{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T21:08:37Z","timestamp":1792098517421,"version":"4.4.0"},"reference-count":96,"publisher":"Wiley","issue":"S1","license":[{"start":{"date-parts":[[2018,9,3]],"date-time":"2018-09-03T00:00:00Z","timestamp":1535932800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100005036","name":"Universitetet i Bergen","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100005036","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["European J Oral Sciences"],"published-print":{"date-parts":[[2018,10]]},"abstract":"<jats:p>Sj\u00f6gren's syndrome is a lymphoproliferative disease with autoimmune features characterized by mononuclear cell infiltration of exocrine glands, notably the lacrimal and salivary glands. These lymphoid infiltrations lead to dryness of the eyes (keratoconjunctivitis sicca), dryness of the mouth (xerostomia), and, frequently, dryness of other surfaces connected to exocrine glands. Sj\u00f6gren's syndrome is associated with the production of autoantibodies because B\u2010cell activation is a consistent immunoregulatory abnormality. The spectrum of the disease extends from an organ\u2010specific autoimmune disorder to a systemic process and is also associated with an increased risk of B\u2010cell lymphoma. Current treatments are mainly symptomatic. As a result of the diverse presentation of the syndrome, a major challenge remains to improve diagnosis and therapy. For this purpose an international set of classification criteria for primary Sj\u00f6gren's syndrome has recently been developed and validated and seems well suited for enrolment in clinical trials. Salivary gland biopsies have been examined and histopathology standards have been developed, to be used in clinical trials and patient stratification. Finally, ultrasonography and saliva meet the need of non\u2010invasive imaging and sampling methods for discovery and validation of disease biomarkers in Sj\u00f6gren's syndrome.<\/jats:p>","DOI":"10.1111\/eos.12536","type":"journal-article","created":{"date-parts":[[2018,9,4]],"date-time":"2018-09-04T01:15:41Z","timestamp":1536023741000},"page":"37-48","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":149,"title":["Current concepts on Sj\u00f6gren's syndrome \u2013 classification criteria and\u00a0biomarkers"],"prefix":"10.1111","volume":"126","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9588-0260","authenticated-orcid":false,"given":"Roland","family":"Jonsson","sequence":"first","affiliation":[{"name":"Broegelmann Research Laboratory Department of Clinical Science University of Bergen Bergen Norway"},{"name":"Department of Rheumatology Haukeland University Hospital Bergen Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0593-2731","authenticated-orcid":false,"given":"Karl A.","family":"Brokstad","sequence":"additional","affiliation":[{"name":"Broegelmann Research Laboratory Department of Clinical Science University of Bergen Bergen Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Malin V.","family":"Jonsson","sequence":"additional","affiliation":[{"name":"Department of Clinical Dentistry \u2013 Section\u00a0for Oral and Maxillofacial Radiology University of Bergen Bergen Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicolas","family":"Delaleu","sequence":"additional","affiliation":[{"name":"Broegelmann Research Laboratory Department of Clinical Science University of Bergen Bergen Norway"},{"name":"2C SysBioMed Contra Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kathrine","family":"Skarstein","sequence":"additional","affiliation":[{"name":"Gade Laboratory for Pathology Department of Clinical Medicine University of Bergen Bergen Norway"},{"name":"Department of Pathology Haukeland University Hospital Bergen Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2018,9,3]]},"reference":[{"key":"e_1_2_12_2_1","first-page":"1","article-title":"Zur Kenntnis der Keratoconjunctivitis sicca","volume":"11","author":"Sj\u00f6gren