Should the Biopsychosocial Model Be Considered in Systemic Autoimmune Diseases? Comment on the Article by Posada et al.

We read with interest the study by Posada et al. (1) evaluating the therapeutic effects of RSLV-132 (a new RNase compound) in patients with primary Sjogren syndrome (pSS). At first glance, one may be surprised by the enthusiastic conclusion of authors in spite of a biological effect opposite to what was expected, namely an increased expression of interferon (IFN)-stimulated genes (ISG), while pSS is considered as an acquired interferonopathy. However, therapeutic trials are also a unique opportunity to learn about the pathogenesis of such complex condition. Indeed, this study showed a significant improvement of fatigue (measured by various validated scales) in treated patients, surprisingly correlated with the increased expression of ISG.