11.4.2 Regulation of the Adrenal Steroidogenesis
- •11.4.4 Peripheral Intracrine Synthesis of Sex Steroids
- •11.4.5 Intracrine Sex Steroids Production in pSS and sSS
- •11.4.7 Putative Mechanism of Action of the Intracrine Processing Defect
- •11.5.1 General Histopathology
- •11.5.2 T Lymphocytes
- •11.5.3 B Lymphocytes
- •11.5.4 Chemokines
- •11.5.5 Adhesion Molecules
- •11.5.6 Cytokines
- •References
- •12.1 Background
- •12.2 Incidence, Symptomatic Presentation, and Impact on Quality of Life
- •12.3 Diagnostic Screening Examination
- •12.4 Overview of Dry Eye Management
- •12.4.1 Dry Eyes Deserve Respect and Careful Monitoring
- •12.4.2 Four Levels of Severity Differentiation
- •12.4.2.1 Level 1
- •12.4.2.2 Level 2
- •12.4.2.3 Level 3
- •12.4.2.4 Level 4
- •12.5.2 General Guidelines for the Dry Eye Patient
- •12.6 Additional Types of Therapy
- •12.7 Moisture Preservation and Oral Medications
- •12.7.2 Punctal Plugs
- •12.8 Oral Medications and Supplements
- •12.8.1 Dietary Fatty acids (Flaxseed Oil) and Dry Eyes
- •12.8.2 Oral Medications
- •12.9 Complications Associated with Ophthalmologic Cosmetic Procedures
- •12.10 Summary
- •References
- •13.1 Introduction
- •13.2 The Lacrimal Functional Unit (LFU)
- •13.3 The General Role of the LFU in Normal and Pathological Situation
- •13.4 Innervation of the Lacrimal Functional Unit
- •13.5 Efferent Structures
- •13.5.1 Lacrimal Glands
- •13.5.2 Goblet Cells
- •13.5.3 Meibomian Glands
- •13.6 Maintenance of the Lacrimal Functional Unit
- •13.6.1 Hormonal
- •13.6.2 Immunological
- •13.8 The Normal Ocular Surface Environment
- •13.9 The Makeup of the Tear Film
- •13.9.1 Hydrated Mucin Gel
- •13.9.3 Aqueous Components
- •13.10 The Pathophysiology of Dry Eye
- •13.10.1 Loss of Hormonal Support
- •13.10.2.1 Afferent Arm
- •13.10.2.2 Efferent Arm
- •13.11 Loss of Ocular Surface Homeostasis
- •13.11.1 Alterations of the Mucin, Lipid, and Aqueous Composition
- •13.11.2 Mucins
- •13.11.3 Lipids
- •13.12 The Ocular Surface Immunosuppressive Environment
- •13.14 Late-Breaking Additions
- •References
- •14.1 Saliva in Oral Health and Disease
- •14.1.1 Saliva in Dental and Mucosal Defense
- •14.1.2 Assessment of Oral Dryness
- •14.1.2.2 Objective Measurements of Hyposalivation
- •14.2 Saliva as a Diagnostic Fluid
- •14.2.1 Biomarker Analyses in Saliva
- •14.3 Complications of Oral Dryness
- •14.3.1 Management of Xerostomia
- •14.3.2 Caries Preventive Measures
- •14.3.2.3 Dietary Advice
- •14.3.2.4 The Time Factor
- •References
- •15.1.1 Endothelial Cells
- •15.1.2 Epithelial Cells
- •15.1.3 T cells
- •15.1.4 B cells
- •15.2 Mechanisms Mediating Salivary Gland Dysfunction
- •15.2.1 Acinar Cell Innervation and Humoral Immunity
- •15.2.3 Fluid Movement in the Salivary Glands and Aquaporins
- •15.3.1 Environmental Factors
- •15.3.2 Secondary Signals
- •15.3.3 Apoptosis, Autoantigens, and Potential Danger Signals in the Salivary Glands
- •15.3.4 Immunoregulation
- •15.3.5 B-cell-Activating Factor
- •15.3.6 Hormones
- •15.3.7 Microchimerism
- •References
- •16.1 Introduction
- •16.2 Diagnosis
- •16.3 Head and Neck Manifestations
- •16.3.1 Ophthalmic
- •16.3.2 Oral
- •16.3.3 Otologic
- •16.3.4 Rhinologic
- •16.3.5 Laryngeal
- •16.3.6 Esophageal
- •16.3.7 Thyroid
- •16.3.8 Neurological
- •16.4 Treatment
- •16.5 Conclusion
- •16.6 Patient Handout
- •References
- •17.1 Introduction
- •17.2 Cutaneous/Dermatologic Manifestations
- •17.4 Endocrinopathic/Pancreatic Manifestations
- •17.4.1 Hypothyroidism
- •17.4.2 Adrenal