H","year":"1933","journal-title":"Acta Ophthalmol"},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.1136\/jcp.21.5.656"},{"key":"e_1_2_12_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/0030-4220(74)90417-4"},{"key":"e_1_2_12_5_1","doi-asserted-by":"publisher","DOI":"10.1136\/annrheumdis-2016-210448"},{"key":"e_1_2_12_6_1","doi-asserted-by":"publisher","DOI":"10.1136\/annrheumdis-2016-210571"},{"key":"e_1_2_12_7_1","doi-asserted-by":"publisher","DOI":"10.1136\/annrheumdis-2017-211378"},{"key":"e_1_2_12_8_1","doi-asserted-by":"publisher","DOI":"10.1067\/mcp.2001.113989"},{"key":"e_1_2_12_9_1","first-page":"495","volume-title":"Samter\u2032s Immunologic Diseases","author":"Jonsson R","year":"2001"},{"key":"e_1_2_12_10_1","doi-asserted-by":"publisher","DOI":"10.2147\/JIR.S137024"},{"key":"e_1_2_12_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.rdc.2016.03.002"},{"key":"e_1_2_12_12_1","doi-asserted-by":"publisher","DOI":"10.1002\/art.1780360309"},{"key":"e_1_2_12_13_1","doi-asserted-by":"publisher","DOI":"10.1136\/ard.61.6.554"},{"key":"e_1_2_12_14_1","doi-asserted-by":"publisher","DOI":"10.1002\/acr.21591"},{"key":"e_1_2_12_15_1","doi-asserted-by":"publisher","DOI":"10.4049\/jimmunol.102.1.117"},{"key":"e_1_2_12_16_1","doi-asserted-by":"publisher","DOI":"10.1002\/art.1780170413"},{"key":"e_1_2_12_17_1","doi-asserted-by":"publisher","DOI":"10.1002\/art.1780190214"},{"key":"e_1_2_12_18_1","first-page":"731","article-title":"Purification and characterization of the Sj\u00f6gren's syndrome A and B antigens","volume":"54","author":"Venables PJ","year":"1983","journal-title":"Clin Exp Immunol"},{"key":"e_1_2_12_19_1","doi-asserted-by":"publisher","DOI":"10.1080\/03009740510017940"},{"key":"e_1_2_12_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bbrc.2005.11.029"},{"key":"e_1_2_12_21_1","first-page":"310","article-title":"Ro60 ribonucleoprotein inhibits transcription by T3 RNA polymerase in\u00a0vitro","volume":"66","author":"Campos\u2010Almaraz MD","year":"1999","journal-title":"Rev Rheum Engl Ed"},{"key":"e_1_2_12_22_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0065-2776(08)60641-0"},{"key":"e_1_2_12_23_1","doi-asserted-by":"publisher","DOI":"10.1006\/clin.1993.1004"},{"key":"e_1_2_12_24_1","first-page":"1205","article-title":"IgA rheumatoid factor and IgA containing immune complexes in primary Sj\u00f6gren's syndrome","volume":"16","author":"Atkinson JC","year":"1989","journal-title":"J Rheumatol"},{"key":"e_1_2_12_25_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1365-2249.1999.00963.x"},{"key":"e_1_2_12_26_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1365-2249.1996.42748.x"},{"key":"e_1_2_12_27_1","first-page":"151","article-title":"Autoantibodies against lacrimal gland M3 muscarinic acetylcholine receptors in patients with primary Sj\u00f6gren's syndrome","volume":"39","author":"Bacman S","year":"1998","journal-title":"Invest Ophthalmol Vis Sci"},{"key":"e_1_2_12_28_1","doi-asserted-by":"publisher","DOI":"10.1073\/pnas.95.13.7538"},{"key":"e_1_2_12_29_1","doi-asserted-by":"publisher","DOI":"10.1002\/1529-0131(200007)43:7<1647::AID-ANR31>3.0.CO;2-P"},{"key":"e_1_2_12_30_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1365-3083.1999.00490.x"},{"key":"e_1_2_12_31_1","doi-asserted-by":"publisher","DOI":"10.3109\/s10165-012-0788-5"},{"key":"e_1_2_12_32_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaut.2013.12.012"},{"key":"e_1_2_12_33_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0116744"},{"key":"e_1_2_12_34_1","doi-asserted-by":"publisher","DOI":"10.1136\/ard.2010.129049"},{"key":"e_1_2_12_35_1","doi-asserted-by":"publisher","DOI":"10.3109\/03009749409103041"},{"key":"e_1_2_12_36_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1699-0463.1996.tb04953.x"},{"key":"e_1_2_12_37_1","doi-asserted-by":"publisher","DOI":"10.3109\/03009742.2013.848930"},{"key":"e_1_2_12_38_1","first-page":"1006","article-title":"Serum calprotectin is a biomarker of carotid