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Jimenez-Royo P, Bombardieri M, Ciurtin C, Kostapanos M, Tappuni AR, Jordan N, Saleem A, Fuller T, Port K, Pontarini E, Lucchesi D, Janiczek R, Galette P, Searle G, Patel N, Kershaw L, Gray C, Ratia N, van Maurik A, de Groot M, Wisniacki N, Bergstrom M, Tarzi R. Advanced imaging for quantification of abnormalities in the salivary glands of patients with primary Sjögren's syndrome. Rheumatology (Oxford) 2021; 60:2396-2408. [PMID: 33221921 PMCID: PMC8121449 DOI: 10.1093/rheumatology/keaa624] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2020] [Revised: 08/21/2020] [Indexed: 12/23/2022] Open
Abstract
Objectives To assess non-invasive imaging for detection and quantification of gland structure, inflammation and function in patients with primary Sjogren's syndrome (pSS) using PET-CT with 11C-Methionine (11C-MET; radiolabelled amino acid), and 18F-fluorodeoxyglucose (18F-FDG; glucose uptake marker), to assess protein synthesis and inflammation, respectively; multiparametric MRI evaluated salivary gland structural and physiological changes. Methods In this imaging/clinical/histology comparative study (GSK study 203818; NCT02899377) patients with pSS and age- and sex-matched healthy volunteers underwent MRI of the salivary glands and 11C-MET PET-CT. Patients also underwent 18F-FDG PET-CT and labial salivary gland biopsies. Clinical and biomarker assessments were performed. Primary endpoints were semi-quantitative parameters of 11C-MET and 18F-FDG uptake in submandibular and parotid salivary glands and quantitative MRI measures of structure and inflammation. Clinical and minor salivary gland histological parameter correlations were explored. Results Twelve patients with pSS and 13 healthy volunteers were included. Lower 11C-MET uptake in parotid, submandibular and lacrimal glands, lower submandibular gland volume, higher MRI fat fraction, and lower pure diffusion in parotid and submandibular glands were observed in patients vs healthy volunteer, consistent with reduced synthetic function. Disease duration correlated positively with fat fraction and negatively with 11C-MET and 18F-FDG uptake, consistent with impaired function, inflammation and fatty replacement over time. Lacrimal gland 11C-MET uptake positively correlated with tear flow in patients, and parotid gland 18F-FDG uptake positively correlated with salivary gland CD20+ B-cell infiltration. Conclusion Molecular imaging and MRI may be useful tools to non-invasively assess loss of glandular function, increased glandular inflammation and fat accumulation in pSS.
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Affiliation(s)
| | - Michele Bombardieri
- Experimental Medicine and Rheumatology, Queen Mary University of London, London
| | - Coziana Ciurtin
- Centre for Adolescent Rheumatology, University College London, London
| | - Michalis Kostapanos
- GlaxoSmithKline Clinical Unit Cambridge, Cambridge.,Department of Medicine, Addenbrooke's Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge
| | - Anwar R Tappuni
- Institute of Dentistry, Queen Mary University of London, London
| | - Natasha Jordan
- Rheumatology Department, Addenbrooke's Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge
| | - Azeem Saleem
- Invicro, Centre for Imaging Sciences, A Konica Minolta Company, London.,Faculty of Health Sciences, University of Hull, Hull
| | - Teresa Fuller
- Research and Development, GlaxoSmithKline, Stevenage
| | - Kathleen Port
- Research and Development, GlaxoSmithKline, Stevenage
| | - Elena Pontarini
- Experimental Medicine and Rheumatology, Queen Mary University of London, London
| | - Davide Lucchesi
- Experimental Medicine and Rheumatology, Queen Mary University of London, London
| | | | - Paul Galette
- Research and Development, GlaxoSmithKline, Stevenage
| | - Graham Searle
- Invicro, Centre for Imaging Sciences, A Konica Minolta Company, London
| | - Neel Patel
- Research and Development, GlaxoSmithKline, Stevenage
| | - Lucy Kershaw
- Centre for Inflammation Research, University of Edinburgh.,Edinburgh Imaging, University of Edinburgh, Edinburgh
| | - Calum Gray
- Edinburgh Imaging, University of Edinburgh, Edinburgh
| | - Nirav Ratia
- Research and Development, GlaxoSmithKline, Stevenage
| | | | - Marius de Groot