- •17.4.3 Pancreas
- •17.5 Pulmonary Manifestations
- •17.5.1 Interstitial Pneumonitis
- •17.6.1 Pericarditis
- •17.6.2 Autonomic Manifestations
- •17.6.3 Congenital Heart Block
- •17.6.4 Accelerated Atherosclerosis
- •17.7 Gastrointestinal Manifestations
- •17.8 Hepatic and Pancreatic Manifestations
- •17.9 Renal/Urological Manifestations
- •17.10 Hematologic Manifestations
- •17.11 Obstetrical/Gynecological Manifestations
- •17.12 Vasculitis
- •17.12.1 CNS Arteritis in the SS Patient
- •17.13 Differential Diagnosis of Extraglandular Manifestations of SS
- •17.13.1 Medications and Other Metabolic Disorders
- •17.14 Manifestations and Differential Diagnosis in the Pediatric Population
- •17.15 Summary
- •17.16 Late-Breaking Updates
- •References
- •18.1 Introduction
- •18.2 Treatment and Management of Cutaneous Manifestations
- •18.2.1 Treatment of Dry Skin
- •18.3 Arthralgia/Arthritis
- •18.4.1 Chronic Cough
- •18.5 Renal Manifestations
- •18.5.1 Interstitial Nephritis
- •18.5.1.1 Glomerular Disease
- •18.6 Gastrointestinal Manifestations
- •18.6.1 Mesenteric Vasculitis
- •18.6.2 Primary Biliary Cirrhosis
- •18.7 Urologic
- •18.8 Therapeutic Management of Obstetrical/Gynecological Manifestations
- •18.9 Special Precautions at the Time of Surgery
- •18.10 Vaccinations in the SS Patient
- •18.11 Summary
- •18.12 Late-Breaking Updates
- •References
- •19.1 Introduction
- •19.3.1 Fatigue
- •19.3.2 Musculoskeletal
- •19.3.4 Gastrointestinal Manifestations
- •19.3.5 Liver Involvement
- •19.3.6 Lung Involvement
- •19.3.7 Kidney Involvement
- •19.3.8 Neurologic Involvement
- •19.3.9 Hematologic Involvement
- •19.4 Conclusions
- •References
- •20.1 Introduction
- •20.2 Diagnosis
- •20.3 Staging and Evaluation of Treatment Response
- •20.4 Treatment
- •20.5 Summary/Pearls
- •References
- •21.1 Introduction
- •21.2 What Is Fatigue?
- •21.3 Potential Causes of Fatigue in pSS
- •21.3.1 Biological
- •21.3.1.1 Cytokines
- •21.3.1.2 Neuroendocrine
- •21.3.1.3 Sleep
- •21.3.2 Psychosocial
- •21.3.2.1 Depression
- •21.3.2.2 Fibromyalgia
- •21.4 Measurement of Fatigue and Other Extraglandular Symptoms
- •21.6 Potential Approaches to Treatment of Fatigue and Other Extraglandular Symptoms
- •21.7 Measurement of Dryness (Sicca) Symptoms
- •21.8 Data from Existing Clinical Studies Addressing Dryness in pSS
- •21.9 Conclusion: Clinical Trial Outcomes
- •References
- •22.1 Introduction
- •22.2 Clinical Evaluation of Neurological Findings in SS
- •22.3.1 Role of Cell-Mediated Immunity
- •22.3.2 The Role of Antibodies Associated with Neurological Manifestations of SS
- •22.4 Investigations
- •22.4.1 Neurophysiology
- •22.4.2 Autonomic Studies
- •22.4.3 MR Imaging of the Spinal Cord
- •22.5 Peripheral Clinical Manifestations
- •22.6 Painful Sensory Neuropathies
- •22.6.1 Differential Diagnosis
- •22.7 Sensory Ataxic Neuropathy
- •22.7.1 Differential Diagnosis
- •22.8 Neuromuscular Weakness
- •22.8.1 Differential Diagnosis
- •22.9 Neuromuscular Pain
- •22.9.1 Differential Diagnosis
- •22.10 Autonomic Neuropathy
- •22.10.1 Differential Diagnosis
- •22.11 Trigeminal Neuropathy and Other Cranial Neuropathies
- •22.12 Central Nervous System Manifestations
- •22.12.2 Cognitive Impairment
- •22.12.3 Movement Disorders
- •22.12.4 Aseptic meningitis and Meningoencephalitis
- •22.12.5 Other Neurological Disorders
- •22.13 Investigations of Central Nervous System Manifestations
- •22.13.1 Serology
- •22.13.2 Spinal Fluid
- •22.13.4 Nuclear Brain Imaging Studies
