Evidence map›Paper›PMID 39780265›Full record

ArticleAdvances in rheumatology (London, England)2025

Endoplasmic reticulum stress in the salivary glands of patients with primary Sjögren's syndrome, associated Sjögren's syndrome, and non-Sjögren's sicca syndrome: a comparative analysis and the influence of chloroquine.

Graziela Vieira Cavalcanti, Fabiola Reis de Oliveira, Rafael Ferraz Bannitz, Natalia Aparecida de Paula, Ana Carolina Fragoso Motta, Eduardo Melani Rocha, John Chiorini, Hilton Marcos Alves Ricz, Denny Marcos Garcia, Maria Cristina Foss-Freitas and 1 more

Erratum issuedAbstract readComparative Study
In one paragraph

Article in Advances in rheumatology (London, England), 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. [Single-cell RNA sequencing of B cells reveals molecular typing in Sjögren syndrome].Beijing da xue xue bao. Yi xue ban = Journal of Peking University. Health sciences · 2025
    Article
  2. Review
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

11 authors.

Graziela Vieira CavalcantiDepartment of Ophthalmology, Otolaryngology, Head and Neck Surgery, Ribeirão Preto Medical School, University of São Paulo, São Paulo, Brazil. grazivc@yahoo.com.br.ORCID 0000-0002-7349-5273
Fabiola Reis de OliveiraDepartment of Internal Medicine, Ribeirão Preto Medical School, University of São Paulo, São Paulo, Brazil.ORCID 0000-0002-9196-7422
Rafael Ferraz BannitzDepartment of Internal Medicine, Ribeirão Preto Medical School, University of São Paulo, São Paulo, Brazil.ORCID 0000-0003-4496-4883
Natalia Aparecida de PaulaDepartment of Internal Medicine, Ribeirão Preto Medical School, University of São Paulo, São Paulo, Brazil.ORCID 0000-0002-3744-8947
Ana Carolina Fragoso MottaDepartment of Stomatology, Public Health and Forensic Dentistry, Ribeirão Preto School of Dentistry, University of São Paulo, São Paulo, Brazil.ORCID 0000-0002-3887-9239
Eduardo Melani RochaDepartment of Ophthalmology, Otolaryngology, Head and Neck Surgery, Ribeirão Preto Medical School, University of São Paulo, São Paulo, Brazil.ORCID 0000-0001-9888-7313
John ChioriniAdeno-Associated Virus Biology Section, National Institute of Dental and Craniofacial Research, National Institutes of Health, Bethesda, MD, USA.
Hilton Marcos Alves RiczDepartment of Ophthalmology, Otolaryngology, Head and Neck Surgery, Ribeirão Preto Medical School, University of São Paulo, São Paulo, Brazil.ORCID 0000-0002-3019-8949
Denny Marcos GarciaDepartment of Ophthalmology, Otolaryngology, Head and Neck Surgery, Ribeirão Preto Medical School, University of São Paulo, São Paulo, Brazil.ORCID 0000-0001-9123-2728
Maria Cristina Foss-FreitasDivision of Metabolism, Endocrinology, and Diabetes, Department of Internal Medicine, and Caswell Diabetes Institute, University of Michigan, Ann Arbor, MI, USA.ORCID 0000-0002-1350-1125
Luiz Carlos Conti de FreitasDepartment of Ophthalmology, Otolaryngology, Head and Neck Surgery, Ribeirão Preto Medical School, University of São Paulo, São Paulo, Brazil.ORCID 0000-0002-2153-6512

Funding

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior 001
6 · The paper itself

Abstract

backgroundEndoplasmic reticulum stress (ERS) and the unfolded protein response (UPR) are adaptive mechanisms for conditions of high protein demand, marked by an accumulation of misfolded proteins in the endoplasmic reticulum (ER). Rheumatic autoimmune diseases (RAD) are known to be associated with chronic inflammation and an ERS state. However, the activation of UPR signaling pathways is not completely understood in Sjögren’s disease (SD). This study evaluated the expression of ERS-related genes in glandular tissue of patients with primary SD (pSD), associated SD (aSD) with other autoimmune diseases, and non-Sjögren sicca syndrome (NSS).

methodsIn a cross-sectional study, minor salivary gland biopsies were obtained from 44 patients with suspected SD and 13 healthy controls (HC). Patients were classified as pSD, aSD, or NSS based on clinical, serological, and histological assessment. Histopathological analysis and mRNA expression analysis of genes associated with ERS and UPR (PERK, XBP1, ATF-6, ATF-4, CANX, CALR, CHOP, and BIP) were performed on the samples. Differences between groups (pSD, aSD, NSS, and HC) were assessed. The influence of chloroquine (CQ) on the ER was also investigated.

resultsTwenty-eight SD patients showed increased expression of PERK (p = 0.0117) and XBP1 (p = 0.0346), and reduced expression of ATF-6 (p = 0.0003) and CHOP (p = 0.0003), compared to the HC group. Increased expression of BIP (p < 0.0001), PERK (p = 0.0003), CALR (p < 0.0001), and CANX (p = 0.0111) was also observed in the SD group compared to the NSS group (n = 16). Patients receiving CQ (n = 16) showed a significant increase in ATF-6 (p = 0.0317) compared to patients not taking the medication (n = 29).

conclusionsAltogether, the results suggest a greater activation of the ERS and UPR genes in patients with SD, especially in the pSD group. Antimalarial drugs, like CQ, used to treat RAD, may affect the ER function in exocrine glands.

Indexed as

Antirheumatic AgentsChloroquineEndoplasmic Reticulum StressSalivary Glands, MinorSjogren's SyndromeActivating Transcription Factor 4Activating Transcription Factor 6AdultAgedCase-Control StudiesCross-Sectional StudieseIF-2 KinaseEndoplasmic Reticulum Chaperone BiPFemaleHumansMaleActivating Transcription Factor 4Activating Transcription Factor 6Antirheumatic AgentsATF4 protein, humanATF6 protein, humanChloroquineDDIT3 protein, humanEIF2AK3 protein, humaneIF-2 KinaseEndoplasmic Reticulum Chaperone BiPTranscription Factor CHOPX-Box Binding Protein 1XBP1 protein, humanCross-sectional studiesEndoplasmic reticulum stressGene expressionSjögren syndromeUnfolded protein response

Identifiers

PMID39780265
PMCPMC13488755

What Socratic holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.