Kimura-Hayama Eric, Criales-Vera Sergio, Azpeitia-Espinosa Luis, Pacheco-Molina Carlos, Reyes Edgardo, Lima Guadalupe, Hernandez-Ramirez Diego, Llorente Luis, Hernandez-Molina Gabriela
Department of Radiology, Instituto Nacional de Cardiología Ignacio Chávez, Mexico City, Mexico.
Immunology and Rheumatology, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico.
Int J Rheum Dis. 2018 Jun;21(6):1293-1300. doi: 10.1111/1756-185X.13292. Epub 2018 Apr 6.
To evaluate the stiffness of parotid and submandibular glands using elastography ultrasound and to correlate it with B-mode ultrasonographical, clinical and serological features, salivary profibrotic and inflammatory chemokines, and salivary gland fibrosis.
We performed B-mode and elastography ultrasound of major salivary glands of 26 patients with primary Sjögren's syndrome. We registered the shear wave velocity (SWV) and correlated it with the morphologic ultrasonographic changes assessed by the Hocevar scale. We assessed the European League Against Rheumatism (EULAR) Sjögren's Syndrome Disease Activity Index (ESSDAI), EULAR Sjögren's Syndrome Patient Reported Index (ESSPRI), non-stimulated whole salivary flow rate (NSWSF), C3 and C4 levels, anti-Ro/La antibodies, salivary inflammatory (C-X-C motif ligand 13 [CXCL13], CXCL10, CXCL8, C-C motif ligand 2 [CCL2], interleukin 10 [IL-10] and IL-6) and pro-fibrotic (CXCL14, CCL28, tumor necrosis factor-related apoptosis-inducing ligand and transforming growth factor β) chemokines and cytokines and evaluated the presence of fibrosis in the minor salivary gland.
Ninety-two percent of patients were women; mean age was 51.1 ± 11 years; median disease duration was 6.1 years; 92.3% had oral symptoms and 26.9% fibrosis. The median B-mode score was 22.2 points and the median SWV 2.5 m/s (τ = 0.53, P = 0.001). The SWV correlated with the NSWSF (τ = -0.53, P = 0.001), ESSDAI (τ = 0.31, P = 0.03), glandular ESDDAI domain (τ = 0.36, P = 0.02), C4 levels (τ = -0.32, P = 0.04), salivary CXCL13 (τ = 0.29, P = 0.03) and CXCL10 (τ = 0.30, P = 0.003), but not with age and fibrosis.
WV correlated with the B-mode ultrasound score, systemic and glandular activity and in a large degree with CXCL10, an inflammatory chemokine, but not with fibrosis. An increased SWV might represent chronic glandular inflammation rather than fibrotic changes in these patients.
使用弹性成像超声评估腮腺和颌下腺的硬度，并将其与B型超声、临床和血清学特征、唾液促纤维化和炎症趋化因子以及唾液腺纤维化相关联。
我们对26例原发性干燥综合征患者的主要唾液腺进行了B型和弹性成像超声检查。我们记录了剪切波速度（SWV），并将其与通过霍采瓦尔量表评估的形态学超声变化相关联。我们评估了欧洲抗风湿病联盟（EULAR）干燥综合征疾病活动指数（ESSDAI）、EULAR干燥综合征患者报告指数（ESSPRI）、非刺激性全唾液流速（NSWSF）、C3和C4水平、抗Ro/La抗体、唾液炎症（C-X-C基序配体13 [CXCL13]、CXCL10、CXCL8、C-C基序配体2 [CCL2]、白细胞介素10 [IL-10]和IL-6）和促纤维化（CXCL14、CCL28肿瘤坏死因子相关凋亡诱导配体和转化生长因子β）趋化因子和细胞因子，并评估了小唾液腺中纤维化的存在情况。
92%的患者为女性；平均年龄为51.1±11岁；疾病中位持续时间为6.1年；92.3%有口腔症状，26.9%有纤维化。B型超声评分中位数为22.2分，SWV中位数为2.5 m/s（τ = 0.53，P = 0.001）。SWV与NSWSF（τ = -0.53，P = 0.001）、ESSDAI（τ = 0.31，P = 0.03）、腺体ESSDAI域（τ = 0.36，P = 0.02）、C4水平（τ = -0.32，P = 0.04）、唾液CXCL13（τ = 0.29，P = 0.03）和CXCL10（τ = 0.30，P = 0.003）相关，但与年龄和纤维化无关。
SWV与B型超声评分、全身和腺体活动相关，并且在很大程度上与炎症趋化因子CXCL10相关，但与纤维化无关。SWV升高可能代表这些患者的慢性腺体炎症而非纤维化改变。
