Immunological Tests in Primary Sjögren Syndrome

Retamozo, Soledad; Brito-Zerón, Pilar; Gandía, Myriam; Pallarés, L; Ramos‐Casals, Manuel

doi:10.1007/978-0-85729-947-5_28

Cited by 2 publications

(3 citation statements)

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“…it was demonstrated that the incidence of arthritis in ACPA+ pSS patients is higher than in ACPA– patients (p = 0.003) [ 3 , 4 ],…”

Section: Discussionmentioning

confidence: 99%

“…Among the antibodies most common in pSS are those against small ribonucleoproteins – SS-A complex (Ro60 and Ro52) and SS-B/La. The antigen for the anti-SS-A antibodies consists of two proteins of different molecular mass: Ro60 and Ro52, coded by separate genes situated in chromosome 19 for Ro60 and in chromosome 11 for Ro52 [ 4 , 5 ]. Ro52 antigen is a phosphoprotein, production of which is activated through viral infection, type I interferon pathway cascade, or Toll-like receptor stimulation.…”

Section: Introductionmentioning

confidence: 99%

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The prevalence of ANA antibodies, anticentromere antibodies, and anti-cyclic citrullinated peptide antibodies in patients with primary Sjögren’s syndrome compared to patients with dryness symptoms without primary Sjögren’s syndrome confirmation

et al. 2017

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ObjectivesOur study analyses the prevalence of ANA, anti-SS-A, anti-SS-B, and ACA and ACPA antibodies in patients with pSS and with dryness symptoms without pSS confirmation, and the association of ACPA and ACA antibodies with specific clinical symptoms.Materials and methods113 patients were divided into two groups: I – with diagnosed pSS (N = 75); and II – with dryness without pSS evidence (N = 38). Diagnostics: indirect immunofluorescence (IF; Hep-2 cell line) of antinuclear antibodies (ANA), anti-SS-A anti-SS-B antibodies determined with semi-quantitative method, autoantibody profile (14 antigens, ANA Profil 3 EUROLINE); basic laboratory, ophthalmic examination tests, minor salivary gland biopsy with focus score (FS), joint and lung evaluation, and ESSDAI questionnaire (pSS activity).Results88% of group I had ANA antibodies (1 : 320 titre), 5.3% at 1 : 160. Anti-SS-A antibodies were present in 88% of group I, including all ANA 1 : 160. Anti-SS-A antibodies positively correlated with greater and moderate activity of ESSDAI 5 (p = 0.046) and FS. The presence of SS-B antibodies significantly affected disease activity. ACPA present: group I – 13% (associated with higher arthritis incidence; p = 0.003); group II – 8%. ACA antibodies present in 4% of group I, but not in group II. No ACA association with interstitial lung changes (small ACA + group excludes full conclusions).ConclusionsANA antibodies should also be considered in a titre of less than 1 : 320, but the presence of anti-SS-A antibodies is still the most important immunological marker for pSS. Anti-SS-A antibodies correlate with higher disease activity (ESSDAI ≥ 5) and higher FS. The presence of the anti-SS-B antibody was significantly affected by higher activity of the disease. The incidence of arthritis was higher in patients with ACPA+ pSS compared to ACPA– (p = 0.003). There was no relationship between ACPA and arthritis in patients with dry-type syndrome without diagnosis of pSS.

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“…it was demonstrated that the incidence of arthritis in ACPA+ pSS patients is higher than in ACPA– patients (p = 0.003) [ 3 , 4 ],…”

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

The prevalence of ANA antibodies, anticentromere antibodies, and anti-cyclic citrullinated peptide antibodies in patients with primary Sjögren’s syndrome compared to patients with dryness symptoms without primary Sjögren’s syndrome confirmation

et al. 2017

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“…Around 50% of individuals with pSS may have systemic involvement including the pulmonary, renal, hepatic, pancreatic, vascular, central nervous and peripheral nervous systems [ 7 ]. Individuals with pSS present a large spectrum of alterations in laboratorial tests such as cytopenias, hypergammaglobulinemia, presence of anti-Ro/SSA and anti-La/SSB antinuclear antibodies, rheumatoid factor (RF), cryoglobulins and hypocomplementemia [ 8 ]. Therapeutic options include mainly symptomatic and supportive measures [ 9 ].…”

Section: Introductionmentioning

confidence: 99%

Rituximab Effectiveness and Safety for Treating Primary Sjögren’s Syndrome (pSS): Systematic Review and Meta-Analysis

et al. 2016

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BackgroundPrimary Sjögren’s Syndrome (pSS) is a systemic autoimmune disease that involves the exocrine glands and internal organs. pSS leads to destruction and loss of secretory function due to intense lymphoplasmacytic infiltration. Therapeutic options include mainly symptomatic and supportive measures, and traditional immunosuppressant drugs have shown no effectiveness in randomized trials. Rituximab (RTX) is a chimeric antibody anti-CD20 that leads to B cell depletion by diverse mechanisms. There is evidence that this drug may be effective for treating pSS. The objective of this systematic review was to evaluate Rituximab effectiveness and safety for treating pSS.Methods and FindingsWe conducted a systematic review of RCTs published until December 2015, with no language restriction. We registered a protocol on Plataforma Brasil (40654814.6.0000.5505) and developed search strategies for the following scientific databases: MEDLINE, EMBASE, CENTRAL and LILACS. We included adults with established pSS diagnosis and considered the use of Rituximab as intervention and the use of other drugs or placebo as control. Four studies met our eligibility criteria: three with low risk of bias and one with uncertain risk of bias. The total number of participants was 276 (145 RTX, 131 placebo). We assessed the risk of bias of each included study and evaluated the following as primary outcomes: lacrimal gland function, salivary gland function, fatigue improvement and adverse events. We found no significant differences between the groups in the Schirmer test at week 24 meta-analysis (MD 3.59, 95% CI -2.89 to 10.07). Only one study evaluated the lissamine green test and reported a statistically significant difference between the groups at week 24 (MD -2.00, 95% CI -3.52 to -0.48). There was a significant difference between the groups regarding salivary flow rate (MD 0.09, 95% CI 0.02 to 0.16) and improvement in fatigue VAS at weeks 6 (RR 3.98, 95% CI 1.61 to 9.82) and week 16 (RR 3.08, 95% CI 1.21 to 7.80).ConclusionsAccording to moderate quality evidence, the treatment with a single RTX course in patients with SSp presents discrete effect for improving lacrimal gland function. Low-quality evidence indicates the potential of this drug for improving salivary flow. According to low quality evidence, no differences were observed in the evaluation after 24 weeks regarding fatigue reduction (30% VAS), serious adverse events occurrence, quality of life improvement and disease activity. With a very low level of evidence, there was no improvement in oral dryness VAS evaluation.

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Immunological Tests in Primary Sjögren Syndrome

Cited by 2 publications

References 73 publications

The prevalence of ANA antibodies, anticentromere antibodies, and anti-cyclic citrullinated peptide antibodies in patients with primary Sjögren’s syndrome compared to patients with dryness symptoms without primary Sjögren’s syndrome confirmation

The prevalence of ANA antibodies, anticentromere antibodies, and anti-cyclic citrullinated peptide antibodies in patients with primary Sjögren’s syndrome compared to patients with dryness symptoms without primary Sjögren’s syndrome confirmation

Rituximab Effectiveness and Safety for Treating Primary Sjögren’s Syndrome (pSS): Systematic Review and Meta-Analysis

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