Sjögren’s Disease: From Exocrine Pathobiology to Systemic Complications and Novel Drug Development

This chapter reviews the pathogenesis of Sjögren’s disease — formerly Sjögren’s syndrome — with particular focus on the roles of ectopic lymphoid structures, B-cell hyperactivation, and salivary gland epithelial dysfunction in driving both glandular and extraglandular manifestations. Recent advances in disease classification, patient stratification by serological and histological biomarkers, and the emerging clinical trial landscape — including BAFF/APRIL inhibition, muscarinic receptor agonism, and toll-like receptor antagonism — are critically examined.