- Research and Development, GlaxoSmithKline, Stevenage.,GlaxoSmithKline Clinical Unit Cambridge, Cambridge
| | | | | | - Ruth Tarzi
- Research and Development, GlaxoSmithKline, Stevenage
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GALLO A, BENAZZO M, CAPACCIO P, DE CAMPORA L, DE VINCENTIIS M, FUSCONI M, MARTELLUCCI S, PALUDETTI G, PASQUINI E, PUXEDDU R, SPECIALE R. Sialoendoscopy: state of the art, challenges and further perspectives. Round Table, 101(st) SIO National Congress, Catania 2014. ACTA OTORHINOLARYNGOLOGICA ITALICA : ORGANO UFFICIALE DELLA SOCIETA ITALIANA DI OTORINOLARINGOLOGIA E CHIRURGIA CERVICO-FACCIALE 2015; 35:217-33. [PMID: 26824208 PMCID: PMC4731883] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/13/2015] [Accepted: 06/18/2015] [Indexed: 11/23/2022]
Abstract
This draft of the Official Round Table held during the 101(st) SIO National Congress is an updated review on sialoendoscopy, a technique used for diagnosis and treatment of obstructive pathologies of salivary glands in a minimally invasive fashion. This review treats many aspects of salivary gland endoscopy, starting from anatomy to deal with the more advanced surgical techniques and analyses the main decisional algorithms proposed in the literature. In addition, particular attention was directed to the current limitations of this technique and to the potential developments that sialoendoscopy could have in the near future.
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Affiliation(s)
- A. GALLO
- Department of Medico-surgical sciences and biotechnologies, ENT Section, Sapienza University of Rome, Italy
| | - M. BENAZZO
- Department of Otorhinolaryngology, University of Pavia, IRCCS Policlinico "S. Matteo" Foundation, Pavia, Italy
| | - P. CAPACCIO
- Department of Biomedical, Surgical and Dental Sciences, Fondazione I.R.C.C.S. Ospedale Maggiore Policlinico "Mangiagalli e Regina Elena", University of Milano, Italy
| | - L. DE CAMPORA
- Department of Otorhinolaryngology, "Fatebenefratelli" Hospital, Roma, Italy
| | - M. DE VINCENTIIS
- Department of Sense Organs, ENT Section, Policlinico "Umberto I", Sapienza University of Rome, Italy
| | - M. FUSCONI
- Department of Sense Organs, ENT Section, Policlinico "Umberto I", Sapienza University of Rome, Italy
| | - S. MARTELLUCCI
- Department of Medico-surgical sciences and biotechnologies, ENT Section, Sapienza University of Rome, Italy
| | - G. PALUDETTI
- Department of Head and Neck Surgery, Institute of Otorhinolaryngology, Università Cattolica del Sacro Cuore, Italy
| | - E. PASQUINI
- Ear, Nose and Throat Unit, "Sant'Orsola-Malpighi" Hospital, Bologna, Italy
| | - R. PUXEDDU
- Department of Otorhinolaryngology, AOU, PO "S. Giovanni di Dio", University of Cagliari, Italy
| | - R. SPECIALE
- Department of Biomedicine and Neurosciences Clinic, Otorhinolaryngology Unit, University of Palermo; Italy
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Ahmadi E, Fallahi S, Alaeddini M, Hasani Tabatabaei M. Severe dental caries as the first presenting clinical feature in primary Sjögren's syndrome. CASPIAN JOURNAL OF INTERNAL MEDICINE 2013; 4:731-734. [PMID: 24009970 PMCID: PMC3755841] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 07/05/2012] [Revised: 08/08/2012] [Accepted: 08/13/2012] [Indexed: 06/02/2023]
Abstract
BACKGROUND Sjögren's syndrome is an autoimmune syndrome involving the exocrine glands specially the salivary and lacrimal glands leading to xerostomia and xerophtalmia. This paper presents a case with primary Sjögren's syndrome that severe dental caries were the first clinical manifestation. CASE PRESENTATION A 42-year-old man was referred to the School of Dentistry, Tehran University of Medical Sciences due to unexplained severe dental decays. After systematic evaluation and consultation with the rheumatologist and the ophthalmologist, the diagnosis of primary Sjögren's syndrome was suggested and confirmed by serologic and histopathologic study. CONCLUSION Primary Sjögren's syndrome should be considered in the differential diagnosis of patients with early severe dental caries.
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Affiliation(s)
- Elham Ahmadi
- Shahrekord University of Medical Sciences, Shahrekord, Iran. ; Dental Research Center, Tehran University of Medical Sciences, Tehran, Iran
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