- •22.13.5 Cerebral Angiography
- •22.14 The Puzzling Neurological Manifestations of Fibromyalgia
- •22.15 Interpretation of ANA in the Patient with Neurological Symptoms
- •22.16 Treatment
- •22.16.1 Peripheral Nervous System Treatment: Overview
- •22.16.2 Painful Sensory Neuropathies
- •22.16.3 Ataxic Neuropathy
- •22.16.4 Motor and Sensory Neuropathies
- •22.16.5 Central Nervous System Treatment
- •22.16.6 Side Effects of Immunosuppressive Therapy
- •22.17 Summary of Special Points to Neurologists
- •22.17.3 Relationship of Neurological Symptoms to Sicca Manifestations
- •22.18 Summary for Rheumatologists
- •References
- •23.1 Introduction
- •23.3.1 Labial Minor Salivary Gland Biopsy
- •23.3.2 Sialography
- •23.4 The Application of a Bite Guard
- •References
- •24.1 Introduction
- •24.2 How to Provide the Essential Tear Components to the Ocular Surface
- •24.3 Use of Autologous Serum Eye Drops for the Treatment of Dry Eye
- •24.4 Ongoing Research with Autologous Serum Eye Drops
- •24.5 Preparation of Autologous Serum Eye Drops
- •24.8 Conclusion
- •References
- •References
- •27.1 A Disease of Antiquity in Ancient China
- •References
- •References
- •References
- •30.1 Introduction
- •30.2 Evaluation of Systemic Features of Primary SS
- •30.2.4 Comparisons of Systemic Disease Activity Scores
- •30.3.1 The SSI: Sicca Symptoms Inventory
- •30.4 Conclusion
- •References
- •31.1 Clinical Practice Guidelines
- •31.2 Clinical Trials Consortium
- •31.3 Professional Education and Awareness
- •31.4.1 Rheumatology Working Group
- •31.4.2 Ocular Working Group
- •31.4.3 Oral Working Group
- •31.4.5 Facilitator for Both Initiatives
- •32.1 Introduction
- •32.2 For Which Patients Should Biological Therapy Be Considered?
- •32.7 BAFF Inhibition
- •32.8 Interferon Inhibition
- •32.9 Gene Therapy
- •32.10 Other Targets for Biologic Therapy
- •32.11 Conclusions and Future Directions
- •References
- •33.1 Overview of the Pathogenesis of pSS
- •33.1.1 Initial Steps
- •33.1.1.1 Breach of Self-tolerance
- •33.1.1.2 Activation of Innate Immunity and Interferon Pathways
- •33.1.1.4 Regulation of BAFF Secretion
- •33.1.1.6 Other Cytokines, Chemokines, and Adhesion Molecules Are Involved in the Pathogenesis of the Disease
- •33.1.3 Glandular Hypofunction Rather Than Glandular Destruction
- •33.2 Emerging Therapies
- •33.2.1 Prerequisite for the Development of New Drugs in pSS
- •33.2.1.1 Disease Activity Score
- •33.2.1.2 Selection of Patients
- •33.2.3.1 Inhibition of the Triggering Factors of IFN Activation
- •33.2.3.2 IFN Blockade
- •33.2.3.3 Antagonists of BAFF and APRIL
- •33.2.3.4 B-cell Depletion
- •33.2.3.5 Other B-cell-Targeted Therapy: Other Anti-CD20 and Anti-CD22
- •33.3 Other Therapeutic Perspectives
- •33.3.1 Inhibition of Other Cytokines and Chemokines
- •33.3.3 Gene Therapy
- •33.4 Conclusion
- •References
- •34.1 Introduction
- •34.5 Conclusion
- •References
- •Index
Contributors
Ilias Alevizos SjšgrenÕs Syndrome Clinic, National Institute of Dental and Craniofacial Research, Bethesda, MD, USA, alvizosi@nidcr.nih.gov
Elaine Alexander SjšgrenÕs Syndrome Foundation Medical and ScientiÞc Advisory Board, San Diego, CA, USA, elaine@easandiego.com
Jacqui E. Allen Department of Otolaryngology, University of Auckland, Auckland, New Zealand, jacquieallen@yahoo.com
Chiara Baldini Rheumatology Unit, University of Pisa, Pisa, Italy, chiara.baldini@gmail.com
Peter C. Belafsky The Center for Voice and Swallowing, University of California at Davis, Davis, CA, USA, pbelafsky@sbcglobal.net
