Salomonsson Stina, Rozell Barbro Lundh, Heimburger Mikael, Wahren-Herlenius Marie
Department of Medicine, Rheumatology Unit, Karolinska Institutet, Stockholm, Sweden.
J Oral Pathol Med. 2009 Mar;38(3):282-8. doi: 10.1111/j.1600-0714.2008.00697.x. Epub 2008 Sep 12.
Focal lymphocytic infiltrates of minor salivary glands are considered target-organ related signs of Sjögren's syndrome. The percentages of plasma cells expressing IgA, IgG and IgM in minor salivary gland biopsies have also been suggested as useful in establishing a diagnosis of Sjögren's syndrome, and this study aimed at evaluating this method.
All biopsies from patients under investigation for Sjögren's syndrome (n = 210) at our department during 4 years were analyzed for IgA, IgG and IgM producing cells by immunohistochemistry, and related to Sjögren classification parameters.
A focus score >or=1 was observed in 67/210 patients and the frequency of IgA producing cells was <70% in 42/210 patients. Sufficient clinical data for classification of disease were available for 57/210 patients. Patients were classified as having primary Sjögren's syndrome (pSS) (n = 9), secondary Sjögren's syndrome (sSS) (n = 12) or non-Sjögren's syndrome (non-SS) (n = 36). IgA expressing cells were significantly decreased (P < 0.01) and IgG expressing cells significantly increased (P < 0.02) in patients with pSS compared to non-SS. Also, increased numbers of salivary gland IgG producing plasma cells correlated with increased IgG serum levels (P < 0.001). However, there was no significant difference between sSS and non-SS with regard to IgA, IgG or IgM expressing cells in the glands.
Our results support previous reports indicating the relevance of quantitative evaluation of Ig isotype expression in plasma cells in the clinical investigation of Sjögren's syndrome and further indicate a difference in plasma cell populations between pSS and sSS.
小唾液腺局灶性淋巴细胞浸润被认为是干燥综合征的靶器官相关体征。小唾液腺活检中表达IgA、IgG和IgM的浆细胞百分比也被认为有助于干燥综合征的诊断，本研究旨在评估该方法。
对4年间在我科接受干燥综合征调查的患者（n = 210）的所有活检标本进行免疫组织化学分析，检测产生IgA、IgG和IgM的细胞，并与干燥综合征分类参数相关联。
210例患者中有67例焦点评分≥1，210例患者中有42例产生IgA的细胞频率<70%。210例患者中有57例有足够的临床数据用于疾病分类。患者被分为原发性干燥综合征（pSS）（n = 9）、继发性干燥综合征（sSS）（n = 12）或非干燥综合征（非SS）（n = 36）。与非SS患者相比，pSS患者中表达IgA的细胞显著减少（P < 0.01），表达IgG的细胞显著增加（P < 0.02）。此外，唾液腺中产生IgG的浆细胞数量增加与血清IgG水平升高相关（P < 0.001）。然而，sSS和非SS患者腺体中表达IgA、IgG或IgM的细胞之间没有显著差异。
我们的结果支持先前的报告，表明在干燥综合征临床研究中对浆细胞中Ig同种型表达进行定量评估的相关性，并进一步表明pSS和sSS患者浆细胞群体存在差异。
