Department of Biotechnological and Applied Clinical Sciences, Rheumatology Unit, University of L'Aquila, L'Aquila, Italy.
Department of Life, Health and Environment Sciences, Andrology Unit, University of L'Aquila, L'Aquila, Italy.
Front Immunol. 2021 Jun 11;12:686457. doi: 10.3389/fimmu.2021.686457. eCollection 2021.
Patients with primary Sjögren's syndrome (pSS) may develop a potentially severe disease with extra-glandular involvement and lymphoma insurgence. Minor salivary gland biopsy is routinely used in the disease diagnosis, but its potential role as a biomarker for clinical disease presentation and prognosis is still poorly understood.
We performed a systematic review and meta-analysis on clinical presentation and prognosis in pSS patients who underwent minor salivary gland biopsy at diagnosis according to the PRISMA guidelines.
We included five retrospective studies and 589 pSS patients. Ectopic GCs presence was not associated with a significant increase in the odds ratio for the clinical variables explored such as salivary gland swelling, arthritis, and Raynaud's phenomenon. As far as serological features are concerned, ectopic GCs presence accounted for an increased ratio of antibodies anti-SSA (OR = 3.13, 95% CI: 1.25-7.85, p = 0.02, I = 79%), anti-SSB (OR = 3.94, 95% CI: 1.50-10.37, p = 0.0005, I = 80%), and RFs presence (OR = 3.12, 95% CI: 1.94-5.00, p < 0.00001, I = 0%).
This study showed that the association between ectopic GC in salivary glands identifies a clinical subset characterized by autoantibodies presence, and probably pSS patients affected from a more severe disease.
原发性干燥综合征(pSS)患者可能会出现腺体外受累和淋巴瘤侵袭等潜在严重疾病。唾液腺活检通常用于疾病诊断,但作为临床疾病表现和预后的生物标志物,其潜在作用仍知之甚少。
我们根据 PRISMA 指南,对诊断时接受唾液腺活检的 pSS 患者的临床表现和预后进行了系统评价和荟萃分析。
我们纳入了五项回顾性研究和 589 例 pSS 患者。异位 GC 的存在与探索的临床变量(如唾液腺肿胀、关节炎和雷诺现象)的优势比增加无关。就血清学特征而言,异位 GC 的存在导致抗 SSA 抗体(OR = 3.13,95%CI:1.25-7.85,p = 0.02,I = 79%)、抗 SSB 抗体(OR = 3.94,95%CI:1.50-10.37,p = 0.0005,I = 80%)和 RFs 存在的比值增加(OR = 3.12,95%CI:1.94-5.00,p < 0.00001,I = 0%)。
本研究表明,唾液腺中异位 GC 的存在确定了一个具有自身抗体存在特征的临床亚组,可能与更严重的疾病有关。