Passage of progesterone into the brain changes with photoperiod in the ewe

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Translational Research in Sjögren’s Syndrome

Sjögren’s syndrome (SS) is an autoimmune inflammatory disorder of the exocrine glands, particularly affecting lacrimal and salivary glands. Hallmark symptoms are dry mouth and dry eye, often in conjunction with general symptoms, such as malaise and fatigue. Lymphomas could develop in 5–10% of the patients. As SS is a rather complex syndrome with many features, the one patient being diagnosed with SS may suffer from a different complex of complaints than another SS patient and may thus be in need of a different treatment approach. To better classify SS patients and to personalize their treatment, many clinicians and researchers are currently working on efforts (1) to refine classification of SS patients, (2) to ease the diagnostic work-up of SS, and (3) to better understand the etiopathogenesis of SS. Latter knowledge is essential to understand the course of the disease. This way clinicians will be able to identify patients who are at risk of developing SS or lymphomas; can intervene at an early stage of the disease to prevent damage to, e.g., the glands; as well as can personalize treatment with, e.g., biologicals. In this chapter, current major achievements are discussed, and promising new directions are indicated

Clinical evaluation of a nutraceutical diet as an adjuvant to pharmacological treatment in dogs affected by Keratoconjunctivitis sicca.

BACKGROUND: Canine keratoconjunctivitis sicca (cKCS) is an inflammatory eye condition related to a deficiency in the tear aqueous fraction. Etiopathogenesis of such disease is substantially multifactorial, combining the individual genetic background with environmental factors that contribute to the process of immunological tolerance disruption and, as a consequence, to the emergence of autoimmunity disease. In this occurrence, it is of relevance the role of the physiological immune-dysregulation that results in immune-mediated processes at the basis of cKCS. Current therapies for this ocular disease rely on immunosuppressive treatments. Clinical response to treatment frequently varies from poor to good, depending on the clinical-pathological status of eyes at diagnosis and on individual response to therapy. In the light of the variability of clinical response to therapies, we evaluated the use of an anti-inflammatory/antioxidant nutraceutical diet with potential immune-modulating activity as a therapeutical adjuvant in cKCS pharmacological treatment. Such combination was administered to a cohort of dogs affected by cKCS in which the only immunosuppressive treatment resulted poorly responsive or ineffective in controlling the ocular symptoms. RESULTS: Fifty dogs of different breeds affected by immune-mediated cKSC were equally distributed and randomly assigned to receive either a standard diet (control, n = 25) or the nutraceutical diet (treatment group, n = 25) both combined with standard immunosuppressive therapy over a 60 days period. An overall significant improvement of all clinical parameters (tear production, conjunctival inflammation, corneal keratinization, corneal pigment density and mucus discharge) and the lack of food-related adverse reactions were observed in the treatment group (p < 0.0001). CONCLUSIONS: Our results showed that the association of traditional immune-suppressive therapy with the antioxidant/anti-inflammatory properties of the nutraceutical diet resulted in a significant amelioration of clinical signs and symptoms in cKSC. The beneficial effects, likely due to the presence of supplemented nutraceuticals in the diet, appeared to specifically reduce the immune-mediated ocular symptoms in those cKCS-affected dogs that were poorly responsive or unresponsive to classical immunosuppressive drugs. These data suggest that metabolic changes could affect the immune response orchestration in a model of immune-mediated ocular disease, as represented by cKSC