Rheumatology Unit, Department of Medicine, University of Perugia, Italy.
Rheumatology Unit, Department of Clinical and Experimental Medicine, University of Pisa, Italy.
Clin Exp Rheumatol. 2020 Jul-Aug;38 Suppl 126(4):53-56. Epub 2020 Oct 22.
Immunological parameters exert a relevant diagnostic and prognostic role in primary Sjögren's syndrome (pSS) and may identify specific disease phenotypes. Among disease-associated immunological features, anti-La/SSB are rarely found without concomitant anti-Ro/SSA and their clinical significance in patients with pSS has been poorly investigated. Thus, we aimed to characterise the value of anti-La/SSB analysing clinical and serologic features of a wide cohort of pSS patients with both circulating anti-Ro/SSA and positive salivary gland biopsy (SGB).
Clinical and serological data of 600 pSS patients with both anti-Ro/SSA and SGB positivity and categorised according to anti-La/SSB status were retrospectively analysed. Comparisons between patients with and without circulating anti-La/SSB were performed.
Among the whole cohort, 319 (53%) of patients were anti-La/SSB negative and 281 (47%) were anti-La/SSB positive. Anti-La/SSB positive patients were younger at disease diagnosis and had a longer disease duration. Moreover, anti-La/SSB positive patients had a higher prevalence of hypergammaglobulinaemia and circulating rheumatoid factor and of lymphoproliferative disorders in comparison to seronegative group. At multivariate analysis, hypergammaglobulinaemia (OR=1,7; 95% CI 1.17, 2.43), rheumatoid factor (OR=2.3; 95% CI 1.6, 3.3) and lymphoma (OR=2.6; 95% CI 1.12, 5.96) were identified as independent variables significantly associated with anti-La/SSB positivity.
In patients with pSS and concomitant anti-Ro/SSA and SGB positivity, the presence of anti-La/SSB may help in identifying a disease subset with distinct prognostic features, especially in terms of higher risk of lymphoproliferative complications.
免疫参数在原发性干燥综合征（pSS）中具有重要的诊断和预后作用，并可识别特定的疾病表型。在与疾病相关的免疫特征中，抗-La/SSB 很少在没有同时存在抗-Ro/SSA 的情况下发现，其在 pSS 患者中的临床意义尚未得到充分研究。因此，我们旨在通过分析广泛的 pSS 患者队列的临床和血清学特征来描述抗-La/SSB 的价值，这些患者均同时具有循环抗-Ro/SSA 和阳性唾液腺活检（SGB）。
回顾性分析了 600 例同时具有抗-Ro/SSA 和 SGB 阳性的 pSS 患者的临床和血清学数据，并根据抗-La/SSB 状态进行分类。比较了有和无循环抗-La/SSB 的患者之间的差异。
在整个队列中，319 例（53%）患者为抗-La/SSB 阴性，281 例（47%）患者为抗-La/SSB 阳性。与血清学阴性组相比，抗-La/SSB 阳性患者的疾病诊断年龄更小，病程更长。此外，抗-La/SSB 阳性患者的高丙种球蛋白血症、循环类风湿因子和淋巴增生性疾病的患病率高于血清学阴性组。多变量分析显示，高丙种球蛋白血症（OR=1.7；95%CI 1.17，2.43）、类风湿因子（OR=2.3；95%CI 1.6，3.3）和淋巴瘤（OR=2.6；95%CI 1.12，5.96）是与抗-La/SSB 阳性显著相关的独立变量。
在同时具有抗-Ro/SSA 和 SGB 阳性的 pSS 患者中，抗-La/SSB 的存在可能有助于识别具有不同预后特征的疾病亚组，尤其是在淋巴增生性并发症风险较高的情况下。
