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    4 biomarkers may improve Sjögren's syndrome treatment


    Confirming the relationship

    Dr. Edman is recruiting additional patients into the study to confirm the relationship between the biomarkers and to determine whether all four would be needed to develop a successful diagnostic tool as well as to understand the statistical power of using one or combinations of the proteins.

    The team has also conducted research on identifying threshold values, particularly for CTSS that might be useful in a future diagnostic test, and help doctors determine when to refer dry eye patients to a rheumatologist for a full work-up for symptoms of Sjögren’s syndrome.

    Yet another avenue of research is a potential correlation between levels of CTSS in tears and the degree of inflammation in the lacrimal gland. Evidence suggesting a relationship has been found in a mouse model, noted Dr. Hamm-Alvarez, and if confirmed, might be used to evaluate the efficacy of treatment aimed at reducing inflammation.

    This ongoing research has produced additional discoveries pertaining to molecular changes in glands in mice that can result in increased release of CTSS and appear to be related to disease processes. Focusing on the proteins Rab3D and Rab27, the research team found that genetically modified mice lacking Rab3D had more CTSS in their tears, while mice lacking Rab27 had lower levels of CTSS.

    The two proteins counteracted each other, and it appears that the loss of Rab3D may increase the influence of Rab27 and contribute to the release of CTSS in patients with Sjögren’s syndrome. This study was published in the American Journal of Physiology—Cell Physiology.1


    1.  Meng Z, Edman MC, Hsueh PY, Chen CY, Klinngam W, Tolmachova T, Okamoto CT, Hamm-Alvarez SF. Imbalanced Rab3D versus Rab27 increases cathepsin S secretion from lacrimal acini in a mouse model of Sjögren's syndrome. Am J Physiol Cell Physiol. April 13, 2016.


    Maria C. Edman, PhD

    e: [email protected]


    Sarah F. Hamm-Alvarez, PhD

    e: [email protected]


    This article was adapted from a poster presented at the 2015 meeting of the Association for Research in Vision and Ophthalmology.

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