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Clark M, Walsh H, Stephens-Laborde I, Khurram SA. The Value of Labial Gland Biopsies as a Diagnostic Test for Sjögren's Syndrome. Head Neck Pathol 2024; 18:64. [PMID: 38958850 PMCID: PMC11222351 DOI: 10.1007/s12105-024-01662-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/17/2024] [Accepted: 06/01/2024] [Indexed: 07/04/2024]
Abstract
PURPOSE There are a number of diagnostic criteria that can be used to support a diagnosis of Sjögren's syndrome (SS), a chronic autoimmune condition often characterised by xerostomia and xerophthalmia. Of the available investigations, the most invasive is the labial gland biopsy (LGB) for histopathology, which is associated with a risk of long-term altered sensation to the lip. A positive histological diagnosis is currently considered to be one of the most objective criteria, however there is debate about the interobserver agreement between pathologists, as well as the sensitivity and specificity of this test. We aim to determine if the diagnostic value of the LGB is significant enough to warrant the surgical procedure and its associated risks. METHODS This study involved assessing the degree of agreement between members of a pathology team for a cohort of 50 LGBs taken for the purpose of confirming or excluding SS. The Tarpley system was used, which involves the allocation of a 'focus score'. Additionally, the histological diagnoses were compared to the relevant serological findings where available. RESULTS All cases within the cohort had adequate tissue for assessment. 84% agreement (Cohen's Kappa = 0.585) was seen between the current team's consensus and the original reporting pathologist on whether the appearance was supportive of SS. However, only 58% agreement was seen for focus scores (Weighted Kappa = 0.496). The agreement between the serology result and whether the histology was supportive of SS was 79% (Cohen's Kappa = 0.493). CONCLUSION The findings raise the possibility that undue emphasis is placed on the value of a histological SS diagnosis. The current system for assessing and grading these biopsies is ambiguous in nature, with a low threshold considered indicative of SS. Due to the risk of complications associated with a LGB, alternative minimally invasive investigations should always be considered. The histological findings in isolation, particularly when a low focus score is seen, may not be predictive of a diagnosis of SS.
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Affiliation(s)
- Mollie Clark
- Unit of Oral and Maxillofacial Pathology, The School of Clinical Dentistry, University of Sheffield, Sheffield, S10 2TA, UK.
| | - Hannah Walsh
- Unit of Oral and Maxillofacial Pathology, The School of Clinical Dentistry, University of Sheffield, Sheffield, S10 2TA, UK
| | - India Stephens-Laborde
- Unit of Oral and Maxillofacial Pathology, The School of Clinical Dentistry, University of Sheffield, Sheffield, S10 2TA, UK
| | - Syed Ali Khurram
- Unit of Oral and Maxillofacial Pathology, The School of Clinical Dentistry, University of Sheffield, Sheffield, S10 2TA, UK
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Mahla RS. Decoding Sjögren syndrome: A comprehensive approach to multiparametric diagnosis: comment on the article by Bettacchioli et al. Arthritis Rheumatol 2024; 76:1162-1163. [PMID: 38321957 DOI: 10.1002/art.42821] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2024] [Accepted: 01/24/2024] [Indexed: 02/08/2024]
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Cirillo N. A Roadmap for the Rational Use of Biomarkers in Oral Disease Screening. Biomolecules 2024; 14:787. [PMID: 39062501 PMCID: PMC11274832 DOI: 10.3390/biom14070787] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2024] [Revised: 06/27/2024] [Accepted: 06/28/2024] [Indexed: 07/28/2024] Open
Abstract
Oral health has witnessed a significant transformation with the integration of biomarkers in early-diagnostic processes. This article briefly reviews the types of biomarkers used in the screening and early detection of oral diseases, particularly oral cancer, periodontal diseases, and dental caries, with an emphasis on molecular biomarkers. While the advent of these biomarkers may represent a leap forward in oral healthcare, it also opens the door to potential overtesting, overdiagnosis, and overtreatment. To inform the selection of novel biomarkers and ensure their rational use in screening tests, it is imperative to consider some key characteristics, which are specific to the biomarker (e.g., surrogate biomarkers should reliably reflect the primary health outcome), to the test (e.g., sensitivity and specificity must be balanced based on the disease of interest), and to the disease (e.g., the efficacy of treatment should improve when the condition is diagnosed earlier). For systemic conditions associated with oral diseases, researchers should be extremely cautious when determining who is "at risk", particularly when such risk is small, non-existent, or inconsequent. This framework aims to ensure that advancements in oral health diagnostics translate into genuine improvements in patient care and well-being.
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Affiliation(s)
- Nicola Cirillo
- Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, 720 Swanston Street, Carlton, VIC 3053, Australia;
- School of Dentistry, University of Jordan, Amman 11733, Jordan
- CoTreatAI, CoTreat Pty Ltd., Melbourne, VIC 3000, Australia
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Hashemi MH, Ambrus JL, Shukla AA, Zhu D, Ying GS, Asbell PA. Association of Systemic Markers of Inflammation with Signs and Symptoms of Dry Eye Disease and Sjogren's Syndrome in the Dry Eye Assessment and Management (DREAM©) Study. Curr Eye Res 2024; 49:574-581. [PMID: 38345056 DOI: 10.1080/02713683.2024.2312937] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2023] [Accepted: 01/28/2024] [Indexed: 05/23/2024]
Abstract
PURPOSE To evaluate the possible role of systemic inflammation in dry eye disease (DED) via systemic inflammatory marker associations with DED signs and symptoms, and an analysis of a subgroup with Sjogren's Syndrome (SS). METHODS Participant serums were analyzed using line immunoassays (LIAs) for the presence of antibodies against 34 systemic inflammatory markers. Using the 2012 American College of Rheumatology definition, the 481 participants were categorized into group 1 (SS; n = 52), group 2 (autoimmune disease not including SS; n = 66), or group 3 (control, i.e. no autoimmune disease; n = 363). RESULTS 3 markers were positive in ≥10% of participants: Ro52 (19.3%), Scl-70 (15.0%), CN-1A (14.2%). 2 markers were positively associated with symptoms: PM-Scl100 (p = 0.02), Sm (p = 0.009). 5 markers were positively associated with signs: U2SnRNP A', Ro52, La, DNA, Ro60. SS participants showed significantly higher positivity for 4 markers compared to participants with no autoimmune disease: PL-7 (p = 0.02), Ro52 (p < 0.0001), La (p < 0.0001), Ro60 (p < 0.0001). SS participants showed significantly higher positivity for 3 markers compared to participants with another autoimmune disease: Ro52 (p < 0.0001), La (p = 0.002), Ro60 (p < 0.0001). CONCLUSIONS This study did not show evidence of significant systemic inflammation in participants with moderate-to-severe DED, based on the markers tested. PM-Scl100 and Sm may be associated with more severe DED symptoms. U2SnRNP A', Ro52, La, DNA, and Ro60 may be associated with more severe ocular surface disease. Ro52 and PL-7 may be diagnostic markers for SS. Future research evaluating these relationships and their clinical significance is needed.