Julius Birnbaum Division of Rheumatology, The Jerome L. Greene SjšgrenÕs Syndrome Center, Johns Hopkins Bayview Medical Center, Baltimore, MD, USA, jbirnba2@jhmi.edu
Stefano Bombardieri Rheumatology Unit, University of Pisa, Pisa, Italy, s.bombardieri@int.med.unipi.it
Hendrika Bootsma Department of Rheumatology and Clinical Immunology, University of Groningen, Groningen, The Netherlands; University Medical Center, Groningen, The Netherlands, h.bootsma@reuma.umcg.nl
Simon J. Bowman Department of Rheumatology, University Hospitals Birmingham, Birmingham, England, simon.bowman@uhb.nhs.uk
Steven E. Carsons SUNY at Stony Brook School of Medicine, Stony Brook, NY, USA; Division of Rheumatology, Allergy and Immunology, Winthrop-University Hospital, Mineola, NY, USA, Scarsons@winthrop.org
Seunghee Cha Department of Oral Surgery and Diagnostic Sciences, University of Florida College of Dentistry, Gainesville, FL, USA; Department of Oral Biology, University of Florida College of Dentistry, Gainesville, FL, USA, SCHA@dental.uß.edu
Edward K.L. Chan Department of Oral Biology, University of Florida College of Dentistry, Gainesville, FL, USA, echan@uß.edu
xi
xii |
Contributors |
|
|
John A. Chiorini Department of Molecular Physiology and Therapeutics
Branch, National Institute of Dental and Craniofacial Research, Bethesda,
MD, USA, jchiorin@mail.nih.gov
Philip L. Cohen Section of Rheumatology, Department of Medicine, Temple University School of Medicine, Philadelphia, PA, USA, philco@temple.edu
Debashish Danda Department of Clinical Immunology and Rheumatology, Christian Medical College, Vellore, India, debashishdandacmc@hotmail.com
Nicolas Delaleu Broegelmann Research Laboratory, The Gade Institute, University of Bergen, Bergen, Norway; Rheumatology Clinic, Scripps Memorial Hospital and Research Foundation, La Jolla, CA, USA, nicolas.delaleu@gades.uib.no
Carla M. Fox Rheumatology Clinic, Scripps Memorial Hospital and
Research Foundation, La Jolla, CA, USA, carlafoxrn@mac.com
Robert I. Fox Rheumatology Clinic, Scripps Memorial Hospital and
Research Foundation, La Jolla, CA, USA, robertfoxmd@mac.com
Jonn Terje Geitung Haraldsplass Deaconess University Hospital, Bergen, Norway, jtgeit@online.no; jonn.terje.geitung@haraldsplass.no
Tom Gordon Department of Immunology, Flinders Medical Center,
Flinders, Australia, t.gordon@ßinders.edu.au
Jacques-Eric Gottenberg Centre de Recherche BiomŽdical Strasbourgeois (CRBS), H™pitaux Universitaires de Strasbourg, UniversitŽ de Strasbourg, Strasbourg, France, jacques-eric.gottenberg@chru-strasbourg.fr
Katherine Morland Hammitt SjšgrenÕs Syndrome Foundation,
Lynchburg, VA, USA, khammitt@sjogrens.org
John B. Harley Division of Rheumatology, Cincinnati ChildrenÕs Hospital Medical Center, Cincinnati, OH, john.Harley@cchmc.org
Jing He Department of Rheumatology and Immunology, PeopleÕs Hospital, Peking University Medical School, Beijing, China, hejing_1105@yahoo.com
Gustaaf W. van Imhoff Department of Hematology, University of
Groningen, Groningen, The Netherlands; University Medical Center,
Groningen, The Netherlands, g.w.van.imhoff@int.umcg.nl
Malin V. Jonsson Institute of Medicine - Section for Rheumatology,
University of Bergen, Bergen, Norway, malin.jonsson@odont.uib.no
Roland Jonsson Broegelmann Research Laboratory, The Gade Institute, University of Bergen, Bergen, Norway; Department of Rheumatology, Haukeland University Hospital, Bergen, Norway, roland.jonsson@gades.uib.no
Contributors |
xiii |
|
