Lee Kyung-Eun, Kang Ji-Hyoun, Yim Yi-Rang, Kim Ji-Eun, Lee Jeong-Won, Wen Lihui, Park Dong-Jin, Kim Tae-Jong, Park Yong-Wook, Yoon Kyung Chul, Lee Ji Shin, Lee Shin-Seok
Department of Rheumatology, Chonnam National University Medical School and Hospital, Gwangju, Republic of Korea.
Department of Ophthalmology, Chonnam National University Medical School and Hospital, Gwangju, Republic of Korea.
Clin Exp Rheumatol. 2017 Mar-Apr;35(2):234-240. Epub 2016 Oct 21.
To investigate whether CCL21 and CXCL13 expression levels in the minor salivary gland are associated with the laboratory and clinical manifestations of Sjögren's syndrome (SS).
Sociodemographic data on 106 SS patients were obtained and the glandular and extraglandular manifestations of the disease were documented. In addition, minor salivary gland biopsies were performed and the patients' laboratory findings were analysed. European League Against Rheumatism SS disease activity index (ESSDAI) values of SS disease activity at the time of biopsy and the SS disease damage index (SSDDI) values were also recorded. An immunohistochemical approach was used to semiquantitatively measure the CCL21 and CXCL13 expression in the minor salivary glands.
The minor salivary glands of SS patients stained positively for CCL21 and CXCL13 in 46.2% (49/106) and 70.7% (75/106) of all cases, respectively. Higher-level expression of CCL21 and CXCL13 was associated with increases in ESR, IgG and rheumatoid factor levels, as well as anti-SS-A and -SS-B titers. A higher focus score and ESSDAI value at the time of biopsy were also associated with these chemokines. In patients with extraglandular manifestations of SS, the prevalence of lymphadenopathy increased with increasing CCL21 levels.
The expression levels of CCL21 and CXCL13 within the lymphocytic infiltrates of SS patients were associated with several laboratory features of the disease as well as lymphadenopathy and the extent of clinical disease activity. CCL21 and CXCL13 levels can therefore serve as useful markers to predict the disease activity and prognosis of patients with SS.
研究小唾液腺中CCL21和CXCL13的表达水平是否与干燥综合征（SS）的实验室检查结果及临床表现相关。
获取106例SS患者的社会人口统计学数据，并记录该疾病的腺体及腺外表现。此外，进行小唾液腺活检并分析患者的实验室检查结果。还记录了活检时SS疾病活动的欧洲抗风湿病联盟疾病活动指数（ESSDAI）值和SS疾病损伤指数（SSDDI）值。采用免疫组织化学方法半定量测量小唾液腺中CCL21和CXCL13的表达。
在所有病例中，SS患者的小唾液腺CCL21染色阳性率为46.2%（49/106），CXCL13染色阳性率为70.7%（75/106）。CCL21和CXCL13的高表达与血沉、免疫球蛋白G和类风湿因子水平升高以及抗SS - A和抗SS - B滴度升高相关。活检时较高的灶性评分和ESSDAI值也与这些趋化因子相关。在有SS腺外表现的患者中，淋巴结病的患病率随CCL21水平升高而增加。
SS患者淋巴细胞浸润内CCL21和CXCL13的表达水平与该疾病的多项实验室特征、淋巴结病及临床疾病活动程度相关。因此，CCL21和CXCL13水平可作为预测SS患者疾病活动和预后的有用标志物。