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Affiliation(s)
- Marium H Hashemi
- University of Tennessee Health Sciences Center, Memphis, TN, USA
| | - Julian L Ambrus
- Department of Medicine, SUNY at Buffalo School of Medicine, Buffalo, NY, USA
| | | | - Di Zhu
- Department of Ophthalmology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA
| | - Gui-Shuang Ying
- Department of Ophthalmology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA
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Sri Kumaran S. Autoimmune Switch From Graves' Disease to Hashimoto's Thyroiditis With Coexisting Sjogren's Syndrome: A Case of Polyautoimmunity in a Young Woman. Cureus 2024; 16:e59446. [PMID: 38826946 PMCID: PMC11141106 DOI: 10.7759/cureus.59446] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/01/2024] [Indexed: 06/04/2024] Open
Abstract
Autoimmune thyroid disease (AITD) encompasses a spectrum of conditions ranging from Graves' disease (GD) to Hashimoto's thyroiditis (HT). These conditions often coexist with other autoimmune diseases (AIDs). This case describes a young woman in her 20s who transitioned from GD to HT during her first pregnancy, while having another coexisting AID, Sjogren's syndrome (SS). AITD and SS are recognized as the most common polyautoimmune diseases, sharing many common pathophysiological characteristics such as the presence of lymphocytic infiltrates, similar expressions of the human leukocyte antigen molecules, and predisposing environmental factors. This case underscores the importance for physicians to be vigilant regarding the possibility of changing antibodies in AITD and the potential for concurrent AIDs in a single individual. It highlights the need for screening such patients for comprehensive management.
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Parisis D, Sarrand J, Cabrol X, Delporte C, Soyfoo MS. Clinical Profile of Patients with Primary Sjögren's Syndrome with Non-Identified Antinuclear Autoantibodies. Diagnostics (Basel) 2024; 14:935. [PMID: 38732349 PMCID: PMC11083107 DOI: 10.3390/diagnostics14090935] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2024] [Revised: 04/08/2024] [Accepted: 04/22/2024] [Indexed: 05/13/2024] Open
Abstract
Objectives-The aim of the present study was to characterize the clinical phenotype of patients with primary Sjögren's syndrome (pSS) with non-identified antinuclear antibodies (ANA) in comparison with that of patients with pSS with negative ANA, positive typical ANA (anti-Ro/SSA and/or La/SSB) and positive atypical ANA. Methods-We conducted an observational, retrospective monocentric study at the Erasme University Hospital (Brussels, Belgium). Two hundred and thirty-three patients fulfilling the 2002 American-European Consensus Group criteria for pSS were included in this study. The patients were subdivided according to their ANA profile and demographics. The clinical and biological data of each subgroup were compared. Moreover, the relationships between these data and the ANA profiles were determined by multiple correspondence analysis. Results-In our cohort, 42 patients (18%) presented a non-identified ANA-positive profile. No statistically significant difference could be observed between non-identified ANA patients and ANA-negative patients in terms of age and/or ESSDAI score at diagnosis. There were significantly more frequent articular manifestations, positive rheumatoid factor (RF), and the use of corticosteroids in anti-Ro/SSA-positive patients compared to ANA-negative (p ≤ 0.0001) and non-identified ANA-positive patients (p ≤ 0.01). However, a significantly higher proportion of RF positivity and corticosteroid treatment was observed in non-identified ANA-positive patients compared to ANA-negative patients (p < 0.05). Conclusions-For the first time to our knowledge, our study has characterized the clinical phenotype of patients with pSS with non-identified ANA at diagnosis. The non-identified ANA-positive patients featured mostly a clinical phenotype similar to that of the ANA-negative patients. On the other hand, the non-identified ANA-positive patients were mainly distinguished from the ANA-negative patients by a greater proportion of RF positivity and the need for corticosteroid use due to articular involvement.
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Affiliation(s)
- Dorian Parisis
- Department of Rheumatology, Erasme Hospital, Hôpital Universitaire de Bruxelles (HUB), Université Libre de Bruxelles, 1070 Brussels, Belgium; (D.P.); (J.S.); (X.C.)
- Laboratory of Pathophysiological and Nutritional Biochemistry, Faculty of Medicine, Université Libre de Bruxelles, 1070 Brussels, Belgium;
| | - Julie Sarrand
- Department of Rheumatology, Erasme Hospital, Hôpital Universitaire de Bruxelles (HUB), Université Libre de Bruxelles, 1070 Brussels, Belgium; (D.P.); (J.S.); (X.C.)
| | - Xavier Cabrol
- Department of Rheumatology, Erasme Hospital, Hôpital Universitaire de Bruxelles (HUB), Université Libre de Bruxelles, 1070 Brussels, Belgium; (D.P.); (J.S.); (X.C.)
- Laboratory of Pathophysiological and Nutritional Biochemistry, Faculty of Medicine, Université Libre de Bruxelles, 1070 Brussels, Belgium;
| | - Christine Delporte
- Laboratory of Pathophysiological and Nutritional Biochemistry, Faculty of Medicine, Université Libre de Bruxelles, 1070 Brussels, Belgium;
| | - Muhammad S. Soyfoo
- Department of Rheumatology, Erasme Hospital, Hôpital Universitaire de Bruxelles (HUB), Université Libre de Bruxelles, 1070 Brussels, Belgium; (D.P.); (J.S.); (X.C.)
