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Sjogren’s Syndrome and Causal Theories


Sjögren’s Syndrome refers to an autoimmune disorder due to which a person experiences both dry mouth and dry eyes. In addition, in serious cases, the disease spreads beyond exocrine glands and affects other organs such as the kidneys, lungs, and nervous system. Sjögren’s Syndrome shows symptoms that are usually misdiagnosed to be other diseases such as multiple sclerosis, fibromyalgia, diabetes, chronic fatigue syndrome, lupus, and rheumatoid arthritis (Ng, 2016). The disease is more common in women than men, though this number is expected to increase as awareness is raised. Ironically, Sjögren’s syndrome has not been given much attention by researchers as opposed to other related diseases such as systemic lupus erythematosus (SLE) and rheumatoid arthritis (RA) due to the notion that the condition is a nuisance without acknowledging the dangers it pauses to the vital organs of the body (Ngo et al., 2016).

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Model 1: First Casual Theory for Sjogren’s syndrome

The first model is known as Engel’s biopsychosocial model, which states that oral-health-related quality of life (OHRQoL) and health-related quality of life (HRQoL) consider psychological, physical, and social aspects of an individual’s health. OHRQoL examines the extent to which oral disorders disrupt a person’s normal functioning, while HRQoL focuses on health aspects integrated with different components such as the world view of well-being and functioning (Ngo et al., 2016). Both HRQoL and OHRQoL have proved that Sjögren’s Syndrome affects an individual’s quality of life. Two factors play an essential role according to this model, which are the characteristics of an individual and the characteristics of the environment in which the individual lives. These factors contribute to the overall health outcome of an individual. This is an indicator that an individual’s lifestyle might lead to one contracting the disease, as well as environmental aspects such as the cleanliness of a person’s surroundings, can also push one to contract Sjogren’s syndrome.

Model 2: Second causal theory for Sjogren’s syndrome

The second model is the Murine model that extensively focuses on lymphoplasmacytic cell penetration of the lacrimal glands. According to this model, lacrimal glands have many ductal and acinar cells that are not affected, which means that Sjögren’s syndrome has impaired the functions of the lacrimal (Maria, et al., 2015). In this model, the main concern was how the disease affects the body and the areas are affected by the secretion of the acetylcholine that contributes to impaired secretion of the glands. It can be noted that the decrease in lacrimal and salivary glands secretion is the main cause of dry mouth and eyes (Holdgate, & Clair, 2016). The model states that the loss of acetylcholine in the nerves is a result of the impaired release of acetylcholine because the exocrine tissues are not able to release their neurotransmitters.

Prediction of both Model 1 and Model 2

In the first model, the observable output indicated that the quality of life, both physical and psychological, was interrelated when it comes to contracting the disease. Most of the participants expressed that they felt pain when they ate food, brushed their teeth, and their lips became dry. The observable output indicated that healthcare professionals play a significant role in educating members of the public on the ways one can avoid contracting the disease as well as how to manage it when one has contracted Sjögren’s syndrome. For someone suffering from Sjögren’s syndrome, active and passive patients’ roles depend on an individual, which has significant implications for the copying process. In addition, factors such as personalization of the disease, knowledge of the disease, and attitude towards the disease are also important in the coping process. For each participant that had Sjögren’s syndrome, these individual characteristics were different from each other.

The observable output in the second model indicated that after close to a period of ten years, the average tear functions returned to normal in patients suffering from Sjögren’s syndrome, however, this did not fall all the patients. This, therefore, meant that a reversible component in the tear function was evident. The study also found out that the female but no male salivary glands recorded a hyper-responsive to medication; it took about eighteen weeks for the female patients to be able to respond to mediation (Maria, et al., 2015; Nocturne & Mariette, 2015). In addition, Nocturne & Mariette, (2015) assert that it was found that activation of the lacrimal and salivary glands penetrated with lymphocytes did not have an increase in the excretion of neurotransmitters that resulted in impaired secretion of the salivary and lacrimal glands.

Data from both Models

The results got from Engel’s biopsychosocial model were obtained based on four qualitative analysis approaches the diagnosis process, the interaction between patient and healthcare professional, the impact of the disease, and the positive recovery process. A Shortened Xerostomia Inventory (SXI) was completed by the participants after an interview was conducted. It was noted from the SXI that about 80% of the patients realized that something was wrong with their eyes and mouth before visiting the hospital and being diagnosed, while 20% thought the symptoms would disappear after a while (Ngo et al., 2016). Patients experienced both physical and psychological impact of the disease but the quality of life improved once the pain had gone although their mouths and eyes were still dry. The results also indicated that most participants had positive coping mechanisms as they initiated several trial and error methods in the quest to find a solution to Sjögren’s syndrome.

On the other hand, the results from the Murine model showed that patients with severe inflammation complained about dry eyes, while those with mild cases had no pain but rather just either a dry eye or mouth. In addition, the application of the theory suggests that there is a need for new therapeutic approaches for the disease.

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In conclusion, the two models of Sjögren’s syndrome bring out a different perspective of the disease. However, the theory that has a viable notion is Engel’s biopsychosocial model that concentrates on why the disease occurs and how it can be managed. It states that both environmental and individual characteristics are contributing factors to Sjögren’s syndrome. The model, in summary, notes that for the patients suffering from the condition, one has to be examined by individualized characteristics such as lifestyle, personality, perception as well as the environment in which the patient lives and his or her interaction with a healthcare professional (Alunno, et al., 2017). On the other hand, the Murine model is only based on treatment outcomes without looking at other issues related to Sjögren’s syndrome such as individual characteristics and the environmental circumstances, which makes it lacking research and satisfaction of theoretical virtues.


Alunno, A., Carubbi, F., Bistoni, O., Bartoloni, E., Valentini, V., & Gerli, R. (2017). Novel Therapeutic Strategies in Primary-Sjögren’s Syndrome. The Israel Medical Association Journal: Imaj, 19(9), 576-580. Web.

Holdgate, N., & Clair, E. W. S. (2016). Recent advances in primary Sjogren’s syndrome. F1000Research, 5. Web.

Maria, N. I., Vogelsang, P., & Versnel, M. A. (2015). The clinical relevance of animal models in Sjögren’s syndrome: the interferon signature from mouse to man. Arthritis research & therapy, 17(1), 1-12. Web.

Ng, W.-F. (2016). Sjögren’s syndrome. Oxford: Oxford University Press

Ngo, D. Y. J., Thomson, W. M., Nolan, A., & Ferguson, S. (2016). The lived experience of Sjögren’s Syndrome. BMC Oral Health, 16, 7-7. Web.

Nocturne, G., & Mariette, X. (2015). Sjögren Syndrome‐associated lymphomas: an update on pathogenesis and management. British journal of haematology, 168(3), 317-327. Web.

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