ArticleRMD open2016
Fatigue in primary Sjögren's syndrome is associated with lower levels of proinflammatory cytokines.
Article in RMD open, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 50 papers, 2 of them syntheses that pooled it.
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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.
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Who cites it
50 citing papers in PubMed, 2 syntheses or guidelines pooled it, 82 citations in OpenAlex.
- Pooled it
- An investigation into the prevalence of sleep disturbances in primary Sjögren's syndrome: a systematic review of the literature.Rheumatology (Oxford, England) · 2017Pooled it
- Revisiting the JOQUER trial: stratification of primary Sjögren's syndrome and the clinical and interferon response to hydroxychloroquine.Rheumatology international · 2021Trial
- Improvement of Severe Fatigue Following Nuclease Therapy in Patients With Primary Sjögren's Syndrome: A Randomized Clinical Trial.Arthritis & rheumatology (Hoboken, N.J.) · 2021Trial
- Fatigue in Sjögren's Disease - Integrating Biomedical and Psychosocial Aspects: A Narrative Review.Rheumatology and therapy · 2026Review
- Cytokine Networks and Clinical Heterogeneity in Sjögren's Disease: From Glandular Inflammation to Therapeutic Stratification.International journal of molecular sciences · 2026Review
- When Dryness Extends to the Brain: Brain-Related Non-Sicca Manifestations of Sjögren's Disease.Journal of clinical medicine · 2026Review
- Fatigue in primary and associated Sjögren's disease: similar burden, distinct determinants.Clinical rheumatology · 2026Article
- Article
- Decreased IL-4 is the risk factor of depression in patients with Takayasu arteritis.Frontiers in medicine · 2024Article
- Association of Inflammatory Cytokine Levels with Extra Glandular Manifestations, Fatigue, and Disease Activity in Primary Sjögren's Syndrome in Saudi Patients: A Cross-Sectional Study.Diagnostics (Basel, Switzerland) · 2023Article
- Depression is the most significant independent predictor of fatigue in patients with primary Sjögren's syndrome.Archives of rheumatology · 2023Article
- NMDA Receptors in Health and Diseases: New Roles and Signaling Pathways-Anti-N-Methyl-D-Aspartate Receptor (NMDAR) Autoantibodies as Potential Biomarkers of Fatigue in Patients with Rheumatic Diseases.International journal of molecular sciences · 2023Article
- Potential Mechanism of Fatigue Induction and Its Management by JAK Inhibitors in Inflammatory Rheumatic Diseases.Journal of inflammation research · 2023Review
- The multifaceted nature of IL-10: regulation, role in immunological homeostasis and its relevance to cancer, COVID-19 and post-COVID conditions.Frontiers in immunology · 2023Review
- Neural dysregulation in post-COVID fatigue.Brain communications · 2023Article
- The Future of Targeted Treatment of Primary Sjögren's Syndrome: A Focus on Extra-Glandular Pathology.International journal of molecular sciences · 2022Review
- Symptom-Based Cluster Analysis Categorizes Sjögren's Disease Subtypes: An International Cohort Study Highlighting Disease Severity and Treatment Discordance.Arthritis & rheumatology (Hoboken, N.J.) · 2022Article
- The interplay between cognition, depression, anxiety, and sleep in primary Sjogren's syndrome patients.Scientific reports · 2022Article
- Sjögren's and non-Sjögren's sicca share a similar symptom burden but with a distinct symptom-associated proteomic signature.RMD open · 2022Article
Corrections and comments
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Authors and funding
32 authors at 20 institutions in 1 country.
Funding
Abstract
objectivesThis article reports relationships between serum cytokine levels and patient-reported levels of fatigue, in the chronic immunological condition primary Sjögren's syndrome (pSS).
methodsBlood levels of 24 cytokines were measured in 159 patients with pSS from the United Kingdom Primary Sjögren's Syndrome Registry and 28 healthy non-fatigued controls. Differences between cytokines in cases and controls were evaluated using Wilcoxon test. Patient-reported scores for fatigue were evaluated, classified according to severity and compared with cytokine levels using analysis of variance. Logistic regression was used to determine the most important predictors of fatigue levels.
results14 cytokines were significantly higher in patients with pSS (n=159) compared to non-fatigued healthy controls (n=28). While serum levels were elevated in patients with pSS compared to healthy controls, unexpectedly, the levels of 4 proinflammatory cytokines-interferon-γ-induced protein-10 (IP-10) (p=0.019), tumour necrosis factor-α (p=0.046), lymphotoxin-α (p=0.034) and interferon-γ (IFN-γ) (p=0.022)-were inversely related to patient-reported levels of fatigue. A regression model predicting fatigue levels in pSS based on cytokine levels, disease-specific and clinical parameters, as well as anxiety, pain and depression, revealed IP-10, IFN-γ (both inversely), pain and depression (both positively) as the most important predictors of fatigue. This model correctly predicts fatigue levels with reasonable (67%) accuracy.
conclusionsCytokines, pain and depression appear to be the most powerful predictors of fatigue in pSS. Our data challenge the notion that proinflammatory cytokines directly mediate fatigue in chronic immunological conditions. Instead, we hypothesise that mechanisms regulating inflammatory responses may be important.
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Registered trials
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 OpenQuestion graph.