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Chiang S, Grogan T, Kamounah S, Wei F, Tayob N, Kim JY, Kyun Park J, Akin D, Elashoff DA, Pedersen AML, Song YW, Wong DTW, Chia D. Distinctive profile of monomeric and polymeric anti-SSA/Ro52 immunoglobulin A1 isoforms in saliva of patients with primary Sjögren's syndrome and Sicca. RMD Open 2024; 10:e003666. [PMID: 38599651 PMCID: PMC11015269 DOI: 10.1136/rmdopen-2023-003666] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2023] [Accepted: 03/04/2024] [Indexed: 04/12/2024] Open
Abstract
OBJECTIVE Primary Sjögren's syndrome (pSS) is the second most common chronic autoimmune connective tissue disease. Autoantibodies, immunoglobulin (IgG) anti-SSA/Ro, in serum is a key diagnostic feature of pSS. Since pSS is a disease of the salivary gland, we investigated anti-SSA/Ro52 in saliva. METHODS Using a novel electrochemical detection platform, Electric Field-Induced Release and Measurement, we measured IgG/M/A, IgG, IgA, IgA isotypes (IgA1 and IgA2) and IgA1 subclasses (polymeric and monomeric IgA1) to anti-SSA/Ro52 in saliva supernatant of 34 pSS, 35 dry eyes and dry mouth (patients with Sicca) and 41 health controls. RESULTS Saliva IgG/M/A, IgG, IgA, IgA isotypes and IgA1 subclasses to anti-SSA/Ro52 differed significantly between pSS, non-pSS Sicca and healthy subjects. Elevated monomeric IgA1 was observed in patients with non-pSS Sicca while elevated polymeric IgA1 (pIgA1) was observed in patients with pSS. Salivary polymeric but not monomeric IgA1 (mIgA1) isoform correlated with focus score (r2=0.467, p=0.001) CONCLUSIONS: Salivary anti-Ro52 polymeric IgA1 isoform is associated with glandular inflammation in pSS, while salivary monomeric IgA1 is associated with Sicca. Whether IgA1 isotope switching plays a role in the progression of the Sicca to pSS warrants further investigation.
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Affiliation(s)
| | - Tristan Grogan
- Department of Medicine Statistics Core, University of California, Los Angeles, Los Angeles, California, USA
| | - Sarah Kamounah
- Oral Biology and Immunopathology/Oral Medicine & Pathology, University of Copenhagen Faculty of Health and Medical Sciences, Copenhagen N, Denmark
| | - Fang Wei
- UCLA School of Dentistry, Los Angeles, California, USA
| | - Nabihah Tayob
- Data Science, Dana-Farber Cancer Institute, Boston, Massachusetts, USA
| | - Ju Yeon Kim
- Rheumatology, Seoul National University Hospital, Seoul, Korea
| | - Jin Kyun Park
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
| | - David Akin
- UCLA School of Dentistry, Los Angeles, California, USA
| | - David A Elashoff
- Department of Medicine Statistics Core, University of California, Los Angeles, Los Angeles, California, USA
| | - Anne Marie Lynge Pedersen
- Section for Oral Biolology and Immunopathology, Oral Medicine and Pathology, Department of Odontology, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Yeong Wook Song
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
| | | | - David Chia
- Department of Pathology and Laboratory Medicine, University of California, Los Angeles, Los Angeles, California, USA
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Stoopler ET, Villa A, Bindakhil M, Díaz DLO, Sollecito TP. Common Oral Conditions: A Review. JAMA 2024; 331:1045-1054. [PMID: 38530258 DOI: 10.1001/jama.2024.0953] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/27/2024]
Abstract
Importance Dry mouth, oral candidiasis, and recurrent aphthous ulcers are 3 of the most common oral conditions that may be associated with patient discomfort, decreased quality of life, and morbidity. Observations In a meta-analysis of 26 population-based cohort and cross-sectional studies, the global prevalence of dry mouth symptoms was 23% (95% CI, 18% to 28%), placing individuals at risk of oral candidiasis, dental caries, dysgeusia, masticatory/speech impairment, and oropharyngeal dysphagia. Dry mouth is associated with using more than 3 oral medications per day (odds ratio [OR], 2.9 [95% CI, 1.4 to 6.2]), head and neck radiation, and Sjögren disease. Symptoms may include difficulty swallowing and speaking, thirst, and halitosis. Dry mouth is associated with an 11.5% (95% CI, 3.6% to 27%) higher risk of oral candidiasis, based on a meta-analysis of 6 observational cohorts. Management of dry mouth includes mechanical salivary stimulants, oral moisturizers, and/or systemic sialagogues. Oral candidiasis is an opportunistic fungal infection caused by overgrowth of the Candida genus with C albicans, which accounts for 76.8% of infections. The prevalence of oral candidiasis is higher in patients who are immunosuppressed, for example, those with HIV (35% [95% CI, 28% to 42%]) and those with salivary gland hypofunction (OR, 3.02 [95% CI, 1.73 to 5.28]). Common risk factors associated with oral candidiasis include use of antibiotics (P = .04) and oral mucosal disorders such as lichen planus. Oral burning and dysgeusia are common symptoms of oral candidiasis. Treatment includes addressing risk factors and use of topical and/or systemic antifungal medications. Recurrent aphthous stomatitis is characterized by symptomatic round or oval oral ulcers, which are covered by a gray-white fibrin layer and encircled by an erythematous ring. A meta-analysis of 10 case-controlled studies revealed an increased risk of recurrent aphthous stomatitis associated with polymorphism of IL-1β (+3954C/T) (OR, 1.52 [95% CI, 1.07 to 2.17]) and IL-1β (-511C/T) (OR, 1.35 [95% CI, 1.09 to 1.67]). Another meta-analysis of 9 case-control studies reported that patients with recurrent aphthous stomatitis had a higher frequency of nutritional deficiencies, including vitamin B12 (OR, 3.75 [95% CI, 2.38 to 5.94]), folic acid (OR, 7.55 [95% CI, 3.91 to 14.60]), and ferritin (OR, 2.62 [95% CI, 1.69 to 4.06]). Recurrent aphthous stomatitis can be associated with systemic diseases. A meta-analysis of 21 case-control studies revealed that celiac disease is associated with a higher incidence of recurrent aphthous stomatitis (25% vs 11%; OR, 3.79 [95% CI, 2.67 to 5.39]; P <.001). Topical corticosteroids are first-line agents to manage recurrent aphthous stomatitis; however, systemic medications may be necessary in more severe cases. Conclusions and Relevance Dry mouth, oral candidiasis, and recurrent aphthous ulcers are common oral conditions that may be associated with patient discomfort, decreased quality of life, and morbidity. First-line treatment includes over-the-counter sialagogues for dry mouth, topical antifungals for oral candidiasis, and topical corticosteroids for aphthous ulcers. Oral conditions that do not improve with first-line treatment may require treatment with systemic medications.
