THERAPEUTIC POTENTIAL OF THE MEDITERRANEAN DIET IN PRIMARY SJÖGREN’S SYNDROME: A SYSTEMATIC REVIEW Of CLINICAL AND IMMUNOLOGICAL OUTCOMES

Abstract

The Mediterranean diet (MD) is increasingly recognized for its anti-inflammatory and immunomodulatory effects. Given the autoimmune nature of primary Sjögren’s syndrome (pSS), dietary modification through MD may hold clinical promise. A thorough search of the literature was conducted using PubMed, Scopus, and Web of Science until March 2025. Research articles evaluating the association between MD adherence and clinical or immunological outcomes in primary pSS and DES were included. Six relevant studies met the inclusion criteria. Higher adherence to MD correlated with lower disease activity scores (ESSDAI, ClinESSDAI), better ocular surface parameters (OSDI, TBUT), and favorable changes in biomarkers (IgG, C3, anti-Ro/La). Consumption of fish and foods high in polyunsaturated fatty acids (PUFAs) appeared particularly advantageous. However, some studies failed to demonstrate statistically significant effects. This review emphasizes the MD's possible role in reducing symptoms and controlling immunological dysfunction in pSS. Although the results are encouraging, further longitudinal and interventional research is needed to assess its potential as a treatment.

KEYWORDS:

Mediterranean diet, primary Sjögren’s syndrome, dry eye syndrome, autoimmune disease, inflammation, polyunsaturated fatty acids