Introduction and purpose: Sjögren’s disease (SjD) is a systemic autoimmune process in which traditional symptomatic treatment often fails to prevent organ complications. Thanks to intensive research into its pathogenesis, new therapeutic targets are being discovered, which may enable the causal treatment of the disease. This paper provides a review of modern therapeutic strategies, with a particular focus on JAK/BTK/SYK inhibitors, the CD40-CD40L pathway, and anti-CD20 therapy. Based on the latest clinical trial results, the article analyzes the potential of immunomodulation in modifying the course of SjD and preventing its systemic manifestations. Description of the state of knowledge: Current scientific consensus defines Sjögren's disease as a complex, multifactorial autoimmune condition. The progression of the disease is primarily driven by the overexpression of factors such as BAFF and APRIL, excessive interferon production, and specific lymphocyte populations, including follicular helper T-cells (Tfh) and CD8+ GZMK+ T-cells. Despite a detailed understanding of these molecular mechanisms, effective disease-modifying treatment remains elusive. Currently, researchers' attention is focused on therapies targeting novel signaling pathways. Conclusions: Modern treatment of Sjögren’s disease is evolving toward disease-modifying therapies that target the molecular mechanisms of epithelial inflammation and the type I interferon signature. Key strategies include targeted B- and T-cell immunomodulation and the inhibition of intracellular signaling pathways, which effectively reduce systemic activity and offer a significant steroid-sparing effect. The future of therapy relies on personalized medicine and the use of regenerative medicine, including exosomes, to restore the function of damaged glands.
Płecka et al. (Thu,) studied this question.