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Affiliation(s)
| | - Alessandro Villa
- Miami Cancer Institute, Baptist Health South Florida, Herbert Wertheim College of Medicine, Florida International University, Miami
| | - Mohammed Bindakhil
- Augusta University, Augusta, Georgia
- Now with Riyadh Elm University, Riyadh, Saudi Arabia
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Zhao L, Liu L, Liu Y, Zheng H, Jiang P. Role of serum B-cell-activating factor and interleukin-17 as biomarkers in the classification of interstitial pneumonia with autoimmune features. Open Life Sci 2024; 19:20220814. [PMID: 38465342 PMCID: PMC10921473 DOI: 10.1515/biol-2022-0814] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2023] [Revised: 11/15/2023] [Accepted: 11/17/2023] [Indexed: 03/12/2024] Open
Abstract
Interstitial pneumonia with autoimmune features (IPAF) is a type of interstitial lung disease (ILD) with immune features that do not meet the diagnostic criteria for specific connective tissue diseases (CTDs). This retrospective case-control study investigated the role of serum B-cell-activating factor of the tumor necrosis factor family (BAFF) and interleukin (IL)-17 as biomarkers for IPAF. The differences in serum BAFF, IL-17, and IL-10 were compared among patients with idiopathic pulmonary fibrosis (IPF), IPAF, ILD associated with CTD (CTD-ILD), and healthy controls. The patients were treatment naïve. The correlations of BAFF with IL-10, IL-17, and pulmonary function were analyzed. The classifiable value of BAFF for IPAF was examined. The results showed that the serum levels of BAFF and IL-17 in the IPAF and CTD-ILD groups were higher than in the IPF group. High BAFF levels and high predicted diffusion capacity of the lungs for carbon monoxide (DLCO) were independent predictive factors for IPAF vs IPF. In the IPAF and CTD-ILD groups, serum BAFF levels were negatively correlated with predicted values of forced vital capacity (FVC%) and diffusing capacity of the lungs for carbon monoxide (DLCO%) and positively correlated with serum IL-17 and IL-10 levels. The cutoff value of combined BAFF and IL-17 was 0.704, and the sensitivity and specificity for classifying IPAF were 78.9 and 95.7%, respectively. In conclusion, combining serum BAFF and IL-17 as a biomarker may have classifiable value in differentiating IPAF from other forms of ILD.
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Affiliation(s)
- Lihong Zhao
- Department of Respiratory and Critical Care Medicine, Tianjin First Central Hospital, Tianjin, 300192, China
| | - Li Liu
- Department of Respiratory and Critical Care Medicine, Tianjin First Central Hospital, Tianjin, 300192, China
| | - Yehua Liu
- Department of Clinical Laboratory, Tianjin First Central Hospital, Tianjin, 300192, China
| | - Hong Zheng
- Department of Respiratory and Critical Care Medicine, Tianjin First Central Hospital, Tianjin, 300192, China
| | - Ping Jiang
- Department of Respiratory and Critical Care Medicine, Tianjin First Central Hospital, 24 Fukang Road,
Nankai District, Tianjin, 300192, China
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Mahla RS. B cells clonality and primary Sjögren's syndrome: comment on the article by Arvidsson et al. Arthritis Rheumatol 2024; 76:313-314. [PMID: 37691295 DOI: 10.1002/art.42698] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2023] [Accepted: 08/29/2023] [Indexed: 09/12/2023]
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Wu KY, Serhan O, Faucher A, Tran SD. Advances in Sjögren's Syndrome Dry Eye Diagnostics: Biomarkers and Biomolecules beyond Clinical Symptoms. Biomolecules 2024; 14:80. [PMID: 38254680 PMCID: PMC10812982 DOI: 10.3390/biom14010080] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2023] [Revised: 01/04/2024] [Accepted: 01/06/2024] [Indexed: 01/24/2024] Open
Abstract
Sjögren's syndrome dry eye (SSDE) is a subset of Sjögren's syndrome marked by dry eye symptoms that is distinct from non-Sjögren's syndrome dry eye (NSSDE). As SSDE can lead to severe complications, its early detection is imperative. However, the differentiation between SSDE and NSSDE remains challenging due to overlapping clinical manifestations. This review endeavors to give a concise overview of the classification, pathophysiology, clinical features and presentation, ocular and systemic complications, clinical diagnosis, and management of SSDE. Despite advancements, limitations in current diagnostic methods underscore the need for novel diagnostic modalities. Thus, the current review examines various diagnostic biomarkers utilized for SSDE identification, encompassing serum, salivary, and tear analyses. Recent advancements in proteomic research and exosomal biomarkers offer promising diagnostic potential. Through a comprehensive literature review spanning from 2016 to 2023, we highlight molecular insights and advanced diagnostic modalities that have the potential to enhance our understanding and diagnosis of SSDE.
