Tokuno T, Takahashi H, Suzuki C, Yamamoto M, Naishiro Y, Sugaya A, Sakamoto H, Imai K
First Department of Internal Medicine, Sapporo Medical University School of Medicine, Sapporo, Japan.
Scand J Rheumatol. 2003;32(5):268-72. doi: 10.1080/03009740310003884.
We investigated the incidence of B-cell clonality in the minor salivary gland and liver (extra-glandular lesion) of patients with Sjögren's syndrome (SS). We also compared B-cell clonality in the minor salivary gland and liver in the same individuals, and compared its incidence among patients with various liver diseases, such as primary biliary cirrhosis (PBC) and autoimmune hepatitis (AIH).
A minor salivary gland biopsy was performed on 35 patients with SS (30 patients with primary SS, and five patients with secondary SS). A liver biopsy was performed on nine patients with SS associated with bile duct lesions, two patients with PBC, one patient with AIH, one patient with drug-induced liver dysfunction, and three patients with viral hepatitis. DNA was extracted from each tissue sample and then subjected to Polymerase Chain Reaction (PCR). B-cell clonality was analysed by assessing the rearrangement of the immunoglobulin heavy chain (IgH) gene by PCR.
B-cell clonality was confirmed in the minor salivary gland biopsy sample in 23 of the 35 patients (65.7%), and in the liver biopsy sample (non-exocrine organ involvement) in seven of the nine patients (77.8%). The presence or absence of B-cell clonality was investigated in both the minor salivary gland and liver in seven patients, but B-cell clonality was confirmed in both tissues in only one patient, and the pattern of clonality in the minor salivary gland differed from that in the liver. B-cell clonality was detected in the liver of the PBC and AIH patients.
B-cell clonality is a phenomenon that is observed frequently in SS lesions in the salivary glands and liver. The appearance of B-cell clonality was shown to be attributable to antigen-driven clonal expansion.
我们调查了干燥综合征（SS）患者小唾液腺和肝脏（腺外病变）中B细胞克隆性的发生率。我们还比较了同一患者小唾液腺和肝脏中的B细胞克隆性，并比较了其在各种肝脏疾病患者中的发生率，如原发性胆汁性肝硬化（PBC）和自身免疫性肝炎（AIH）。
对35例SS患者（30例原发性SS患者和5例继发性SS患者）进行小唾液腺活检。对9例伴有胆管病变的SS患者、2例PBC患者、1例AIH患者、1例药物性肝功能障碍患者和3例病毒性肝炎患者进行肝脏活检。从每个组织样本中提取DNA，然后进行聚合酶链反应（PCR）。通过PCR评估免疫球蛋白重链（IgH）基因的重排来分析B细胞克隆性。
35例患者中的23例（65.7%）小唾液腺活检样本中证实存在B细胞克隆性，9例患者中的7例（77.8%）肝脏活检样本（非外分泌器官受累）中证实存在B细胞克隆性。在7例患者的小唾液腺和肝脏中均调查了B细胞克隆性的存在与否，但仅1例患者的两个组织中均证实存在B细胞克隆性，且小唾液腺中的克隆性模式与肝脏中的不同。在PBC和AIH患者的肝脏中检测到B细胞克隆性。
B细胞克隆性是在SS患者唾液腺和肝脏病变中经常观察到的一种现象。B细胞克隆性的出现被证明归因于抗原驱动的克隆性扩增。
