Dry Eyes and Dry Mouth: Chinese Cohort Maps Sicca Syndrome’s Clinical and Antibody Landscape

Analysing the records of 765 adults treated between January 2023 and December 2025, researchers at Guangzhou University of Chinese Medicine found a patient population dominated by middle-aged women and marked by substantial variability in both symptoms and laboratory findings. The cohort averaged 52.8 years of age, with a standard deviation of 13.6 years, and 86.7 percent of patients were female. Seventy percent of patients had both ocular and oral dryness, the two hallmark features of the syndrome.

The study, published as a retrospective observational analysis in Frontiers in Medicine, also examined what happens beyond the glands. In this cohort, 59.1 percent of patients had at least one extraglandular manifestation, meaning a systemic feature extending beyond the dryness of the eyes and mouth. The authors set out to assess the clinical and serologic characteristics of patients with sicca syndrome and to identify factors associated with these systemic manifestations.

Sicca syndrome, as the authors describe it, is a clinical syndrome with heterogeneous pathogenesis, defined by chronic ocular and/or oral dryness resulting from autoimmune disorders, medications, ageing, or other systemic disorders. Because the clinical and serologic spectrum is broad, the team argued that it must be clearly defined to enable accurate diagnostic assessment and clinical characterisation.

Serologic testing revealed a detailed antibody landscape in the cohort. Antinuclear antibodies, a broad marker of autoimmunity, were positive in 74.6 percent of patients. Anti-SSA/Ro antibodies appeared in 61.2 percent, anti-SSB/La antibodies in 36.1 percent, and rheumatoid factor in 44.7 percent of the cohort.

The statistical analysis, performed with SPSS version 29.0, included comparative analysis, correlation tests, multivariable logistic regression, and sensitivity analysis of the regression model. The reported association between anti-SSA positivity and systemic involvement was the standout result. Patients carrying anti-SSA/Ro antibodies had extraglandular manifestations in 65.2 percent of cases, compared with 49.5 percent among those who were anti-SSA negative, a difference the authors report as statistically significant with P less than 0.001.

Beyond antibodies, the study identified hypergammaglobulinemia, increased inflammatory markers, and complement consumption as features associated with systemic manifestations. According to the authors, these laboratory signals may contribute to clinical characterisation and assessment of patients with sicca syndrome, helping to describe which patients present with disease features beyond dryness.

The data were retrieved from the electronic medical record and covered demographic, clinical, laboratory, and autoantibody information for every patient in the cohort. This record-based approach allowed the team to assemble a large dataset within a single tertiary rheumatology centre, although it also means the analysis reflects the information captured in routine clinical care rather than a purpose-designed prospective protocol.

Because the study was retrospective and drew exclusively on patients seen at a single tertiary care centre in China, the findings describe a referred, hospital-based population rather than the general population. Patients referred to a tertiary centre may have more complex disease than those managed elsewhere, so the proportions reported here should not be read as prevalence estimates for the wider population. The observational design also identifies associations, not causal relationships, between antibody status and systemic disease.

Even with those limitations, the study offers a detailed picture of how sicca syndrome presents in this setting: a cohort dominated by middle-aged women, with most patients experiencing both ocular and oral dryness, a majority showing at least one extraglandular manifestation, and a serologic profile in which anti-SSA positivity, hypergammaglobulinemia, raised inflammatory markers, and complement consumption cluster with systemic involvement. The authors conclude that these factors may contribute to clinical characterisation and assessment of patients with sicca syndrome, providing a reference point for future diagnostic evaluation in similar tertiary care populations.

Subject of Research: Clinical and serologic characteristics of sicca syndrome in a Chinese tertiary care cohort

Article Title: Clinical and serologic features of sicca syndrome in a tertiary care cohort in China: a retrospective rheumatologic study

Article References: Zhang, Y., Sun, Z., Zhang, J., Su, C., Sun, L., Chen, S., He, S., & Tang, C. (2026). Clinical and serologic features of sicca syndrome in a tertiary care cohort in China: a retrospective rheumatologic study. Frontiers in Medicine, 13, 1935003. https://doi.org/10.3389/fmed.2026.1935003

Image Credits: AI Generated

DOI: 10.3389/fmed.2026.1935003

Keywords: sicca syndrome, anti-SSA/Ro, autoantibodies, extraglandular manifestations, rheumatology, serologic markers, autoimmune disease, retrospective study, dry eyes, dry mouth, China, tertiary care