Serological Influences on Dry Eye: Insights from the Sjögren's International Collaborative Clinical Alliance

IF 3.2 Q1 OPHTHALMOLOGY

Ophthalmology science Pub Date : 2025-06-02 DOI:10.1016/j.xops.2025.100843

Chloe Shields BS , Pragnya Rao Donthineni MD , Rohit Muralidhar BS , Shreya Bhatt MS , Ema V. Karakoleva BS , Alan Baer MD , Robert Fox MD , Sara S. McCoy MD, PhD , Anat Galor MD, MSPH

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Abstract

Purpose

To define associations between serologies, specifically Sjögren syndrome–related antigen A (SSA) antibody and immunoglobulin (Ig) levels, on ocular profiles in patients enrolled in the Sjögren's International Collaborative Clinical Alliance (SICCA) cohort.

Design

A retrospective cohort study.

Subjects

Individuals from the SICCA cohort (n = 3514).

Methods

A retrospective analysis to examine relationships between dry eye (DE) symptoms and signs and serologic status, including SSA (SSA+ Sjögren disease [SjD], SSA− SjD, non-SjD) and Ig (G, A, M) levels (low, normal, and high).

Main Outcome Measures

Univariate analyses using analysis of variance and chi-square tests examined differences in ocular profiles by serologies. Multivariable analyses were then performed to account for potential confounding variables, including other serological measures.

Results

The mean age of the SICCA cohort was 53 ± 13 years, with the majority identifying as female (91%, n = 3185) and White (54%, n = 1894). The presence of SSA impacted ocular profiles, with the SSA+ SjD group reporting less severe symptoms compared with the SSA− SjD and non-SjD groups (spontaneous pain: 2.61 ± 2.83 vs. 3.39 ± 3.01 vs. 3.52 ± 3.09, P < 0.001), but more frequently having ocular signs (low tear production: 57% vs. 52% vs. 28%, P < 0.001; ocular surface staining [OSS]: 83% vs. 69% vs. 35%, P < 0.001). Immunoglobulin levels showed a similar pattern, with the high IgG level group reporting less severe ocular symptoms in the SjD (spontaneous pain: 2.41 ± 2.82 vs. 3.10 ± 2.91 vs. 3.40 ± 2.96; P < 0.001 and P < 0.05) and non-SjD (spontaneous pain: 2.09 ± 2.35 vs. 3.58 ± 3.11 vs. 3.85 ± 3.11; P < 0.001) groups but more severe signs (SjD group: low tear production: 60% vs. 53% vs. 49%; OSS: 88% vs. 72% vs. 70%; P < 0.001) compared with the normal and low-level groups. A similar pattern was noted for IgA levels. Most associations remained significant when considered concomitantly.

Conclusions

Ocular manifestations of DE are influenced by serological factors. Specifically, SSA+ and high IgG and IgA status align with a disease picture of clinical signs of DE disease out of proportion to pain symptoms, while SSA− and low and normal IgG and IgA status align with a DE disease picture of symptoms that outweigh signs.

Financial Disclosure(s)

Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.

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血清学对干眼症的影响：来自Sjögren国际合作临床联盟的见解

目的确定Sjögren国际临床合作联盟（SICCA）队列中患者眼部特征的血清学，特别是Sjögren综合征相关抗原A （SSA）抗体和免疫球蛋白（Ig）水平之间的关系。设计：回顾性队列研究。受试者：来自SICCA队列的个体（n = 3514）。方法回顾性分析干眼症（DE）症状和体征与血清学状态的关系，包括SSA （SSA+ Sjögren疾病[SjD]、SSA−SjD、非SjD）和Ig （G、A、M）水平（低、正常和高）。主要结果测量：单因素分析采用方差分析和卡方检验检查血清学中眼部特征的差异。然后进行多变量分析，以解释潜在的混杂变量，包括其他血清学测量。结果SICCA队列的平均年龄为53±13岁，以女性（91%,n = 3185）和白人（54%,n = 1894）居多。SSA的存在影响了眼部轮廓，与SSA -SjD和非SjD组相比，SSA+ SjD组报告的症状较轻(自发疼痛：2.61±2.83 vs. 3.39±3.01 vs. 3.52±3.09,P <；0.001)，但更常见的是眼部症状(低泪液生成：57% vs. 52% vs. 28%, P <；0.001;眼表染色[OSS]: 83% vs. 69% vs. 35%；0.001)。免疫球蛋白水平表现出类似的模式，高IgG水平组报告的SjD眼部症状较轻(自发疼痛：2.41±2.82 vs. 3.10±2.91 vs. 3.40±2.96；P & lt;0.001和P <；非sjd(自发性疼痛：2.09±2.35 vs. 3.58±3.11 vs. 3.85±3.11；P & lt;0.001)组，但症状更严重(SjD组：低撕裂量：60% vs. 53% vs. 49%；OSS: 88% vs. 72% vs. 70%；P & lt;0.001)，与正常组和低水平组比较。IgA水平也出现了类似的模式。当同时考虑时，大多数关联仍然显著。结论DE的眼部表现受血清学因素的影响。具体来说，SSA+和高IgG和IgA状态与DE疾病的临床症状相一致，与疼痛症状不成比例，而SSA -和低和正常IgG和IgA状态与DE疾病的症状大于体征相一致。财务披露专有或商业披露可在本文末尾的脚注和披露中找到。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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