The British Journal of Rheumatology, Vol 36, 969-975, Copyright © 1997 by British Society for Rheumatology
R Gerli, C Muscat, M Giansanti, MG Danieli, M Sciuto, A Gabrielli, E Fiandra and C Vitali
The aim of this study was to investigate the possible relationship between
the degree of inflammatory infiltration of salivary glands in Sjogren'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.
ORIGINAL PAPERS
Quantitative assessment of salivary gland inflammatory infiltration in primary Sjogren's syndrome: its relationship to different demographic, clinical and serological features of the disorder
Institute of Internal Medicine and Oncological Sciences, University of Perugia, Italy.
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