Treatment of dry syndrome

  How can we fight this drought and guard the oasis in our body?  There are a lot of drugs available for the treatment of this disease, so the “copy+paste” type of drug introduction is of limited help, so we will not repeat it here. We will share some new treatment progress in recent years for your reference.  (1) A variety of eye drops, oral tears, oral saliva, mouthwash, widely used, but “spraying water on the leaves” is not good enough to nourish the thirst of the land, is “a drop in the bucket”. Some of the eye drops containing glucocorticoids are not effective for dry eyes, and can cause degeneration and perforation of the epithelial cells of the cornea, so they should not be applied.  (2) A variety of anti-inflammatory painkillers, as we all know, are “treating the symptoms but not the root cause”.  (3) Glucocorticosteroids, many people stay away from them because of their possible side effects. However, some cases do require short-term, small amounts of use, and the benefits outweigh the disadvantages.  (5) Hydroxychloroquine can treat fatigue, joint pain, myalgia, and skin problems caused by the disease, but many people look at the instructions and are frightened. In fact, the side effects of the drug mainly lie in the eyes, and other side effects are rarely seen.  (6) Various herbal formulas/Chinese patent medicines that nourish Yin and moisten dryness and tonify Yin and benefit Qi have a long history of application in the majority of cities and villages, but they cannot reverse the immune disorder of dryness syndrome, their efficacy is not exact, and they are basically ineffective for many important internal lesions. The herbal medicine Leigongteng, which is widely used in the clinical practice of rheumatology and immunology, can theoretically regulate human immunity, but it is not recognized because it can aggravate dry mouth and dry eyes, and some people have greater digestive reactions.  (7) In order to suppress abnormal immune reactions, some patients may be using methotrexate, leflunomide, cyclophosphamide, azathioprine and other drugs, the use of which is reasonably effective in preventing and controlling visceral lesions. However, there are common toxic side effects (such as elevated transaminases, reduced white blood cells, etc.), which may lead to severe immunosuppression and induce serious infections. It cannot be said to be the “ideal drug”.  Modern medicine is evolving very rapidly, especially in rheumatology. SLE is slowly changing from a “terminal disease” to a “common chronic disease”. The emergence of biological agents has also made ankylosing spondylitis and rheumatoid arthritis completely get rid of the hat of “immortal cancer”. So, what are the new advances in the treatment of dry syndrome in recent years?  (1) Mesenchymal stem cell therapy. This treatment extracts MSCs from embryos or bone marrow (someone else’s, not the patient’s), cultures them, and injects them into the patient’s body through an infusion bottle, which is a simple, convenient and painless treatment option. It is found that this therapy exerts its therapeutic effect through mechanisms such as stabilizing and regulating the immune system, regulating the function and differentiation of lymphocytes, suppressing abnormal activation of the immune system, and repairing damaged exocrine glands (carrying out the process of setting things right and restoring social working order).  At present, in addition to dry syndrome, it has also achieved certain results in the treatment of rheumatic immune diseases such as systemic lupus erythematosus and scleroderma (systemic sclerosis), and is a useful supplementary treatment to traditional treatment. At present, the practical application in China is gradually increasing. Our department has also joined hands with Zhongshan University and the Cell Therapy Center of Lingnan Hospital of Zhongshan University and other platforms to conduct more practice in the use of MSCs for the treatment of various rheumatic immune diseases, and has accumulated much practical experience.  (2) Other novel drugs. Rituximab, anti-CD-22 monoclonal antibody and other drugs were originally used to treat hematological tumors, lymphoma and systemic lupus erythematosus. However, they are generally used only for patients for whom traditional treatment drugs are ineffective.  (3) Plasma replacement, immunosorbent, bone marrow transplantation and other treatment methods can no longer be regarded as “new means”, and some people have applied them to dry syndrome in recent years, but generally they are only used in cases where general treatment is not effective, and they are currently in the exploration stage.