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Affiliation(s)
- Kevin Y. Wu
- Division of Ophthalmology, Department of Surgery, University of Sherbrooke, Sherbrooke, QC J1G 2E8, Canada; (K.Y.W.); (A.F.)
| | - Olivia Serhan
- Faculty of Medicine, University of Sherbrooke, Sherbrooke, QC J1G 2E8, Canada
| | - Anne Faucher
- Division of Ophthalmology, Department of Surgery, University of Sherbrooke, Sherbrooke, QC J1G 2E8, Canada; (K.Y.W.); (A.F.)
| | - Simon D. Tran
- Faculty of Dental Medicine and Oral Health Sciences, McGill University, Montreal, QC H3A 1G1, Canada
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Shbeer AM, Ahmed Robadi I. The role of Interleukin-21 in autoimmune Diseases: Mechanisms, therapeutic Implications, and future directions. Cytokine 2024; 173:156437. [PMID: 37972478 DOI: 10.1016/j.cyto.2023.156437] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2023] [Revised: 11/05/2023] [Accepted: 11/07/2023] [Indexed: 11/19/2023]
Abstract
IL-21 is a multifunctional cytokine that regulates the functional activity of various immune cells. Initial studies have shown that IL-21 can influence the differentiation, proliferation and function of T and B cells, as well as promote the maturation and increase the cytotoxicity of CD8 + T cells and NK cells. During humoral immune responses, IL-21 has significant effects on B cell activation, differentiation and apoptosis. In addition, IL-21 promotes the differentiation of both naive and memory B cells, ultimately leading to the activation of plasma cells. The function of IL-21 in the immune system is complex, as it has the ability to either stimulate or inhibit immune responses. in addition, IL-21 facilitates the differentiation of naive and memory B cells into plasma cells. The functionality of IL-21 in the immune system is diverse, as it has the ability to stimulate or inhibit immune responses. This cytokine has been implicated in several diseases including cancer, allergies and autoimmune diseases. Research has suggested that this cytokine is involved in the development of autoimmune diseases such as systemic lupus erythematosus and rheumatoid arthritis. Several studies have suggested that inhibition of IL-21 has a therapeutic effect on autoimmune diseases. Therefore, targeting both the cytokine's receptor and IL-21 in autoimmune diseases may be an effective approach to reduce the severity of the disease or to treat it. This review will examine the biological effects of IL-21 on various immune cells and the role of the cytokine in autoimmune diseases.
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Affiliation(s)
- Abdullah M Shbeer
- Department of Surgery, Faculty of Medicine, Jazan University, Jazan, Saudi Arabia.
| | - Ibrahim Ahmed Robadi
- Department of pathology, Faculty of Medicine, Jazan University, Jazan, Saudi Arabia
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Nascimento Da Conceicao V, Sun Y, Chai X, Ambrus JL, Mishra BB, Singh BB. Metformin-induced activation of Ca 2+ signaling prevents immune infiltration/pathology in Sjogren's syndrome-prone mouse models. J Transl Autoimmun 2023; 7:100210. [PMID: 37711153 PMCID: PMC10497794 DOI: 10.1016/j.jtauto.2023.100210] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2023] [Revised: 08/14/2023] [Accepted: 08/29/2023] [Indexed: 09/16/2023] Open
Abstract
Immune cell infiltration and glandular dysfunction are the hallmarks of autoimmune diseases such as primary Sjogren's syndrome (pSS), however, the mechanism(s) is unknown. Our data show that metformin-treatment induces Ca2+ signaling that restores saliva secretion and prevents immune cell infiltration in the salivary glands of IL14α-transgenic mice (IL14α), which is a model for pSS. Mechanistically, we show that loss of Ca2+ signaling is a major contributing factor, which is restored by metformin treatment, in IL14α mice. Furthermore, the loss of Ca2+ signaling leads to ER stress in salivary glands. Finally, restoration of metformin-induced Ca2+ signaling inhibited the release of alarmins and prevented the activation of ER stress that was essential for immune cell infiltration. These results suggest that loss of metformin-mediated activation of Ca2+ signaling prevents ER stress, which inhibited the release of alarmins that induces immune cell infiltration leading to salivary gland dysfunction observed in pSS.
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Affiliation(s)
- Viviane Nascimento Da Conceicao
- Department of Periodontics, School of Dentistry, University of Texas Health Science Center San Antonio, San Antonio, TX 78229, USA
| | - Yuyang Sun
- Department of Periodontics, School of Dentistry, University of Texas Health Science Center San Antonio, San Antonio, TX 78229, USA
| | - Xiufang Chai
- Department of Periodontics, School of Dentistry, University of Texas Health Science Center San Antonio, San Antonio, TX 78229, USA
| | - Julian L. Ambrus
- Division of Allergy, Immunology, and Rheumatology, Department of Medicine, School of Medicine and Biomedical Sciences, State University of New York, Buffalo, NY 14203, USA
| | - Bibhuti B. Mishra
- Department of Developmental Dentistry, School of Dentistry, University of Texas Health Science Center San Antonio, San Antonio, TX 78229, USA
| | - Brij B. Singh
- Department of Periodontics, School of Dentistry, University of Texas Health Science Center San Antonio, San Antonio, TX 78229, USA
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14
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Barsottini OGP, Moraes MPMD, Fraiman PHA, Marussi VHR, Souza AWSD, Braga Neto P, Spitz M. Sjogren's syndrome: a neurological perspective. ARQUIVOS DE NEURO-PSIQUIATRIA 2023; 81:1077-1083. [PMID: 38157875 PMCID: PMC10756846 DOI: 10.1055/s-0043-1777105] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/18/2023] [Accepted: 10/20/2023] [Indexed: 01/03/2024]
Abstract
Sjogren's syndrome (SS) is a complex autoimmune disease characterized by lymphocytic infiltration of salivary and lacrimal glands, resulting in sicca symptoms. Additionally, SS presents with neurological manifestations that significantly impact the nervous system. This review aims to provide a comprehensive overview of the neurological aspects of SSj, covering both the peripheral and central nervous system involvement, while emphasizing diagnosis, treatment, and prognosis.
