Division of Oral Medicine, Department of Oral and Maxillofacial Diagnostic Sciences, and Department of Oral Biology, University of Florida College of Dentistry, Gainesville, FL, USA.
Division of Critical Care Medicine, Department Anesthesiology, University of Florida College of Medicine, Gainesville, FL, USA.
Clin Exp Rheumatol. 2021 Jul-Aug;39(4):795-803. doi: 10.55563/clinexprheumatol/gy6udz. Epub 2020 Oct 6.
To elucidate the clinical values of anti-M3R in Sjögren's syndrome (SS) in the largest cohort for an anti-M3R study.
The plasma of 361 subjects (156 primary SS [pSS], 62 non-SS-sicca [SICCA], 40 systemic lupus erythematosus [SLE], 50 rheumatoid arthritis [RA], and 53 healthy controls [HC]) was screened using our modified On-Cell-Western assay. Saliva from pSS (n=37) compared to SICCA (n=26) was also analysed. The sensitivity and specificity of anti-M3R and its association with comprehensive clinical and laboratory features were determined.
Plasma-anti-M3R was higher in pSS compared to other groups, differentiating pSS with good-to-excellent diagnostic power with a specificity of 85% and a sensitivity between 75% and 98%. pSS plasma-anti-M3R was positively correlated with ocular staining scores, anti-Ro/SSA, IgG, β2-microglobulin, ESR, and ESSDAI. It was negatively correlated with WBC, C4, and salivary scintigraphic indices. Saliva-anti-M3R was 3.59 times higher in pSS than in SICCA. Interestingly, the agreement between the 2002 American European Consensus Group criteria and the criteria substituted with plasma-anti-M3R for the lip biopsy reached 92%, with a significant kappa of 0.824.
Anti-M3R enhances sensitivity and specificity for SS diagnosis, correlating with ocular dryness and glandular hypofunction, and the haematological/biological domains of the ESSDAI. Our findings also highlight the clinical significance of anti-M3R in SS diagnosis, especially where clinical assessments, such as lip biopsy, sialometry, or ocular evaluation, by multi-disciplinary specialists are limited.
在最大的抗-M3R 研究队列中阐明抗-M3R 在干燥综合征（SS）中的临床价值。
使用我们改良的 On-Cell-Western 检测法筛选了 361 名受试者的血浆（156 名原发性 SS [pSS]、62 名非 SS 干燥 [SICCA]、40 名系统性红斑狼疮 [SLE]、50 名类风湿关节炎 [RA]和 53 名健康对照 [HC]）。还分析了 pSS（n=37）与 SICCA（n=26）的唾液。确定了抗-M3R 的灵敏度和特异性及其与综合临床和实验室特征的关系。
与其他组相比，pSS 的血浆抗-M3R 较高，具有 85%的特异性和 75%至 98%的灵敏度，可很好地鉴别 pSS。pSS 血浆抗-M3R 与眼部染色评分、抗 Ro/SSA、IgG、β2-微球蛋白、ESR 和 ESSDAI 呈正相关。与白细胞计数、C4 和唾液闪烁扫描指数呈负相关。pSS 的唾液抗-M3R 比 SICCA 高 3.59 倍。有趣的是，2002 年美国欧洲共识小组标准与用血浆抗-M3R 替代唇活检的标准之间的一致性达到 92%，kappa 值显著为 0.824。
抗-M3R 提高了 SS 诊断的灵敏度和特异性，与眼部干燥和腺体功能低下以及 ESSDAI 的血液学/生物学领域相关。我们的研究结果还强调了抗-M3R 在 SS 诊断中的临床意义，特别是在多学科专家进行的临床评估（如唇活检、唾液测量或眼部评估）有限的情况下。