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Yrjö T. Konttinen Department of Medicine, Biomedicum Helsinki, Helsinki University Central Hospital, Helsinki, Finland; ORTON Orthopaedic Hospital of the ORTON Foundation, Helsinki, Finland; COXA Hospital for the Joint Replacement, Tampere, Finland, yrjo.konttinen@helsinki.Þ
Katja Koskenpato Department of Medicine, Biomedicum Helsinki, Helsinki University Central Hospital, Helsinki, Finland, katja.koskenpato@helsinki.Þ
Chak-sing Lau Division of Rheumatology and Clinical Immunology,
Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong
Kong, China, cslau@hku.hk
Zhan-Guo Li Department of Rheumatology and Immunology, PeopleÕs Hospital, Peking University Medical School, Beijing, China, zgli98@yahoo.com
Menelaos N. Manoussakis Department of Pathophysiology, School of
Medicine, University of Athens, Athens, Greece, menman@med.uoa.gr
Xavier Mariette Assistance Publique-H™pitaux de Paris (AP-HP), H™pital Bic•tre, Institut Pour la SantŽ et la Recherche MŽdicale (INSERM) U 1012, UniversitŽ Paris-Sud 11, Le Kremlin Bic•tre, France, xavier.mariette@bct.aphp.fr
Mihaela C. Marthinussen Section for Cariology, Department of Clinical Dentistry, Faculty of Medicine and Dentistry, Bergen, mihaela.cuida@iko.uib.no
Paul E. Michelson Eye Care of La Jolla, Scripps Memorial Hospital, La Jolla, CA, USA; UCSD School of Medicine, La Jolla, CA, USA, pmichel2@san.rr.com
Ramnath Misra Department of Immunology, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, India, rnmisra2000@gmail.com
Kathy L. Moser Arthritis and Immunology Program, Oklahoma Medical
Research Foundation, Oklahoma City, OK, USA, moserk@omrf.org
Haralampos M. Moutsopoulos Department of Pathophysiology, School of
Medicine, University of Athens, Athens, Greece, hmoutsop@med.uoa.gr
Yoichi Nakagawa Second Department of Oral and Maxillofacial Surgery, Tsurumi University School of Dental Medicine, Yokohama, Japan, nakagawa-y@tsurumi-u.ac.jp
Nikolay P. Nikolov SjšgrenÕs Syndrome Clinic, National Institute of Dental and Craniofacial Research, Bethesda, MD, USA, nikolovn@mail.nih.gov
Kazuhisa Nozawa Department of Rheumatology and Internal Medicine,
Urayasu Hospital Juntendo University, Chiba, Japan; Institute for
xiv |
Contributors |
|
|
Environment and Gender SpeciÞc Medicine, Juntendo University Graduate
School of Medicine, Chiba, Japan; Department of Rheumatology, Juntendo
Urayasu Hospital, Chiba, Japan, k-nozawa@juntendo.ac.jp
Sapan Pandya Department of Rheumatology, Vedanta Institute of Medical Sciences, Ahmedabad, India, sapancpandya@yahoo.com
Stephen C. Pflugfelder Department of Ophthalmology, Baylor College of Medicine, Houston, TX, USA, stevenp@bcm.edu
Justin Pijpe Department of Oral and Maxillofacial Surgery, Catharina
Hospital Eindhoven, Eindhoven, The Netherlands; University Medical
Center, Groningen, The Netherlands, j.pijpe@gmail.com
Raimo Pöllänen Department of Medicine, Biomedicum Helsinki, Helsinki University Central Hospital, Helsinki, Finland, raimo.pollanen@helsinki.Þ
Alberto Vivó Porcar Department of Medicine, Biomedicum Helsinki, Helsinki University Central Hospital, Helsinki, Finland, siralbertvivoporcar@gmail.com
Pauliina Porola Department of Medicine, Biomedicum Helsinki, Helsinki University Central Hospital, Helsinki, Finland, pauliina.porola@helsinki.Þ
Beata D. Przybyla Department of Microbiology and Immunology,
University of Arkansas for Medical Sciences, Little Rock, AK, USA,
BDPrzybyla@uams.edu
Manuel Ramos-Casals Sjšgren Syndrome Research Group (AGAUR),
