Gerli R, Muscat C, Giansanti M, Danieli M G, Sciuto M, Gabrielli A, Fiandra E, Vitali C
Institute of Internal Medicine and Oncological Sciences, University of Perugia, Italy.
Br J Rheumatol. 1997 Sep;36(9):969-75. doi: 10.1093/rheumatology/36.9.969.
The aim of this study was to investigate the possible relationship between the degree of inflammatory infiltration of salivary glands in Sjögren's syndrome (SS) and the different demographic, clinical and serological features of the disease. A quantitative assessment of the extension of the infiltrates was performed on histology samples from the labial salivary glands (LSG) of 82 patients with primary SS, by calculating the ratio of the infiltrated area to the total area of glandular tissue in the samples. The correlations between the amount of inflammatory infiltrate and the main features of the disorder were then analysed. A significant negative correlation between the degree of LSG infiltration and the patient's age at disease onset was observed (P < 0.05). In contrast, the percentage of infiltrate did not correlate with the disease duration. A significant correlation was found between the degree of infiltration of the salivary tissue and (i) the total number of extraglandular features (P < 0.01) and (ii) the presence of specific extraglandular features such as Raynaud's phenomenon (P < 0.05), vasculitis (P < 0.0001), lymph node or spleen enlargement (P < 0.05) and leucopenia (P < 0.02). Finally, patients with antinuclear antibodies, anti-SSA/Ro antibodies, or anti-SSA/Ro plus anti-SSB/La antibodies showed a more widespread inflammatory infiltration in the LSG tissue than patients without these autoantibodies (P < 0.01). The degree of infiltration in the salivary tissue was significantly greater in those patients with anti-SSA/Ro plus anti-SSB/La antibodies in their sera than in patients with anti-SSA/Ro antibodies alone (P < 0.05). In conclusion, patients with SS and active inflammatory infiltration of the salivary glands usually experience an earlier disease onset and a larger number of systemic extraglandular manifestations. In addition, the antibodies directed against certain nuclear/cytoplasmic specificities, and particularly those which react with the SSB/La antigen, seem to play a key role in enhancing the autoimmune process in the salivary glands.
本研究旨在探讨干燥综合征（SS）患者唾液腺炎症浸润程度与该疾病不同人口统计学、临床及血清学特征之间的可能关系。通过计算82例原发性SS患者唇腺（LSG）组织学样本中浸润面积与腺组织总面积的比值，对浸润范围进行了定量评估。随后分析了炎症浸润量与该疾病主要特征之间的相关性。观察到LSG浸润程度与患者发病年龄呈显著负相关（P < 0.05）。相比之下，浸润百分比与疾病持续时间无关。发现唾液组织浸润程度与（i）腺外特征总数（P < 0.01）以及（ii）特定腺外特征的存在，如雷诺现象（P < 0.05）、血管炎（P < 0.0001）、淋巴结或脾脏肿大（P < 0.05）和白细胞减少（P < 0.02）之间存在显著相关性。最后，与无这些自身抗体的患者相比，抗核抗体、抗SSA/Ro抗体或抗SSA/Ro加抗SSB/La抗体的患者在LSG组织中表现出更广泛的炎症浸润（P < 0.01）。血清中同时存在抗SSA/Ro加抗SSB/La抗体的患者，其唾液组织浸润程度显著高于仅存在抗SSA/Ro抗体的患者（P < 0.05）。总之，患有SS且唾液腺有活跃炎症浸润的患者通常发病较早，全身腺外表现较多。此外，针对某些核/细胞质特异性的抗体，尤其是那些与SSB/La抗原反应的抗体，似乎在增强唾液腺自身免疫过程中起关键作用。