atherosclerosis in patients with primary Sj\u00f6gren's syndrome","volume":"34","author":"Balarini GM","year":"2016","journal-title":"Clin Exp Rheumatol"},{"key":"e_1_2_12_39_1","doi-asserted-by":"publisher","DOI":"10.1136\/annrheumdis-2015-207751"},{"key":"e_1_2_12_40_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2013.278448"},{"key":"e_1_2_12_41_1","doi-asserted-by":"publisher","DOI":"10.1002\/art.39214"},{"key":"e_1_2_12_42_1","doi-asserted-by":"publisher","DOI":"10.1136\/ard.53.10.637"},{"key":"e_1_2_12_43_1","doi-asserted-by":"publisher","DOI":"10.1136\/annrheumdis-2013-203953"},{"key":"e_1_2_12_44_1","doi-asserted-by":"publisher","DOI":"10.1136\/annrheumdis-2013-204634"},{"key":"e_1_2_12_45_1","doi-asserted-by":"publisher","DOI":"10.1136\/ard.2010.144782"},{"key":"e_1_2_12_46_1","doi-asserted-by":"publisher","DOI":"10.1136\/annrheumdis-2016-209300"},{"key":"e_1_2_12_47_1","doi-asserted-by":"publisher","DOI":"10.1093\/rheumatology\/kel266"},{"key":"e_1_2_12_48_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.micinf.2009.04.004"},{"key":"e_1_2_12_49_1","doi-asserted-by":"publisher","DOI":"10.1093\/rheumatology\/ket179"},{"key":"e_1_2_12_50_1","doi-asserted-by":"publisher","DOI":"10.1006\/clim.2002.5199"},{"key":"e_1_2_12_51_1","doi-asserted-by":"publisher","DOI":"10.3109\/08916934.2012.712170"},{"key":"e_1_2_12_52_1","doi-asserted-by":"publisher","DOI":"10.1002\/art.11311"},{"key":"e_1_2_12_53_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-0714.2008.00674.x"},{"key":"e_1_2_12_54_1","doi-asserted-by":"publisher","DOI":"10.1080\/08916934.2016.1183656"},{"key":"e_1_2_12_55_1","doi-asserted-by":"publisher","DOI":"10.1080\/08916934.2017.1385776"},{"key":"e_1_2_12_56_1","doi-asserted-by":"publisher","DOI":"10.1186\/ar3220"},{"key":"e_1_2_12_57_1","doi-asserted-by":"publisher","DOI":"10.1080\/08916934.2018.1446525"},{"key":"e_1_2_12_58_1","doi-asserted-by":"publisher","DOI":"10.1136\/annrheumdis-2017-211250"},{"key":"e_1_2_12_59_1","doi-asserted-by":"publisher","DOI":"10.1136\/annrheumdis-2017-211290"},{"key":"e_1_2_12_60_1","doi-asserted-by":"publisher","DOI":"10.1136\/annrheumdis-2017-212289"},{"key":"e_1_2_12_61_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.rdc.2016.03.008"},{"key":"e_1_2_12_62_1","first-page":"56","article-title":"Diagnostic utility of major salivary gland ultrasonography in primary Sj\u00f6gren's syndrome","volume":"33","author":"Hammenfors DS","year":"2015","journal-title":"Clin Exp Rheumatol"},{"key":"e_1_2_12_63_1","first-page":"1","article-title":"Salivary gland ultrasonography findings are associated with clinical, histological, and serologic features of Sj\u00f6gren's syndrome","author":"Kim JW","year":"2018","journal-title":"Scand J Rheumatol"},{"key":"e_1_2_12_64_1","doi-asserted-by":"publisher","DOI":"10.1002\/acr.22264"},{"key":"e_1_2_12_65_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.tripleo.2007.11.007"},{"key":"e_1_2_12_66_1","first-page":"311","article-title":"Ultrasound assessment of salivary glands in patients with primary Sj\u00f6gren's syndrome treated with rituximab: Quantitative and Doppler waveform analysis","volume":"1","author":"Jousse\u2010Joulin S","year":"2007","journal-title":"Biologics"},{"key":"e_1_2_12_67_1","doi-asserted-by":"publisher","DOI":"10.1002\/art.39088"},{"key":"e_1_2_12_68_1","doi-asserted-by":"publisher","DOI":"10.1136\/rmdopen-2016-000364"},{"key":"e_1_2_12_69_1","doi-asserted-by":"publisher","DOI":"10.1136\/annrheumdis-2017-211992"},{"key":"e_1_2_12_70_1","doi-asserted-by":"publisher","DOI":"10.1093\/rheumatology\/keh588"},{"key":"e_1_2_12_71_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13075-015-0657-7"},{"key":"e_1_2_12_72_1","doi-asserted-by":"publisher","DOI":"10.1111\/jop.12387"},{"key":"e_1_2_12_73_1","first-page":"2198","article-title":"Ultrasonography of major salivary glands: a highly specific tool for distinguishing primary Sj\u00f6gren's syndrome from undifferentiated connective tissue