Kim Bok Eum, Kwon Jeong-Seung, Choi Jong Hoon, Park Pil Gyu, Ahn Hyung-Joon
Department of Orofacial Pain and Oral Medicine, Yonsei University College of Dentistry, Seoul, Republic of Korea.
Division of Rheumatology, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea.
J Oral Pathol Med. 2023 Feb;52(2):188-194. doi: 10.1111/jop.13369. Epub 2022 Nov 2.
This study analyzed the association between autoantibody types and salivary gland hypofunction in patients with primary Sjögren's syndrome (pSS).
A retrospective analysis was performed on patients who visited the Department of Orofacial Pain and Oral Medicine at Yonsei University Dental Hospital from January 1, 2010 to May 31, 2021, and who were diagnosed with pSS. Out of 191 patients who fulfilled the 2016 American College of Rheumatology/European League Against Rheumatism classification criteria, 50 were positive for both anti-Ro/SSA and anti-La/SSB, whereas 97 had anti-Ro/SSA but not anti-La/SSB antibodies. Forty-four patients for whom neither anti-Ro/SSA nor anti-La/SSB antibodies were found were diagnosed with Sjögren's syndrome by minor salivary gland biopsy.
The anti-Ro/SSA antibody-positive group showed higher rheumatoid factor (RF) levels than the anti-Ro/SSA antibody-negative group. The anti-La/SSB antibody-positive group showed lower unstimulated whole saliva (UWS), stimulated whole saliva (SWS), higher erythrocyte sedimentation rate and RF level than the anti-La/SSB antibody-negative group. In addition, the group with both anti-Ro/SSA and anti-La/SSB antibodies showed lower UWS than the group with only anti-Ro/SSA antibodies. However, there were no significant differences in UWS or SWS after taking pilocarpine, and C-reactive protein.
UWS and SWS were lower when a patient was positive for anti-La/SSB, showing that anti-La/SSB is more likely to be involved in salivary gland hypofunction than anti-Ro/SSA in patients with pSS. Therefore, performing laboratory tests, including anti-La/SSB, helps predict the prognosis of salivary gland function in patients with suspected pSS.
本研究分析了原发性干燥综合征（pSS）患者自身抗体类型与唾液腺功能减退之间的关联。
对2010年1月1日至2021年5月31日在延世大学牙科学院口腔颌面疼痛与口腔医学科就诊并被诊断为pSS的患者进行回顾性分析。在符合2016年美国风湿病学会/欧洲抗风湿病联盟分类标准的191例患者中，50例抗Ro/SSA和抗La/SSB均为阳性，而97例有抗Ro/SSA但无抗La/SSB抗体。44例未检测到抗Ro/SSA和抗La/SSB抗体的患者通过小唾液腺活检被诊断为干燥综合征。
抗Ro/SSA抗体阳性组的类风湿因子（RF）水平高于抗Ro/SSA抗体阴性组。抗La/SSB抗体阳性组的非刺激性全唾液（UWS）、刺激性全唾液（SWS）低于抗La/SSB抗体阴性组，红细胞沉降率和RF水平高于抗La/SSB抗体阴性组。此外，抗Ro/SSA和抗La/SSB抗体均阳性的组UWS低于仅抗Ro/SSA抗体的组。然而，服用毛果芸香碱后UWS或SWS以及C反应蛋白无显著差异。
抗La/SSB阳性患者的UWS和SWS较低，表明在pSS患者中，抗La/SSB比抗Ro/SSA更易导致唾液腺功能减退。因此，进行包括抗La/SSB在内的实验室检查有助于预测疑似pSS患者唾液腺功能的预后。