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Affiliation(s)
- Orlando Grazianni Povoas Barsottini
- Universidade Federal de São Paulo, Escola Paulista de Medicina, Departamento de Neurologia e Neurocirurgia, Setor de Neurologia Geral e Ataxias, São Paulo SP, Brazil.
| | - Marianna Pinheiro Moraes de Moraes
- Universidade Federal de São Paulo, Escola Paulista de Medicina, Departamento de Neurologia e Neurocirurgia, Setor de Neurologia Geral e Ataxias, São Paulo SP, Brazil.
| | - Pedro Henrique Almeida Fraiman
- Universidade Federal de São Paulo, Escola Paulista de Medicina, Departamento de Neurologia e Neurocirurgia, Setor de Neurologia Geral e Ataxias, São Paulo SP, Brazil.
| | | | - Alexandre Wagner Silva de Souza
- Universidade Federal de São Paulo, Escola Paulista de Medicina, Departamento de Medicina, Divisão de Reumatologia, São Paulo SP, Brazil.
- Sociedade Brasileira de Reumatologia, Comissão de Vasculites, São Paulo SP, Brazil.
| | - Pedro Braga Neto
- Universidade Federal do Ceará, Departamento de Medicina Clínica, Divisão de Neurologia, Fortaleza CE, Brazil.
- Universidade do Estado do Ceará, Centro de Ciências da Saúde, Fortaleza CE, Brazil.
| | - Mariana Spitz
- Universidade do Estado do Rio de Janeiro, Serviço de Neurologia, Rio de Janeiro RJ, Brazil.
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15
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Hsu CH, Yu YL. The interconnected roles of TRIM21/Ro52 in systemic lupus erythematosus, primary Sjögren's syndrome, cancers, and cancer metabolism. Cancer Cell Int 2023; 23:289. [PMID: 37993883 PMCID: PMC10664372 DOI: 10.1186/s12935-023-03143-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2023] [Accepted: 11/13/2023] [Indexed: 11/24/2023] Open
Abstract
Protein tripartite motif-containing 21 (TRIM21/Ro52), an E3 ubiquitin ligase, is an essential regulator of innate immunity, and its dysregulation is closely associated with the development of autoimmune diseases, predominantly systemic lupus erythematosus (SLE) and primary Sjögren's syndrome (pSS). TRIM21 /Ro52 also features anti-cancer and carcinogenic functions according to different malignancies. The interconnected role of TRIM21/Ro52 in regulating autoimmunity and cell metabolism in autoimmune diseases and malignancies is implicated. In this review, we summarize current findings on how TRIM21/Ro52 affects inflammation and tumorigenesis, and investigate the relationship between TRIM21/Ro52 expression and the formation of lymphoma and breast cancer in SLE and pSS populations.
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Affiliation(s)
- Chueh-Hsuan Hsu
- Graduate Institute of Biomedical Sciences, College of Medicine, China Medical University, Taichung, 40402, Taiwan
| | - Yung-Luen Yu
- Graduate Institute of Biomedical Sciences, College of Medicine, China Medical University, Taichung, 40402, Taiwan.
- Institute of Translational Medicine and New Drug Development, Taichung, 40402, Taiwan.
- Center for Molecular Medicine, China Medical University Hospital, Taichung, 40402, Taiwan.
- Department of Medical Laboratory Science and Biotechnology, Asia University, Taichung, 41354, Taiwan.
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16
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Canfora F, Calabria E, Spagnuolo G, Coppola N, Armogida NG, Mazzaccara C, Solari D, D’Aniello L, Aria M, Pecoraro G, Mignogna MD, Leuci S, Adamo D. Salivary Complaints in Burning Mouth Syndrome: A Cross Sectional Study on 500 Patients. J Clin Med 2023; 12:5561. [PMID: 37685630 PMCID: PMC10488611 DOI: 10.3390/jcm12175561] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2023] [Revised: 08/21/2023] [Accepted: 08/25/2023] [Indexed: 09/10/2023] Open
Abstract
BACKGROUND Xerostomia and sialorrhea often accompany Burning Mouth Syndrome (BMS) despite no change in saliva quantity. This study analyzed BMS patients with different symptom combinations: burning only (B), burning and xerostomia (BX), burning and sialorrhea (BS), and burning with xerostomia and sialorrhea (BXS), using a large sample of 500 patients from the University of Naples Federico II. METHODS After a medical evaluation, patients were divided into four groups based on their reported symptoms: B (140), BX (253), BS (49), and BXS (58). Patient data on education, BMI, smoking/alcohol habits, comorbidities, medication use, pain intensity, quality, and psychological profile were collected. RESULTS The BX group showed a higher prevalence of patients taking blood thinners. Additional symptoms varied among groups, with the BX group experiencing more dysgeusia and globus, and the BS group reporting more tingling. Multivariate analysis identified BMI, dysgeusia, globus, and blood thinner use as significant factors in the B and BX groups, while male gender, tingling, alcohol use, and pain quality were significant in the BS and BXS groups. CONCLUSIONS Overall, BMS patients display a complex range of symptoms, with xerostomia being the most frequent additional symptom. Sociodemographic, psychological, and medical factors cannot fully explain the variations in symptomatology among different patient subgroups. Further research is needed to understand the underlying causes and develop tailored treatment approaches.
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Affiliation(s)
- Federica Canfora
- Department of Neuroscience, Reproductive Sciences and Dentistry, University of Naples Federico II, 80131 Naples, Italy; (F.C.); (D.A.)
| | - Elena Calabria
- Department of Health Sciences, School of Dentistry, University Magna Graecia of Catanzaro, 88100 Catanzaro, Italy
| | - Gianrico Spagnuolo
- Department of Neuroscience, Reproductive Sciences and Dentistry, University of Naples Federico II, 80131 Naples, Italy; (F.C.); (D.A.)