Hospital Clinic, Barcelona, Spain, mramos@clinic.ub.es
Philippe Ravaud Centre dÕEpidomiologie Clinique, INSERM U738,
H™pital Hotel Dieu, Paris, France, philippe.ravaud@htd.aphp.fr
Maureen Rischmueller Department of Rheumatology, The Queen Elizabeth Hospital/University of Adelaide, Adelaide, South Australia, maureen.rischmueller@health.sa.gov.au
María Lorés Rodriguez Department of Medicine, Biomedicum Helsinki, Helsinki University Central Hospital, Helsinki, Finland, maria.lores.rodriguez@gmail.com
John G. Routsias Department of Pathophysiology, School of Medicine,
University of Athens, Athens, Greece, jroutsias@med.uoa.gr
Ichiro Saito Department of Pathology, Tsurumi University School of Dental Medicine, Yokohama, Japan, saito-i@tsurumi-u.ac.jp
Minoru Satoh Division of Rheumatology and Clinical Immunology,
Department of Medicine, University of Florida, Gainesville, FL, USA;
Department of Pathology, Immunology, and Laboratory Medicine,
University of Florida, Gainesville, FL, USA,
Minoru.Satoh@medicine.uß.edu
Raphaèle Seror Assistance Publique-Hopitaux de Paris, H™pital Bic•tre,
Department of Rheumatology, Institut Pour la SantŽ et la Recherche
Contributors |
xv |
|
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MŽdicale (INSERM) U 802, UniversitŽ Paris-Sud 11, Le Kremlin Bic•tre,
France, raphaele.se@gmail.com
Yehuda Shoenfeld Department of Medicine ÒBÓ and Zabludowicz Center for Autoimmune Diseases, Sheba Medical Center, Tel-Hashomer, Israel, shoenfel@tau.ac.il
Kathrine Skarstein Broegelmann Research Laboratory, Department
of Immunology, The Gade Institute, University of Bergen, Bergen, Norway, kathrine.skarstein@gades.uib.no
Michelle Spaan Department of Medicine, Biomedicum Helsinki, Helsinki University Central Hospital, Helsinki, Finland, michelle.spaan@hotmail.com
Vasily Stegaev Department of Medicine, Biomedicum Helsinki, Helsinki
University Central Hospital, Helsinki, Finland, vasily.stegaev@helsinki.Þ
Michael E. Stern Inßammation Research Program, Allergan, Inc., Irvine,
CA, USA, stern_michael@allergan.com
John H. Stone Division of Rheumatology, Allergy, and Immunology,
Massachusetts General Hospital, Boston, MA, USA, jhstone@partners.org
Yoshinari Takasaki Department of Internal Medicine and Rheumatology, Juntendo University School of Medicine, Tokyo, Japan, tyoshi@juntendo.ac.jp
Elke Theander Skane University Hospital Malmš, Malmš, Sweden, elke.theander@med.lu.se
Moshe Tishler Department of Medicine ÒBÓ, Asaf Harofe Medical
Center, ZeriÞn, Israel 70300, tishlerm@netvision.net.il
Pamela Traisak Section of Rheumatology, Department of Medicine, Temple University School of Medicine, Philadelphia, PA, USA, pammy1000@hotmail.com
Kazuo Tsubota Department of Ophthalmology, Keio University School of Medicine, Tokyo, Japan, tsubota@z3.keio.jp
Athanasios G. Tzioufas Department of Pathophysiology, School of Medicine, University of Athens, Athens, Greece, agtzi@med.uoa.gr
Liisa Virkki Department of Medicine, Biomedicum Helsinki, Helsinki
University Central Hospital, Helsinki, Finland, liisa.m.virkki@helsinki.Þ
Claudio Vitali Section of Rheumatology, Department of Internal
Medicine, Villamarina Hospital, Piombino, Italy, c.vitali@yahoo.it
Frederick B. Vivino Division of Rheumatology, Penn Presbyterian
Medical Center, University of Pennsylvania School of Medicine,
Philadelphia, PA, USA, frederick.vivino@uphs.upenn.edu
Frank A. Wollheim Lund University Hospital SUS, Lund, Sweden, frank.wollheim@med.lu.se
Part I
Introduction
