Sjögren syndrome (SS) in adults is characterised by inflammation of the exocrine glands, principally the salivary and lacrimal glands resulting in xerostomia (dry mouth) and xerophthalmia (dry eyes).It can also present with more extensive exocrinopathy as well as extra-glandular, systemic features. SS is defined as primary SS (pSS) when it occurs in isolation, and as secondary SS, if associated with other autoimmune conditions. The incidence and prevalence rates of SS vary depending on the population. To date, there have been no studies reporting accurate incidence or prevalence of SS in childhood. Childhood onset SS defined as disease diagnosed before 18 years of age is believed to be rare; however, it is likely it is under-recognised and therefore under-diagnosed. The overarching aim of this study is to identify epidemiological, clinical and laboratory characteristics of paediatric SS in a United Kingdom (UK) multi-centre cohort of patients. Using this data our goal is to develop universally accepted classification criteria that could be validated for use in a paediatric population. Inclusion criterion for the study and repository is a diagnosis of SS made before 18 years by the referring physician. A data collection pack will be sent to authors willing to participate. Information collected will include but not exclusive to: demographic, clinical and laboratory/histological data at diagnosis and subsequent follow-up appointments. Biological samples including blood, tears, saliva, urine and glandular and extra-glandular (e.g. renal) tissue will be collected prospectively if available. Outcome measures related to disease activity and damage, as well as patient reported outcomes will also be collected at set time points (every 6 months) and during flares. PaedSSCoRe will capture data on a significant cohort of children with SS providing a powerful resource to help improve our understanding of the pathogenesis and natural course of this disease. Prospective data collection will allow a fuller analysis of poor prognostic features, impact of therapy and damage accrual, and variable outcome of childhood SS.
Study Type
OBSERVATIONAL
Enrollment
300
Patients will be given standard of care as per their clinical needs
Children's Health Ireland (CHI) at Crumlin
Dublin, Ireland
Cambridge University Hospitals NHS Foundation Trust
Cambridge, United Kingdom
Great Ormond Street Hospital For Children NHS Foundation Trust
London, United Kingdom
University College London Hospital
London, United Kingdom
The Newcastle Upon Tyne Hospitals NHS Foundation Trust
Newcastle, United Kingdom
Sheffield Children's NHS Foundation Trust
Sheffield, United Kingdom
Sheffield Teaching Hospitals NHS Foundation Trust
Sheffield, United Kingdom
University Hospital Southampton NHS Foundation Trust
Southampton, United Kingdom
Provide an estimate of the pre valence of relatively uncommon but serious manifestations of Sjögren's syndrome
Provide an estimate of the pre valence of relatively uncommon but serious manifestations of SS. The investigators will describe the prevalence of severe disease manifestations, such as lymphoma, central and peripheral nervous system and renal involvement (for which there is no data in paediatric populations) on all patients recruited to this cohort during this grant. The investigators will be correlating clinical manifestations to various parameters, such as age at onset, disease duration, ethnicity, gender, pubertal status, disease scores and patient and physician outcome measures aiming to establish disease trajectories.
Time frame: 2 years
Explore immune signatures in a multi-centre cohort of childhood onset Sjögren's syndrome
The investigators aim to explore the specific immune signatures identified in adults in children and adolescent patients with paediatric onset SS. The investigators will assess their immune signatures (combined monocyte, B- and T-cell phenotype by multi-parameter flow cytometry)
Time frame: 2 years
Assess the metabolomic/transcriptomic profiles of paediatric Sjögren's syndrome endotypes
The pilot data from adults with SS suggest that certain endotypes could be enriched with an interferon-associated signature or metabolomic profile. Characterisation of these mechanisms could pinpoint additional novel biomarkers for endotype classification and potential novel targets for therapy.
Time frame: 2 years
Correlate -omic data with clinical and disease features to define the disease fingerprint associated with paediatric onset SS.
Following initial cleaning of data to remove metabolites/genes/cytokines showing no differences between paediatric SS patients and healthy donors, the investigators will stratify differentially expressed metabolic and genetic markers according to the identified immune-phenotypes and generate a disease fingerprint (combined -omics analysis) for paediatric SS. Correlations between gene expression and metabolomics and immune-phenotype (cells/cytokines) will be established using regression/cross-correlation analysis. The investigators will confirm which patterns of immune-phenotype/metabolic/ transcriptomic profiles are most highly associated with childhood-onset compared to adult SS endotypes.
Time frame: 2 years
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