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抗着丝点蛋白B抗体阳性的原发性干燥综合征患者的临床及免疫学特征

[Clinical and immunological features of primary Sjögren's syndrome patients with positive anti-centromere protein B antibody].

作者信息

Meng Yan Hong, Chen Yi Fan, Zhou Pei Ru

机构信息

Department of Clinical Laboratory, Peking University School and Hospital of Stomatology & National Center for Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices, Beijing 100081, China.

Department of Information Center, Peking University School and Hospital of Stomatology & National Center for Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices, Beijing 100081, China.

出版信息

Beijing Da Xue Xue Bao Yi Xue Ban. 2023 Dec 18;55(6):1088-1096. doi: 10.19723/j.issn.1671-167X.2023.06.021.

Abstract

OBJECTIVE

To investigate the clinical and immunological features of primary Sjögren's syndrome (pSS) patients with positive anti-centromere protein B (CENP-B) antibody.

METHODS

In this cross-sectional study, the general clinical data, radiographic examination and labial salivary gland biopsy data, and serum immunological and biochemical data of patients diagnosed with pSS from January 2016 to August 2022 were evaluated. The included patients were divided into the anti-CENP-B antibody positive and negative groups. Intergroup differences were analyzed with SPSS 23.0 software. Subgroup analysis was further performed by dividing the anti-CENP-B antibody positive group into the single anti-CENP-B antibody positive and with other auto-antibodies positive groups to determine the characters related to anti-CENP-B antibody.

RESULTS

In this study, 288 patients with pSS were evaluated, including 75 patients with anti-CENP-B antibody positive and 213 with anti-CENP-B antibody negative. Univariate analysis showed that compared with the anti-CENP-B antibody negative group, the patients of the anti-CENP-B antibody positive group were older, had lower proportion of the patients with salivary gland enlargement and higher proportion of autoimmune liver disease. As for immunological indicators, the positive proportions of anti-SSA/Ro60, anti-Ro52, and anti-SSB antibodies were significantly lower. Moreover, the immunoglobulin (Ig) G and rheumatoid factor levels were significantly lower, while the IgM level was significantly higher in the patients of the anti-CENP-B antibody positive group. As for serum biochemical indicators, for the patients of the anti-CENP-B antibody positive group, the level of total protein (TP) was lower, the albumin/globulin ratio was higher, and the levels of serum alanine aminotransferase (ALT), aspartate aminotransferase (AST), alkaline phosphatase (ALP), gamma glutamyl transferase (GGT), lactate dehydrogenase (LDH) were higher. Subgroup analysis showed that the levels of TP and IgA in the patients of the single anti-CENP-B antibody positive group were significantly lower than those of the patients with other autoantibodies positive group.

CONCLUSION

The pSS patients with anti-CENP-B antibody positive have unique clinical and immunological features of lower disease activity, less likely to involve salivary gland, higher risk for autoimmune liver disease, and higher levels of liver function indicators. Anti-CENP-B antibody may be a marker for a distinct subset of polyautoimmunity in Sjögren's syndrome.

摘要

目的

探讨抗着丝点蛋白B(CENP - B)抗体阳性的原发性干燥综合征(pSS)患者的临床及免疫学特征。

方法

在这项横断面研究中,对2016年1月至2022年8月诊断为pSS患者的一般临床资料、影像学检查及唇腺活检数据、血清免疫学及生化数据进行评估。将纳入患者分为抗CENP - B抗体阳性组和阴性组。采用SPSS 23.0软件分析组间差异。进一步将抗CENP - B抗体阳性组分为单纯抗CENP - B抗体阳性组和合并其他自身抗体阳性组进行亚组分析,以确定与抗CENP - B抗体相关的特征。

结果

本研究共评估288例pSS患者,其中抗CENP - B抗体阳性75例,抗CENP - B抗体阴性213例。单因素分析显示,与抗CENP - B抗体阴性组相比,抗CENP - B抗体阳性组患者年龄较大,唾液腺肿大患者比例较低,自身免疫性肝病患者比例较高。在免疫学指标方面,抗SSA/Ro60、抗Ro52及抗SSB抗体阳性比例显著较低。此外,抗CENP - B抗体阳性组患者免疫球蛋白(Ig)G和类风湿因子水平显著较低,而IgM水平显著较高。在血清生化指标方面,抗CENP - B抗体阳性组患者总蛋白(TP)水平较低,白蛋白/球蛋白比值较高,血清丙氨酸氨基转移酶(ALT)、天冬氨酸氨基转移酶(AST)、碱性磷酸酶(ALP)、γ-谷氨酰转移酶(GGT)、乳酸脱氢酶(LDH)水平较高。亚组分析显示,单纯抗CENP - B抗体阳性组患者的TP和IgA水平显著低于合并其他自身抗体阳性组患者。

结论

抗CENP - B抗体阳性的pSS患者具有独特的临床及免疫学特征,疾病活动度较低,较少累及唾液腺,自身免疫性肝病风险较高,肝功能指标水平较高。抗CENP - B抗体可能是干燥综合征中一种独特的多自身免疫亚群的标志物。

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