(light music) Hi, everyone, my name is Erika Darrah. I’m here today with Dr. Julius Birnbaum from the Johns Hopkins Jerome L. Greene Sjogren Center to discuss his most recent research looking at the relationship between neurologic disorders and Sjogren’s Syndrome. First of all, I’d like to congratulate you, Dr. Brinbaum, on your exciting research, and thank you for joining us. Thank you. Can you start by describing the types of neurologic symptoms that patients with Sjogren’s Syndrome can experience? Sure, so a common neurological complication is a neuropathy where there can be severe burning in the fingertips and the toes. However, Sjogren’s patients can also experience neurological complication that is due to brain or spinal cord damage. This may affect thinking, or it can be more severe. It may result in blindness, paralysis, or even incontinence. So these types of neurological complications occur in a disorder called the Neuromyelitis optica spectrum disorder. Large name, it can be referred to by the acronym NMOSD. Multiple sclerosis, in effect, can cause similar neurological complications, but these tend to be less severe. So what was the major goal of your study? So, the goal of this study was to understand the relationship of NMOSD to Sjogren’s. There’s two possibilities. In one scenario, NMOSD would be a direct neurological complication due to Sjogren’s. And in that case, you would treat NMOSD with Sjogren’s Syndrome medications. However, another competing possibility is that NMOSD is totally unrelated to Sjogren’s. It presents as a second and coincidental disorder, and in this case, the treatments that you would use for Sjogren’s might not be sufficient for NMOSD. And what was your major conclusion of this study? So, our conclusion was that NMOSD was unrelated to Sjogren’s, and that patients who experience NMOSD have a second autoimmune disorder. And the therapeutic implication, as we discussed, is that if you are a Sjogren’s patient with NMOSD, you should be treated with NMOSD therapies that are wholly distinct from Sjogren’s Syndrome. So, is NMOSD and disorders like it, are they increased in patients with Sjogren’s Syndrome, compared to the general population? Yeah, it’s an interesting question. So, NMOSD is a very rare autoimmune disorder, and if you don’t have an autoimmune disease, it’s said that you have a better chance of being struck with lightning than experiencing NMOSD. That being said, when you have an autoimmune disease, such as Sjogren’s, you have a higher likelihood of experiencing NMOSD. So, it may be rare in Sjogren’s, but it’s disproportionately more common, compared to patients who don’t have Sjogren’s. Could you describe the connection between Sjogren’s Syndrome and other autoimmune diseases outside of NMOSD? Sure, so, Sjogren’s Syndrome patients definitely have a predilection to be affected by other autoimmune disorders. So, there’s an increased risk of autoimmune thyroid disease, there’s an increased risk of autoimmune liver disease or bile duct disease. So, each of these disorders are seen in Sjogren’s patients, and they have a predilection because Sjogren’s patients can produce antibodies that are seen in these disorders. So, in conclusion, can you describe the impact of this research on patients, what it means for patients with Sjogren’s Syndrome? I think there’s a variety of implications. So, first of all, for the patient who has NMOSD, this means if you have NMOSD, walk away from the treatment that’s being used in Sjogren’s. There’s a burgening supply of medications that are useful for NMOSD. This is where you should go. But you might be asking, “Well, what if I have Sjogren’s “and I don’t have NMOSD? “How is this gonna help me?” It’s another clue in the puzzle saying that here is yet another autoimmune disease that co-occurs in Sjogren’s. So, knowledge that these autoimmune diseases co-occur in Sjogren’s frames the question about why Sjogren’s are experienced with all of these extra neurological complications, other rheumatic diseases. If we understand why Sjogren’s patients can experience other autoimmune diseases, it starts setting the table of understanding diagnosis, identifying mechanisms, and also for tailoring more specific therapies. So what’s next for Sjogren’s Syndrome research? What are you working on now? So, our interest right now is galvanized by trying to understand why Sjogren’s Syndrome patients can experience severe nerve pain. It is a significant source of morbidity, it’s severe, it can be a factor in medications. And this is where we’re going right now, and this compliments our studies with brain and spinal cord disease. We really wanna understand why Sjogren’s patients develop neurological complications, and what we can do to alleviate their suffering. Great, so Dr. Birnbaum, thank you so much for your time. We look forward to see what you do next. Thanks for having me, thank you.