Chronic Rhinosinusitis Is a Risk Factor for Interstitial Lung Disease in Sjogren’s Syndrome

Authors

Brian Schonewald, Thomas Jefferson UniversityFollow
Christopher Xie, Thomas Jefferson UniversityFollow
Andrew Engel, Thomas Jefferson UniversityFollow
Ross Summer, Thomas Jefferson UniversityFollow
Giorgos Loizidis, Thomas Jefferson UniversityFollow

Document Type

Article

Publication Date

11-10-2025

Comments

This article is the author’s final published version in BMC Pulmonary Medicine, Volume 25, Issue 1, 2025, Article number 515.

The published version is available at https://doi.org/10.1186/s12890-025-03992-4. Copyright © The Author(s) 2025.

Abstract

BACKGROUND: Interstitial lung disease (ILD) is a leading cause of morbidity and mortality in Sjögren's syndrome (SS), but its risk factors remain unclear. Although SS affects both the upper and lower respiratory epithelium, it is unknown whether this occurs simultaneously or separately. In other autoimmune conditions-such as eosinophilic granulomatosis with polyangiitis and granulomatosis with polyangiitis-upper airway disease precedes lower lung involvement by months or even years. We hypothesized that chronic rhinosinusitis (CRS), as an upper airway disease, may be a risk factor for ILD in SS.

METHODS: We analyzed the TriNetX Research Network database to compare incident ILD in SS patients with or without CRS. Patients with pre-existing ILD or CRS were excluded, and all participants were being treated with Sjögren's related immunosuppression or sicca therapies. Incident ILD and risk ratios (RR) were calculated at 5 and 10 years after adjusting for important confounding variables, such as age, gender, race, comorbid conditions, and other risk factors.

RESULTS: In matched cohorts, overall risk for developing ILD was significantly higher in patients with CRS. At 5 years, incidence of ILD was 2.56% in patients with CRS versus 1.66% in those without CRS (adjusted RR 1.57, p = 0.01, 95% CI: 1.09-2.27). Likewise, at 10 years, the ILD incidence was 3.01% in patients with CRS versus 1.96% in those without CRS (adjusted RR 1.53, p = 0.01, 95% CI: 1.09-2.13).

CONCLUSION: Our results suggest SS patients with CRS are at higher risk for developing ILD, indicating a possible need for more intensive screening in this population.

Recommended Citation

Schonewald, Brian; Xie, Christopher; Engel, Andrew; Summer, Ross; and Loizidis, Giorgos, "Chronic Rhinosinusitis Is a Risk Factor for Interstitial Lung Disease in Sjogren’s Syndrome" (2025). Division of Pulmonary, Allergy, and Critical Care Medicine Faculty Papers. Paper 55.
https://jdc.jefferson.edu/pulmcritcarefp/55

Creative Commons License

This work is licensed under a Creative Commons Attribution-Noncommercial-No Derivative Works 4.0 License.

PubMed ID

41214590

Language

English