diseases","volume":"52","author":"Luciano N","year":"2015","journal-title":"Rheumatology (Oxford)"},{"key":"e_1_2_12_74_1","doi-asserted-by":"publisher","DOI":"10.1002\/art.37698"},{"key":"e_1_2_12_75_1","doi-asserted-by":"publisher","DOI":"10.1093\/rheumatology\/keu037"},{"key":"e_1_2_12_76_1","doi-asserted-by":"publisher","DOI":"10.1093\/rheumatology\/kev278"},{"key":"e_1_2_12_77_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13075-017-1475-x"},{"key":"e_1_2_12_78_1","first-page":"1286","article-title":"Modification of the classification criteria for primary Sj\u00f6gren syndrome: An International vignette survey","volume":"69","author":"Jousse\u2010Joulin S","year":"2017","journal-title":"Arthritis Rheumatol"},{"key":"e_1_2_12_79_1","first-page":"1152","article-title":"Sjogren's syndrome in childhood","volume":"22","author":"Anaya JM","year":"1995","journal-title":"J Rheumatol"},{"key":"e_1_2_12_80_1","doi-asserted-by":"publisher","DOI":"10.1097\/BOR.0b013e328363ed23"},{"key":"e_1_2_12_81_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00431-003-1277-9"},{"key":"e_1_2_12_82_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1079-2104(03)00159-8"},{"key":"e_1_2_12_83_1","doi-asserted-by":"publisher","DOI":"10.3109\/s10165-012-0633-x"},{"key":"e_1_2_12_84_1","doi-asserted-by":"publisher","DOI":"10.1097\/SCS.0b013e3182942ce3"},{"key":"e_1_2_12_85_1","first-page":"427","article-title":"Juvenile Sj\u00f6gren syndrome: distinctive age, unique findings","volume":"34","author":"Souza TR","year":"2012","journal-title":"Pediatr Dent"},{"key":"e_1_2_12_86_1","first-page":"578","article-title":"Salivary gland ultrasound in children: a useful tool in the diagnosis of juvenile Sj\u00f6gren's syndrome","volume":"32","author":"Nieto\u2010Gonzalez JC","year":"2014","journal-title":"Clin Exp Rheumatol"},{"key":"e_1_2_12_87_1","doi-asserted-by":"publisher","DOI":"10.1007\/978-1-60327-957-4_14"},{"key":"e_1_2_12_88_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.rdc.2016.03.004"},{"key":"e_1_2_12_89_1","doi-asserted-by":"publisher","DOI":"10.1002\/art.22954"},{"key":"e_1_2_12_90_1","doi-asserted-by":"publisher","DOI":"10.1186\/ar3523"},{"key":"e_1_2_12_91_1","doi-asserted-by":"publisher","DOI":"10.1002\/pmic.201200208"},{"key":"e_1_2_12_92_1","doi-asserted-by":"publisher","DOI":"10.1111\/cei.12683"},{"key":"e_1_2_12_93_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1741-2358.1996.tb00149.x"},{"key":"e_1_2_12_94_1","doi-asserted-by":"publisher","DOI":"10.1002\/pmic.201000206"},{"key":"e_1_2_12_95_1","doi-asserted-by":"publisher","DOI":"10.1002\/art.39015"},{"key":"e_1_2_12_96_1","doi-asserted-by":"publisher","DOI":"10.1093\/rheumatology\/kew013"},{"key":"e_1_2_12_97_1","doi-asserted-by":"publisher","DOI":"10.1002\/art.23656"}],"container-title":["European Journal of Oral Sciences"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Feos.12536","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/eos.12536","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/eos.12536","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/eos.12536","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,10]],"date-time":"2023-09-10T05:39:41Z","timestamp":1694324381000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/eos.12536"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018,9,3]]},"references-count":96,"journal-issue":{"issue":"S1","published-print":{"date-parts":[[2018,10]]}},"alternative-id":["10.1111\/eos.12536"],"URL":"https:\/\/doi.org\/10.1111\/eos.12536","archive":["Portico"],"relation":{"is-referenced-by":[{"id-type":"doi","id":"10.1186\/s42358-025-00490-3","asserted-by":"object"}]},"ISSN":["0909-8836","1600-0722"],"issn-type":[{"value":"0909-8836","type":"print"},{"value":"1600-0722","type":"electronic"}],"subject":[],"published":{"date-parts":[[2018,9,3]]},"assertion":[{"value":"2018-05-03","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2018-09-03","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}