- Therapeutic Dentistry Department, Institute for Dentistry, Sechenov University, 119991 Moscow, Russia
| | - Noemi Coppola
- Department of Neuroscience, Reproductive Sciences and Dentistry, University of Naples Federico II, 80131 Naples, Italy; (F.C.); (D.A.)
| | - Niccolò Giuseppe Armogida
- Department of Neuroscience, Reproductive Sciences and Dentistry, University of Naples Federico II, 80131 Naples, Italy; (F.C.); (D.A.)
| | - Cristina Mazzaccara
- Department of Molecular Medicine and Medical Biotechnology, University of Naples Federico II, 80131 Naples, Italy
- CEINGE Advanced Biotechnologies, 80145 Naples, Italy
| | - Domenico Solari
- Department of Neuroscience, Reproductive Sciences and Dentistry, University of Naples Federico II, 80131 Naples, Italy; (F.C.); (D.A.)
| | - Luca D’Aniello
- Department of Social Sciences, University Federico II of Naples, 80138 Naples, Italy
| | - Massimo Aria
- Department of Economics and Statistics, University Federico II of Naples, 80138 Naples, Italy
| | - Giuseppe Pecoraro
- Department of Neuroscience, Reproductive Sciences and Dentistry, University of Naples Federico II, 80131 Naples, Italy; (F.C.); (D.A.)
| | - Michele Davide Mignogna
- Department of Neuroscience, Reproductive Sciences and Dentistry, University of Naples Federico II, 80131 Naples, Italy; (F.C.); (D.A.)
| | - Stefania Leuci
- Department of Neuroscience, Reproductive Sciences and Dentistry, University of Naples Federico II, 80131 Naples, Italy; (F.C.); (D.A.)
| | - Daniela Adamo
- Department of Neuroscience, Reproductive Sciences and Dentistry, University of Naples Federico II, 80131 Naples, Italy; (F.C.); (D.A.)
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17
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Mohammadi T, Yavari T, Ghorbani S, Mohammadi B. Associations of diagnostic findings with disease activity in primary Sjӧgren's syndrome: a cluster analysis. Rev Clin Esp 2023; 223:209-215. [PMID: 36841475 DOI: 10.1016/j.rceng.2023.02.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/27/2023]
Abstract
OBJECTIVE The diagnosis of primary Sjӧgren's syndrome still relies upon a constellation of clinical, laboratory, imaging, and pathological findings. We aimed to evaluate the relation of the disease activity with the results of diagnostic tests for primary Sjӧgren's syndrome. METHODS A principal component with cluster analysis was performed to classify 69 patients with primary Sjӧgren's syndrome based on the results of diagnostic evaluations. RESULTS Anti-SSA autoantibody was the most represented feature on the principal components. The anti-SSA and ultrasound score were positively correlated (p=0.001). We identified two distinct clusters of low or high disease activity (p<0.001). Except for disease duration and serum beta2-microglobulin, the clusters were significantly different in salivary flow (p= 0.004), ultrasound findings (p<0.001), IgG (p= 0.001), and salivary beta2-microglobulin (p= 0.048). Also, positive findings were significantly different between the clusters in rheumatoid factor, antinuclear antibody, anti-SSA, and anti-SSB (all p≤0.013). CONCLUSION Patients with higher syndrome activity were best recognized with serological and ultrasound assessments. However, patients with lower syndrome activity had a longer disease duration, higher stimulated salivary flow rate, and a positive biopsy of minor salivary glands (56%).
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Affiliation(s)
- T Mohammadi
- University of Tehran, College of Science, School of Mathematics, Statistics, and Computer Science, Tehran, Iran
| | - T Yavari
- Tehran University of Medical Sciences, Faculty of Medicine, Shariati Hospital, Tehran, Iran
| | - S Ghorbani
- Kerman University of Medical Sciences, Shafa Hospital, Department of Otorhinolaryngology, Kerman, Iran
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18
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Sjögren's syndrome with and without neurological involvement. J Neurol 2023; 270:2987-2996. [PMID: 36802030 DOI: 10.1007/s00415-023-11613-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2023] [Revised: 02/06/2023] [Accepted: 02/06/2023] [Indexed: 02/21/2023]
Abstract
OBJECTIVE Neurological manifestations of Sjögren's syndrome can be severe but also treatment-responsive. We aimed to systematically evaluate neurological manifestations of primary Sjögren's syndrome and find clinical features allowing sufficient identification of affected patients (pSSN) among those with Sjögren's syndrome without neurological involvement (pSS). METHODS Para-/clinical features of patients with primary Sjögren's syndrome (2016 ACR/EULAR classification criteria) were compared between pSSN and pSS. At our university-based center, patients with suggestive neurological symptoms undergo screening for Sjögren's syndrome, and newly diagnosed pSS patients are thoroughly evaluated for neurologic involvement. pSSN disease activity was rated by the Neurological Involvement of Sjögren's Syndrome Disease Activity Score (NISSDAI). RESULTS 512 patients treated for pSS/pSSN at our site between 04/2018 and 07/2022 were included (238 pSSN patients [46%] vs. 274 pSS patients [54%], cross-sectional design). Independent predictors of neurological involvement in Sjögren's syndrome were male sex [p < 0.001], older age at disease onset [p < 0.0001], hospitalization at first presentation [p < 0.001], lower IgG levels [p = 0.04] and higher eosinophil values (treatment-naïve) [p = 0.02]. Univariate regression additionally showed older age at diagnosis [p < 0.001], lower prevalence of rheumatoid factor [p = 0.001], SSA(Ro)/SSB(La) antibodies [p = 0.03; p < 0.001], higher white blood cell count [p = 0.02] and CK levels [p = 0.02] (treatment-naïve) in pSSN. INTERPRETATION Patients with pSSN had different clinical characteristics than patients with pSS and represented a large proportion of the cohort. Our data suggest that neurological involvement in Sjögren's syndrome has been underestimated. Intensified screening for neurologic involvement should be included in the diagnostic algorithm for Sjögren's syndrome, especially in males of older age and with severe disease course requiring hospitalization.
