Rheumatology, Autoimmunity and Orthopedics

Biography

Biography: Maria Maslinska

Abstract

Introduction & Aim: The study assessed differences in symptoms and immunological parameters between younger (<45) and older primary Sjogren’s syndrome (pSS) patients.

Patients: Group I (GI): n=50 patients with pSS ≥ 45 years old, women [F] (86.7%) and men [M] (10.3%); Group II (GII) n=25 < 45 years old, 24 [F] and 1 [M].

Methods: WBC, CRP, RF, ESR, Serum concentration of gamma globulins and of C4, C3 complement components were assessed. Antinuclear antibodies (ANA) titers, serum anti-SS-A, anti-SS-B and cytokine (BAFF, APRIL, FLT-3L, TNF-β, IL-21) levels were determined. The histopathological evaluation (focus score) and immunohistochemistry (presence of CD3+, CD4+, CD19+, CD21+ CD35+ cells) of minor salivary gland biopsies were studied. A Schirmer’s test and ocular staining (lissamine green and fluorescein) eye assessments were carried out.

Findings: In GII leukopenia, higher gamma globulins and C3 complement component concentrations were observed. In GI Schirmer's test results were significantly lower. In GII higher LT-α levels were observed (p=0.049). No other differences in cytokine serum concentrations were observed. There were no differences in FS evaluation between groups, but in GII the number of dendritic cells (CD35+, CD21+) assessed with immunohistochemistry was significantly higher P=0.042 and P=0.031 respectively.

Conclusion & Significance: GI presented greater immune activity with less severe dryness symptoms. GII showed higher levels of lymphotoxin α (P=0.049) indicating Th1 lymphocytes activity and the active immune response in peripheral lymphoid organs. The presence of CD 35+ and CD 21+ cells in salivary glands in GII may indicate the active early disease phase and dendritic cells activity. Younger pSS patients may present no evident symptoms of dryness, inspite of the dynamic autoimmune process development (confirmed in lab tests).