Toker E, Yavuz S, Direskeneli H
Department of Ophthalmology, Marmara University, School of Medicine, Marmara, Turkey.
Br J Ophthalmol. 2004 Mar;88(3):384-7. doi: 10.1136/bjo.2003.028340.
To investigate the presence of anti-Ro/SSA and anti-La/SSB antibodies in the tear fluid and serum of patients with Sjögren's syndrome and to evaluate the association of these autoantibodies with the severity of keratoconjunctivitis sicca.
Tear fluid and serum were obtained from 28 patients with Sjögren's syndrome and 17 age matched normal control subjects. Evaluation of tear fluid and sera anti-Ro/SSA and anti-La/SSB levels was done by using a quantitative enzyme linked immunosorbent assay kit designed for the quantitative measurement of IgG class autoantibodies directed against highly purified SSA and SSB antigens. Tear function and ocular surface were evaluated by Schirmer I test, tear break up time, and rose bengal staining. Dry eye symptom scores were recorded.
Increased levels of anti-Ro/SSA and anti-La/SSB antibodies were detected in sera of 57.1% and 50% of SS patients, respectively. Six patients had increased levels of anti-Ro/SSA in the tear fluid, in one case anti-Ro/SSA being detected in tear fluid when it was negative in serum. Ten patients had positive anti-La/SSB titres in tear fluid and in four of these patients, anti-La/SSB titres were not elevated in serum. A positive correlation was observed between serum and tear fluid titres of anti-Ro/SSA (r = 0.43, p = 0.02), but not of anti-La/SSB. Serum anti-Ro/SSA and anti-La/SSB concentrations correlated positively with dry eye symptom scores (r = 0.42, p = 0.02 and r = 0.48, p = 0.01, respectively) and negatively correlated with Schirmer I test scores (r = -0.39, p = 0.04 and r = -0.40, p = 0.03, respectively). Significant correlations were found between tear anti-La/SSB concentrations and dry eye symptom score (r = 0.56, p = 0.02) and also rose bengal staining scores of the ocular surface (r = 0.44, p = 0.02).
This study shows that autoantibodies against Ro/SSA and La/SSB antigens are present in the tear fluid of some patients with SS and their presence in serum or tear fluid is associated with the severity of keratoconjunctivitis sicca. Additional measurement of tear fluid levels of anti-Ro/SSA and anti-La/SSB may serve as a valuable diagnostic indicator of SS.
研究干燥综合征患者泪液和血清中抗Ro/SSA及抗La/SSB抗体的存在情况，并评估这些自身抗体与干燥性角结膜炎严重程度的相关性。
收集28例干燥综合征患者及17例年龄匹配的正常对照者的泪液和血清。采用定量酶联免疫吸附测定试剂盒评估泪液和血清中抗Ro/SSA及抗La/SSB水平，该试剂盒用于定量检测针对高度纯化的SSA和SSB抗原的IgG类自身抗体。通过Schirmer I试验、泪膜破裂时间及孟加拉玫瑰红染色评估泪液功能和眼表情况。记录干眼症状评分。
分别在57.1%和50%的干燥综合征患者血清中检测到抗Ro/SSA和抗La/SSB抗体水平升高。6例患者泪液中抗Ro/SSA水平升高，其中1例血清中抗Ro/SSA为阴性时泪液中检测到该抗体。10例患者泪液中抗La/SSB滴度为阳性，其中4例患者血清中抗La/SSB滴度未升高。抗Ro/SSA的血清和泪液滴度之间存在正相关（r = 0.43，p = 0.02），而抗La/SSB则无。血清抗Ro/SSA和抗La/SSB浓度与干眼症状评分呈正相关（分别为r = 0.42，p = 0.02和r = 0.48，p = 0.01），与Schirmer I试验评分呈负相关（分别为r = -0.39，p = 0.04和r = -0.40，p = 0.03）。泪液抗La/SSB浓度与干眼症状评分（r = 0.56，p = 0.02）及眼表孟加拉玫瑰红染色评分（r = 0.44，p = 0.02）之间存在显著相关性。
本研究表明，部分干燥综合征患者泪液中存在针对Ro/SSA和La/SSB抗原的自身抗体，其在血清或泪液中的存在与干燥性角结膜炎的严重程度相关。额外检测泪液中抗Ro/SSA和抗La/SSB水平可能是干燥综合征有价值的诊断指标。