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19
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Radenska-Lopovok SG, Karanova MS, Zanozin AS, Rodionova EB, Palshina SG, Tsvetanov MS, Tregubova AV, Vasilev VI. [Evaluation of morphological activity of primary Sjogren's syndrome on bioptates of minor salivary glands]. Arkh Patol 2023; 85:5-9. [PMID: 36785956 DOI: 10.17116/patol2023850115] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/15/2023]
Abstract
BACKGROUND The results of the morphological study of the minor salivary glands can be used to assess the activity of the primary Sjogren's syndrome and to decide on adequate therapy.The existing protocol of The Sjögren's International Clinical Collaborative Alliance (SICCA) prescribes the methodology for examining biopsy specimens for suspected Sjögren's disease, however, experts interpret data from the analysis of histological preparations differently. OBJECTIVE To identify morphological forms of sialadenitis, as well as to determine the focus score in Russian patients based on the retrospective analysis of minor salivary glands biopsies of patients with primary Sjogren's syndrome. MATERIAL AND METHODS Biopsies of minor salivary glands were studied in 92 patients with primary Sjogren's syndrome and 42 patients without rheumatic disease. RESULTS Focal lymphocytic sialadenitis was detected in 69 patients with primary Sjogren's syndrome. The focus score in patients with primary Sjogren's syndrome was 7.32 (2.8-14.17). In patients without rheumatic diseases, this index was 0.48 (p<0.05). Patients with confluent lymphocytic foci need immunohistochemical examination and dynamic monitoring to exclude lymphoproliferative diseases. CONCLUSION The index of morphological activity of sialadenitis in primary Sjogren's syndrome ranges from 2.8 to 14.17 and reflects the activity of the underlying disease.It should be taken into account in the diagnosis and prescription of adequate therapy. Further study of the correlations of morphological and clinical and laboratory parameters will lead to clarification of the criterion signs of the disease.
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Affiliation(s)
- S G Radenska-Lopovok
- I.M. Sechenov First Moscow State Medical University, Moscow, Russia.,Russian Medical Academy of Continuous Professional Education, Moscow, Russia
| | - M S Karanova
- I.M. Sechenov First Moscow State Medical University, Moscow, Russia
| | - A S Zanozin
- I.M. Sechenov First Moscow State Medical University, Moscow, Russia
| | | | - S G Palshina
- V.A. Nasonova Research Institute of Rheumatology, Moscow, Russia
| | - M S Tsvetanov
- I.M. Sechenov First Moscow State Medical University, Moscow, Russia
| | - A V Tregubova
- National Medical Research center for obstetrics, gynecology and perinatology named after V.I. Kulakov, Moscow, Russia
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20
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Wu KY, Kulbay M, Tanasescu C, Jiao B, Nguyen BH, Tran SD. An Overview of the Dry Eye Disease in Sjögren's Syndrome Using Our Current Molecular Understanding. Int J Mol Sci 2023; 24:1580. [PMID: 36675090 PMCID: PMC9866656 DOI: 10.3390/ijms24021580] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2022] [Revised: 01/10/2023] [Accepted: 01/11/2023] [Indexed: 01/15/2023] Open
Abstract
Sjögren's syndrome is a chronic and insidious auto-immune disease characterized by lymphocyte infiltration of exocrine glands. The patients typically present with ocular surface diseases related to dry eye and other systemic manifestations. However, due to the high prevalence of dry eye disease and the lack of objective and clinically reliable diagnostic tools, discriminating Sjögren's syndrome dry eye (SSDE) from non-Sjögren's syndrome dry eye (NSSDE) remains a challenge for clinicians. Diagnosing SS is important to improve the quality of life of patients through timely referral for systemic workups, as SS is associated with serious systemic complications such as lymphoma and other autoimmune diseases. The purpose of this article is to describe the current molecular understanding of Sjögren's syndrome and its implications for novel diagnostic modalities on the horizon. A literature review of the pre-clinical and clinical studies published between 2016 and 2022 was conducted. The SSDE pathophysiology and immunology pathways have become better understood in recent years. Novel diagnostic modalities, such as tear and saliva proteomics as well as exosomal biomarkers, provide hope on the horizon.
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Affiliation(s)
- Kevin Y. Wu
- Department of Surgery, Division of Ophthalmology, University of Sherbrooke, Sherbrooke, QC J1G 2E8, Canada
| | - Merve Kulbay
- Faculty of Medicine, University of Montreal, Montreal, QC H3T 1J4, Canada
| | - Cristina Tanasescu
- School of Optometry, University of Montreal, Montreal, QC H3T 1P1, Canada
| | - Belinda Jiao
- Department of Medicine, Division of Internal Medicine, University of Sherbrooke, Sherbrooke, QC J1G 2E8, Canada
| | - Bich H. Nguyen
- CHU Sainte Justine Hospital, Montreal, QC H3T 1C5, Canada
| | - Simon D. Tran
- Faculty of Dental Medicine and Oral Health Sciences, McGill University, Montreal, QC H3A 1G1, Canada
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21
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Sequí-Sabater JM, Beretta L. Defining the Role of Monocytes in Sjögren's Syndrome. Int J Mol Sci 2022; 23:ijms232112765. [PMID: 36361554 PMCID: PMC9654893 DOI: 10.3390/ijms232112765] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2022] [Revised: 10/20/2022] [Accepted: 10/20/2022] [Indexed: 01/24/2023] Open
Abstract
Sjögren's syndrome is one of the most prevalent autoimmune diseases after rheumatoid arthritis, with a preference for middle age, and is characterised by exocrine glandular involvement leading to xerostomia and xerophthalmia. It can have systemic implications with vascular, neurological, renal, and pulmonary involvement, and in some cases, it may evolve to non-Hodgkin's lymphoma. For a long time, B- and T-lymphocytes have been the focus of research and have been considered key players in Sjögren's syndrome pathogenesis and evolution. With the development of new technologies, including omics, more insights have been found on the different signalling pathways that lead to inflammation and activation of the immune system. New evidence indicates that a third actor linking innate and adaptive immunity plays a leading role in the Sjögren's syndrome play: the monocyte. This review summarises the recent insights from transcriptomic, proteomic, and epigenetic studies that help us to understand more about the Sjögren's syndrome pathophysiology and redefine the involvement of monocytes in this disease.
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Affiliation(s)
- Jose Miguel Sequí-Sabater
- Rheumatology Department, Reina Sofía University Hospital, Menéndez Pidal Ave., 14005 Córdoba, Spain
- Maimonides Institute for Research in Biomedicine of Córdoba (IMIBIC), University of Córdoba, Menéndez Pidal Ave., 14005 Córdoba, Spain
| | - Lorenzo Beretta
- Referral Center for Systemic Autoimmune Diseases, Fondazione IRCCS Ca’ Granda, Ospedale Maggiore Policlinico di Milano, Francesco Sforza St. 35, 20122 Milan, Italy
- Correspondence:
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