Department of Oral and Maxillofacial Surgery and Systemic Medicine, Graduate School of Life Dentistry at Niigata, The Nippon Dental University, 1-8 Hamaura-cho, Chuo-ku, Niigata 951-8580, Japan.
Clin Rheumatol. 2012 Jan;31(1):105-12. doi: 10.1007/s10067-011-1789-z. Epub 2011 Jun 14.
Anti-SS-A/Ro antibody (SS-A) and anti-SS-B/La antibody (SS-B) are important serologic markers in the diagnostic criteria for Primary Sjögren's syndrome (SS). Although anti-centromere antibody (ACA)-positive SS is frequently experienced, ACA is not included in these criteria. The purpose of this study was to identify the clinical features of ACA-positive SS and discuss the usefulness of ACA in diagnosing SS. Forty-five patients with SS were divided into the following three groups: SS-A only-positive group (n = 17), SS-A and SS-B both-positive group (n = 18), and ACA only-positive group (n = 10). As a control, 54 patients without SS who were negative for antinuclear antibodies were also evaluated. The following items were compared among groups: Saxon's test, unstimulated whole salivary flow (UWSF), salivary gland scintigraphy (SGS), histopathologic examination of the minor salivary glands, Schirmer's test, and fluorescein staining of the cornea. In the ACA only-positive group, Saxon's test was 0.21 ± 0.26 g/2 min (mean ± SD) and UWSF was 0.16 ± 0.25 ml/10 min (mean ± SD), showing a significant decrease in salivary secretion (p < 0.05; vs. non-SS). On SGS, accumulation and disappearance of (99m)TcO (4) (-) were significantly decreased (p < 0.05; vs. non-SS). Histopathologic examination showed moderate or severe lymphocytic infiltration and tissue destruction in all cases, similar to that in the SS-A- and/or SS-B-positive groups. Schirmer's test and fluorescein staining were positive in 60% and 80%, respectively. Impaired lacrimal secretion and keratoconjunctivitis sicca were similar to those in SS-A- and/or SS-B-positive groups. These results suggest that ACA is an autoantibody reflecting impairment in the salivary and lacrimal glands and may be a useful serologic marker for SS.
抗 SSA/ Ro 抗体 (SS-A) 和抗 SSB/La 抗体 (SS-B) 是原发性干燥综合征 (SS) 诊断标准中的重要血清学标志物。虽然抗着丝点抗体 (ACA) 阳性 SS 很常见，但 ACA 并不包含在这些标准中。本研究的目的是确定 ACA 阳性 SS 的临床特征，并讨论 ACA 在诊断 SS 中的有用性。将 45 例 SS 患者分为以下三组：仅 SS-A 阳性组 (n=17)、SS-A 和 SS-B 均阳性组 (n=18) 和 ACA 仅阳性组 (n=10)。作为对照，还评估了 54 例抗核抗体阴性且无 SS 的患者。比较了各组之间的以下项目：Saxon 试验、非刺激全唾液流率 (UWSF)、唾液腺闪烁扫描 (SGS)、小唾液腺组织病理学检查、Schirmer 试验和角膜荧光素染色。在 ACA 仅阳性组中，Saxon 试验为 0.21±0.26 g/2 min（均值±标准差），UWSF 为 0.16±0.25 ml/10 min（均值±标准差），唾液分泌明显减少 (p<0.05；与非 SS 组相比)。在 SGS 上，(99m)TcO(-) 的积聚和消失明显减少 (p<0.05；与非 SS 组相比)。组织病理学检查显示所有病例均有中度或重度淋巴细胞浸润和组织破坏，与 SS-A 和/或 SS-B 阳性组相似。Schirmer 试验和荧光素染色的阳性率分别为 60%和 80%。泪液分泌减少和干燥性角结膜炎与 SS-A 和/或 SS-B 阳性组相似。这些结果表明，ACA 是一种反映唾液腺和泪腺功能障碍的自身抗体，可能是 SS 的一种有用的血清学标志物。
