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Anti-centromere antibodies linked to subtype of patients with Sjögren’s syndrome
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Although patients with Sjögren’s syndrome who had anti-centromere antibodies had more severe exocrine glandular dysfunction and more pronounced inflammation of the labial salivary glandular, this characteristic was not linked with fibrosis, according to recently published research.
Participants enrolled in the Sjögren’s International Collaborative Clinical Alliance (SICCA) Biorepository included 3,514 individuals with at least one of the following: dry eye or mouth symptoms; bilateral parotid enlargement; recent increase in dental caries; previous Sjögren’s syndrome (SS) diagnosis; or elevated titers of antinuclear antibodies (ANA), rheumatoid factor (RF), and/or anti-SSA or anti-SSB antibodies. After excluding patients with incomplete data and patients with additional autoimmune diseases, data from 1,361 participants with primary SS were analyzed.
A systematic evaluation was conducted for each patient and included a minor salivary gland biopsy. Glandular fibrosis was identified in 18 patients, including six patients with anti-centromere antibodies (ACA); six patients with anti-SSA or anti-SSB antibodies without ACA; and six patients without any of the three antibodies.
The presence of ACAs was detected in 82 patients. ACA-positive patients tended to be older, were more likely to be women and less likely to be Caucasian. No significant differences were observed in patients’ symptoms, while all had positive ANA status with a titer of 1:320 or greater, compared to 56% of the ACA-negative participants. Anti-SSA and anti-SSB antibodies, RF and hyperglobulinemia were less commonly seen in ACA-positive participants, but no differences were observed between groups for hypocomplementemia levels or leucopenia.
Investigators found ACA-positive participants had worse exocrine glandular function, with a higher maximum ocular staining score (OSS), lower minimum Schirmer values and a lower unstimulated whole saliva flow. No significant differences were observed between groups with regard to fibrosis.
Positive-ACA participants had more symptoms of systemic sclerosis, higher rates of Raynaud’s syndrome, sclerodactyly, matted telangiectasia, dilated capillary loops and oral mucosal telangiectasia. Investigators found 14 of ACA-positive patients met the American College of Rheumatology/EULAR criteria for systemic sclerosis. – by Shirley Pulawski
Disclosures: Baer reports the receipt of consulting fees from Glenmark and Bristol-Myers Squibb of less than $10,000. The other authors report no relevant financial disclosures.
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