Tsaliki Martha, Cavett Joshua, Kurien Biji T, Bruxvoort Christina, Lewis Valerie M, Ice John A, Dave Devavrat, Khosravani Sina, Grundahl Kiely, Lessard Christopher J, Rasmussen Astrid, Sivils Kathy L, Farris Amy Darise, Koelsch Kristi A, Scofield Robert Hal
Arthritis and Clinical Immunology Research Program, Oklahoma Medical Research Foundation, Oklahoma City, Oklahoma; Department of Pathology, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma; Oklahoma City US Department of Veterans Affairs Medical Center, Oklahoma City, Oklahoma.
Arthritis and Clinical Immunology Research Program, Oklahoma Medical Research Foundation, Oklahoma City, Oklahoma; Oklahoma City US Department of Veterans Affairs Medical Center, Oklahoma City, Oklahoma.
Ann Rheum Dis. 2025 Aug;84(8):1354-1362. doi: 10.1016/j.ard.2025.03.012. Epub 2025 May 3.
Diagnosis of Sjögren's disease (SjD) consists of clinical examinations that include invasive studies such as lower lip biopsies and blood collection to identify presence of serum autoantibodies. Salivary glands of patients with SjD are sites where antibody-secreting cells accumulate and secrete immunoglobulins. Many patients with dry manifestations who do not meet classification criteria are grouped as non-Sjögren's sicca (NSS) and are heavily understudied. We undertook this cross-sectional observational study to investigate the role of salivary autoantibodies as a diagnostic tool and determine presence of salivary autoantibodies in patients with NSS.
In this cross-sectional observational study, we screened whole unstimulated saliva from 446 subjects by direct enzyme-linked immunosorbent assays and capillary western blotting for anti-Ro60, anti-La, and rheumatoid factor (immunoglobulin (Ig)G and IgA) antibodies. All subjects were classified following the ACR/EULAR classification at the Oklahoma Medical Research Foundation Sjögren's Research Clinic.
Patients with SjD were significantly more likely to have salivary antibodies compared with those with NSS and healthy control subjects. In this cohort, there were 88 subjects with NSS with seronegative profiles who had detectable salivary autoantibodies and objective measures of dryness.
Of these 88 subjects with NSS, we identified 75 subjects that had positive objective examinations of dryness and could belong to an early-onset SjD group. Alternatively, these 75 subjects with NSS could belong to a distinct phenotype of SjD that will remain seronegative while being saliva positive for anti-Ro60. These data showed a relationship between ocular and oral dryness and the presence of salivary anti-Ro60 antibodies in subjects with NSS.
干燥综合征（SjD）的诊断包括临床检查，其中包括侵入性检查，如下唇活检和采血以确定血清自身抗体的存在。SjD患者的唾液腺是分泌抗体的细胞积聚和分泌免疫球蛋白的部位。许多有干燥表现但不符合分类标准的患者被归类为非干燥综合征性口干（NSS），且对其研究严重不足。我们进行了这项横断面观察性研究，以调查唾液自身抗体作为诊断工具的作用，并确定NSS患者中唾液自身抗体的存在情况。
在这项横断面观察性研究中，我们通过直接酶联免疫吸附测定和毛细管蛋白质印迹法，对446名受试者的全唾液进行了抗Ro60、抗La和类风湿因子（免疫球蛋白（Ig）G和IgA）抗体的筛查。所有受试者均按照俄克拉荷马医学研究基金会干燥综合征研究诊所的美国风湿病学会/欧洲抗风湿病联盟分类标准进行分类。
与NSS患者和健康对照受试者相比，SjD患者唾液抗体阳性的可能性显著更高。在该队列中，有88名NSS患者血清学阴性，但唾液自身抗体可检测到且有客观的干燥指标。
在这88名NSS患者中，我们确定了75名患者有阳性的干燥客观检查结果，可能属于早发性SjD组。或者，这75名NSS患者可能属于SjD的一种独特表型，血清学呈阴性，但唾液抗Ro60抗体呈阳性。这些数据表明，NSS患者的眼干和口干与唾液抗Ro60抗体的存在之间存在关联。
