A cross-sectional observational study of patients with sicca with salivary autoantibodies defines a potential new phenotype of Sjögren's disease.

IF 20.3 1区 医学 Q1 RHEUMATOLOGY
Martha Tsaliki, Joshua Cavett, Biji T Kurien, Christina Bruxvoort, Valerie M Lewis, John A Ice, Devavrat Dave, Sina Khosravani, Kiely Grundahl, Christopher J Lessard, Astrid Rasmussen, Kathy L Sivils, Amy Darise Farris, Kristi A Koelsch, Robert Hal Scofield
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引用次数: 0

Abstract

Objectives: Diagnosis of Sjögren's disease (SjD) consists of clinical examinations that include invasive studies such as lower lip biopsies and blood collection to identify presence of serum autoantibodies. Salivary glands of patients with SjD are sites where antibody-secreting cells accumulate and secrete immunoglobulins. Many patients with dry manifestations who do not meet classification criteria are grouped as non-Sjögren's sicca (NSS) and are heavily understudied. We undertook this cross-sectional observational study to investigate the role of salivary autoantibodies as a diagnostic tool and determine presence of salivary autoantibodies in patients with NSS.

Methods: In this cross-sectional observational study, we screened whole unstimulated saliva from 446 subjects by direct enzyme-linked immunosorbent assays and capillary western blotting for anti-Ro60, anti-La, and rheumatoid factor (immunoglobulin (Ig)G and IgA) antibodies. All subjects were classified following the ACR/EULAR classification at the Oklahoma Medical Research Foundation Sjögren's Research Clinic.

Results: Patients with SjD were significantly more likely to have salivary antibodies compared with those with NSS and healthy control subjects. In this cohort, there were 88 subjects with NSS with seronegative profiles who had detectable salivary autoantibodies and objective measures of dryness.

Conclusions: Of these 88 subjects with NSS, we identified 75 subjects that had positive objective examinations of dryness and could belong to an early-onset SjD group. Alternatively, these 75 subjects with NSS could belong to a distinct phenotype of SjD that will remain seronegative while being saliva positive for anti-Ro60. These data showed a relationship between ocular and oral dryness and the presence of salivary anti-Ro60 antibodies in subjects with NSS.

唾液自身抗体的sicca患者的横断面观察研究确定了Sjögren病的潜在新表型。
目的:Sjögren病(SjD)的诊断包括临床检查,包括侵入性研究,如下唇活检和采血,以确定血清自身抗体的存在。SjD患者的唾液腺是抗体分泌细胞聚集和分泌免疫球蛋白的部位。许多不符合分类标准的干性表现的患者被归为non-Sjögren's sicca (NSS),并且研究不足。我们进行了这项横断面观察性研究,以研究唾液自身抗体作为诊断工具的作用,并确定NSS患者中唾液自身抗体的存在。方法:在这项横断面观察研究中,我们通过直接酶联免疫吸附法和毛细管免疫印迹法对446名受试者的未刺激唾液进行抗ro60、抗la和类风湿因子(免疫球蛋白(Ig)G和IgA)抗体的筛选。所有受试者按照俄克拉何马医学研究基金会Sjögren研究诊所的ACR/EULAR分类进行分类。结果:与NSS患者和健康对照组相比,SjD患者出现唾液抗体的可能性显著增加。在这个队列中,有88名血清阴性的NSS患者,他们有可检测到的唾液自身抗体和客观的干燥测量。结论:在这88例NSS患者中,我们确定了75例干燥客观检查阳性的患者,可能属于早发性SjD组。另外,这75名NSS患者可能属于一种独特的SjD表型,该表型在唾液中呈抗ro60阳性,而血清中呈阴性。这些数据表明,NSS患者的眼和口腔干燥与唾液中抗ro60抗体的存在有关。
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来源期刊
Annals of the Rheumatic Diseases
Annals of the Rheumatic Diseases 医学-风湿病学
CiteScore
35.00
自引率
9.90%
发文量
3728
审稿时长
1.4 months
期刊介绍: Annals of the Rheumatic Diseases (ARD) is an international peer-reviewed journal covering all aspects of rheumatology, which includes the full spectrum of musculoskeletal conditions, arthritic disease, and connective tissue disorders. ARD publishes basic, clinical, and translational scientific research, including the most important recommendations for the management of various conditions.
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