Fox R I, Chan E, Benton L, Fong S, Friedlaender M, Howell F V
Department of Basic and Clinical Research, Scripps Clinical and Research Foundation, La Jolla, California 92037.
Am J Med. 1988 Oct 14;85(4A):62-7. doi: 10.1016/0002-9343(88)90365-8.
Sjögren's syndrome is an autoimmune disease characterized by lymphocytic infiltration of the salivary/lacrimal glands, autoantibody production, and polyclonal hyperglobulinemia. In view of the efficacy and relative safety of hydroxychloroquine in other autoimmune disorders, the potential benefit of hydroxychloroquine (200 mg per day for 12 months) in 10 patients with Sjögren's syndrome was evaluated. Changes in levels of total immunoglobulin, antibody against Sjögren's syndrome-associated antigen B, rheumatoid factor, and in vitro production of immunoglobulin in the serum were evaluated. For comparison, 10 patients matched according to age and sex, who did not receive hydroxychloroquine were studied. In the hydroxychloroquine-treated group, the following observations were made: (1) significantly decreased total immunoglobulin G (IgG) and IgA levels with little change in IgM levels; (2) significant decrease in IgA-rheumatoid factor with a smaller decrease in IgM-rheumatoid factor; (3) decreased IgG anti-Sjögren's syndrome-associated antigen B autoantibody; and (4) decreased erythrocyte sedimentation rate and increased hemoglobin level. Further, a specific idiotype present on their rheumatoid factor (defined by monoclonal antibody 17-109) was significantly decreased, with disappearance of detectable circulating paraprotein in two hydroxychloroquine-treated patients. Finally, rheumatoid factor production in vitro by lymphocytes from hydroxychloroquine-treated patients using a T cell-dependent mitogen was significantly decreased. These results suggest that hydroxychloroquine modulates lymphoproliferation in patients with Sjögren's syndrome and may prevent progression to extraglandular sites of neoplastic transformation.
干燥综合征是一种自身免疫性疾病，其特征为唾液腺/泪腺的淋巴细胞浸润、自身抗体产生和多克隆高球蛋白血症。鉴于羟氯喹在其他自身免疫性疾病中的疗效和相对安全性，对10例干燥综合征患者使用羟氯喹（每日200毫克，共12个月）的潜在益处进行了评估。评估了总免疫球蛋白、抗干燥综合征相关抗原B抗体、类风湿因子水平以及血清中免疫球蛋白的体外产生情况的变化。为作比较，研究了10例按年龄和性别匹配但未接受羟氯喹治疗的患者。在羟氯喹治疗组中，有以下观察结果：（1）总免疫球蛋白G（IgG）和IgA水平显著降低，而IgM水平变化不大；（2）IgA类风湿因子显著降低，IgM类风湿因子降低幅度较小；（3）IgG抗干燥综合征相关抗原B自身抗体降低；（4）红细胞沉降率降低，血红蛋白水平升高。此外，其类风湿因子上存在的一种特定独特型（由单克隆抗体17 - 109定义）显著降低，两名接受羟氯喹治疗的患者中可检测到的循环副蛋白消失。最后，使用T细胞依赖性有丝分裂原，羟氯喹治疗患者的淋巴细胞体外产生类风湿因子的情况显著降低。这些结果表明，羟氯喹可调节干燥综合征患者的淋巴细胞增殖，并可能预防肿瘤转化进展至腺外部位。
