Clinical and experimental rheumatology最新文献

Objectives: This study investigates serum levels of anti-parotid secretory protein (PSP), anti-salivary gland protein 1 (SP1), and anti-carbonic anhydrase 6(CA6) antibodies in primary Sjögren's disease (pSjD) and other connective tissue diseases (CTDs), further to evaluate their clinical relevance.

Methods: The study enrolled 60 patients diagnosed with pSjD, along with 30 disease controls (DC) suffering from various CTDs and 30 healthy controls (HC) for comparison. The serum levels of anti-PSP, anti-SP1, and anti-CA6 antibodies were measured using chemiluminescent immunoassays. Statistical analyses were performed using SPSS 27.0, including ANOVA, nonparametric tests (Kruskal-Wallis H and Mann-Whitney U), and Spearman correlation.

Results: The Patients with pSjD showed significantly higher serum levels of anti-CA6 immunoglobulin G (IgG), anti-PSP IgG/IgA, and anti-SP1 IgG than the DC and HC groups (p<0.05). These antibodies have a certain predictive accuracy in pSjD. The IgG subtype of anti-CA6, anti-PSP and anti-SP1 had a positive correlation with the erythrocyte sedimentation rate (ESR) and IgG in clinical correlations aspect. The levels of anti-CA6 IgG and anti-PSP IgG increased significantly with the severity of labial gland pathology (p<0.05). The subgroups that were positive for anti-SSA52KD(Ro52)/SSA60KD(Ro60)/SSB(La) exhibited higher levels of anti-CA6 IgG and anti-PSP IgG than their seronegative counterparts (p<0.05), while positivity for anti-centromere antibody (ACA)was linked to lower levels of anti-CA6 and anti-PSP IgG.

Conclusions: Anti-CA6, anti-PSP and anti-SP1 antibodies show diagnostic value in pSjD, with elevated IgG levels reflecting disease progression, histopathological damage, and distinct autoantibody interactions, implicating their pathogenic contributions.

Objectives: Anti-Ro/SSA antibodies are a hallmark of Sjögren's disease (SjD), yet the clinical implications of distinct antigenic targets remain insufficiently defined. We aimed to determine whether specific anti-SSA antigenic profiles-isolated anti-Ro52, isolated anti-Ro60, double anti-Ro52/anti-Ro60, or triple anti-Ro52/anti-Ro60/anti-La/SSB positivity, are associated with distinct systemic, serological, and patient-reported phenotypes in real-life clinical practice.

Methods: We analysed 279 anti-SSA-positive SjD patients fulfilling 2016 ACR/EULAR criteria. Participants were stratified into the four serological subsets and compared for demographics, cumulative ESSDAI domains, systemic activity (ESSDAI), immunologic markers (IgG, C3, C4), and patient-reported outcomes (ESSPRI and subdomains) at study entry. Group comparisons used ANOVA/ANCOVA and Kruskal-Wallis tests, with modified Poisson regression for adjusted prevalence ratios and general linear models for adjusted means.

Results: Triple-positive patients displayed the highest systemic inflammatory activity (ESSDAI median 3 [IQR 1-6]) and IgG levels (1497 [1180-1790] mg/dL; p<0.001), enriched for haematologic, lymphoid, glandular and biological domains. In contrast, isolated anti-Ro60 patients showed the mildest systemic activity (ESSDAI 0 [0-0]) yet the highest patient-reported burden (ESSPRI 6.08 [0.52]; p<0.01), revealing a marked dissociation between objective inflammation and symptoms. Isolated anti-Ro52 displayed the broadest and most heterogeneous phenotype, and older age at diagnosis. In adjusted analyses, only triple-positive patients remained independently associated with increased systemic activity and B-cell hyperactivity (all p<0.05). Symptom measures showed the opposite gradient: isolated anti-Ro52 and anti-Ro60 subsets had the highest adjusted ESSPRI, pain, and fatigue scores, whereas double- and triple-positive patients reported substantially fewer symptoms. When stratified by combined ESSDAI/ESSPRI scores, low-activity/high-symptom cases predominated and were enriched among isolated anti-Ro52 and anti-Ro60 patients.

Conclusions: Anti-SSA antigenic specificity delineates biologically and clinically distinct phenotypes within SjD. These data support serology-informed, multidimensional disease stratification as a foundation for precision-targeted management in SjD.