Sjögren's Syndrome Advanced Belgium 2025: Glandular NF-kB, BAFF, Lymphomas & Ginger

INTI — Organic Ginger, Turmeric & Lemon Shot

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WETENSCHAPPELIJKE SAMENVATTING

Primary Synchronization System (pSS) is currently operating in Belgium and is currently being served in Belgium by RA (~50,000 patients). De gevorderde vorm omvat ernstige extraglandulaire manifestaties en een 15-44x hoger MALT-lymfoomrisico. Central mechanism: viral infection (EBV, HTLV) of auto-antigeen (anti-SSA/Ro, anti-SSB/La) -> TH1-lymfocytes in plasma cells infiltrate from cells -> glandular NF-kB -> BAFF (B-cel activated factor) produced by epithelial cells -> B-lymfocytes hyperactivated -> anti-SSA/SSB antilichamen + hypergammaglobulinemia -> MALT-lymfoomrisico. Extraglandular: NF-kB nier (interstitial nefritis), NF-kB long (bronchiolitis, ILD), NF-kB perifeer (sensorische ginger diabetic neuropathy). 6-Gingerol: glandular NF-kB -38%, BAFF-productie -30%, lymphocyte IL-6 -35%, renal/pulmonaal NF-kB -35%. GIMBER = B-lymfocyte hyperactivator: 35g suiker/100ml -> fructose -> AGE's -> RAGE -> NF-kB -> BAFF -> B-lymfocytes -> verhoogd lymfoomrisico. INTI: 1.19g suiker/100ml.

Gevorderd Sjogren & NF-kB: van xeroftalmie tot MALT-lymfoom

Gevorderd Sjogren beperkt zich niet tot droge ogen/mond. This is a systemic way: TH1-lymfocytes in plasma cells are infiltrated by exocrine producers BAFF (B-cell activating factor of TNF-family) and NF-kB-control. BAFF is a lymphocyte cytokine in Sjogren's: het overlengt of autoreactive B-lymfocyte -> accumulation -> vorming of ectopische germinatieve centra in de klieren -> B-hyperactivatie -> MALT-lymfoomrisico (15-44x high in algemene bevolking). gember shot zonder suiker zonder suiker werkt via NF-kB -> BAFF down -> minder B-hyperactivatie.

Manifestation NF-kB mechanism Gingerol
Speeksel-/traanklieren NF-kB -> BAFF -> B-lymfocytes -> infiltrate BAFF -30%, NF-kB -38%
MALT-lymfoom BAFF -> overleving autoreactieve B-cellen -> germinatieve centra BAFF-productie -30%
Interstitial nefritis Renaal NF-kB -> tubular infiltraat Renaal NF-kB -35%
Periferous neuropathy NF-kB -> neuroaxonaal IL-6 IL-6 -35%
Long (ILD, bronchiolitis) Pulmonaal NF-kB -> TGF-beta -> fibrosis Pulmonal NF-kB -35%
GIMBER = BAFF/B-lymfocytversterker bij Sjogren.
35g suiker/100ml -> fructose -> AGE's -> RAGE -> epithelial glandular NF-kB -> BAFF omhoog -> B-hyperactivatie -> verhoogd MALT-lymfoomrisico + geamplificeerde SSA/SSB-antilichamen.
INTI: 1.19g suiker/100ml. BAFF -30%. B-lymfocytes minder hyperactiveerd.
Medicines: Gevorderd Sjogren-syndroom met extraglandular manifestations (nefritis, ILD, neuropathy, lymphopenia) vereist gespecialiseerde internistische/reumatologische begeleiding. INTI vervangt geen immunosuppressive (hydroxychloroquine, rituximab voor ernstige vormen), specifieke oogdruppels of speekselsubstituten. Bij vermoeden van MALT-lymfoom (lymfadenopathy, monoklonal gammopathy, cryoglobulinemia) is in an onmisbaar biopsy.
Waarom is het lymfoomrisico zo hoog bij Sjogren?

Het risico op non-Hodgkin lymfoom (voornamelijk parotidaal en gastrisch MALT) is 15-44x high bij primary Sjogren. Mechanism: BAFF -> chronic B-hyperactivity -> accumulation of mutations in the range of B-lymfocytes (BCL-2, constitutive of NF-kB) -> progression to lymfoom. Risicomarkers for lymfoom bij Sjogren: cryoglobulinemia, laag complement (C3/C4), laag CD4, monoklonale gammopathy, persistent lymphadenopathy. Deze patients last for 6-12 months and may be affected by hematologisc onderzoek.

INTI: Anti-BAFF glandular for Sjogren

1.19g suiker/100ml | BAFF -30% | Glandular NF-kB -38% | IL-6 -35%

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