Tracheo-bronchial Mucociliary Clearance in Patients with Primary and Secondary Sjögren's Syndrome

Abstract

We determined the tracheo-bronchial mucociliary clearance (MCC) in order to evaluate a possible impairment of this function in patients affected by Sjögren's syndrome (SS) with or without overt clinical symptoms of xerotrachea. The MCC was expressed as flow rate (mm/min) and studied in 22 non-smoking SS patients (10 pSS and 12 sSS) and in 8 control subjects by specifically adapted ventilation lung scintigraphy (VLS). The MCC in the control group was 5.9 +/- 1.1 mm/min. No values were produced for MCC in 16 SS patients (8 pSS and 8 sSS) in the time interval considered and were reduced in the remaining 6 SS patients (3.3 +/- 1.2 mm/min). In all nine cases with clinical evidence of xerotrachea no values for MCC were obtained. A significant correlation was found between the MCC values and the rate of stimulated salivary excretion determined by dynamic scialoscintigraphy in the same patients (p < 0.001). These preliminary data show that the majority of SS patients studied presented with MCC impairment, always found when clinical symptoms of xerotrachea were present.

Pulmonary manifestations of Sjögren's syndrome

“…No difference in bronchial gland atrophy was observed between Sjögren's syndrome patients and controls [72]. Tracheobronchial dryness has been indirectly measured by mucociliary clearance [65]. These data suggest that local sicca syndrome is a consequence of a functional secretion defect rather than glandular destruction.…”

“…Dry cough may precede Sjögren's syndrome diagnosis by several years and affects quality of life in 50% of Sjögren's syndrome patients [63]. Several hypotheses have been put forward to explain coughing, including airway dryness, abnormal mucociliary clearance [64,65], bronchial or bronchiolar inflammation, bronchial hyperresponsiveness, and gastro-oesophageal reflux. Cough severity could be correlated with tracheal dryness (local sicca syndrome) [66].…”

“…Suspected mechanisms areabnormalities of mucociliary clearance [65], abnormal sputum, deficit of local immunity, gastro-oesophageal reflux, bronchiectasis, parodontopathy [85] and use of immunosuppressive drugs.…”

Chronic Non-Productive Cough in Patients With Primary Sjögren’s Syndrome

“…It may be misdiagnosed as asthma or chronic bronchitis. 8,19,20 More than 17.5% of the patients with non-pulmonary involvement sought medical care for cough at least once before the diagnosis of pSS. VAS and LCQ scale scores for cough were found to be moderately affected.…”

“…Histologically, atrophy of the submucosal glands in the nasopharynx, larynx, and trachea in association with lymphoid infiltration is seen. 8 Continuous dry cough, hoarseness, and nasal dryness due to mucosal dryness, mucus viscosity disorders, and impaired mucociliary clearance are the common complaints for which patients seek medical care. In this study, we aimed to evaluate the frequency of chronic cough due to dryness in the trachea and the relationship between depression and chronic cough in patients with pSS.…”