Estrogen receptor ß is high in the minor salivary glands of female patients with primary Sjögren's syndrome

Aim of the work

This study aimed to investigate the expression levels of estrogen receptor (ER) beta (ß) and alpha (α) in the minor salivary gland tissues of patients with primary Sjögren's syndrome (pSS), which has a female predominance and reaches its highest incidence at menopause.

Patients and methods

Sixty-six female pSS patients and 23 matched control were studied. The ER ß and α expressions from salivary gland tissues were immunohistochemically evaluated. The European League Against Rheumatism (EULAR) Sjögren's syndrome disease activity index was assessed.

Results

The 66 female pSS patients had a mean age of 50.1 ± 13.4 years. The ESSDAI was 7 (9–13). The ER ß expressions of the salivary gland were significantly higher in pSS patients than in control both ductal (B: 0.68, OR 1.97, 95 %CI 1.34–2.88, p = 0.001) and acinar (B: 2.18, OR 8.87, 95 %CI 2.34–33.6, p = 0.001). Lymphocytes in the salivary gland infiltrate of pSS cases expressed high levels of ER ß (8, 6–8). Expression of ERα was not detected in the minor salivary gland ductal and acini epithelium and lymphocytes of pSS and control. No significant relationship was found between ER ß expression levels and complement, rheumatoid factor, immunoglobulin G, anti-nuclear antibody, the ESSDAI and the presence of menopause in pSS patients.

Conclusion

pSS patients have higher salivary gland ER ß expression (ductal and acinar epithelial) than controls, and lymphocytes infiltrating the salivary gland in pSS express high levels of ER ß. This study showed that salivary gland ER expression levels in pSS are different from controls, regardless of disease activity.