Women with primary SS exhibit lower 2D:4D digit ratios compared with healthy controls, suggesting that a shifted prenatal estrogen-to-androgen balance may prime the immune system toward the glandular autoimmunity and exocrine dysfunction that define this disease. These findings implicate the prenatal hormonal milieu as a potential contributor to the immunological processes underlying SS pathogenesis.
Gür et al. (2026) studied this question.