A Novel Proposal of Salivary Lymphocyte Detection and Phenotyping in Patients Affected by Sjogren's Syndrome.

Elena Selifanova,Tatjana Beketova,Stefania Leuci,Gianrico Spagnuolo,Anna Turkina

doi:10.3390/jcm9020521

Elena Selifanova, Tatjana Beketova + Show 3 more

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https://doi.org/10.3390/jcm9020521

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Abstract

A preliminary evaluation of the parotid secretion cellular composition in patients with Sjogren’s Syndrome (SS) and a diagnostic accuracy assessment of salivary lymphocyte detection and immunophenotyping in Sjogren’s Syndrome diagnosis and prognosis were performed. The study included 40 consecutive patients, aged 19–60 years, with parenchymal sialadenitis associated with Sjogren’s Syndrome, and 20 healthy donors. The exclusion criteria were exacerbation of sialadenitis, chronic infections, malignant neoplasms, and lymphoproliferative diseases. The standard diagnostic tests were minor salivary gland biopsy and parotid sialography. Immunophenotyping of parotid secretion lymphocytes was performed by multicolor flow cytometry. Lymphocytes were detectable in parotid secretion of patients affected by Sjogren’s Syndrome, both primary (pSS) and secondary (sSS) form, but not in that from healthy donors. Sensitivity, specificity, positive, and negative predictive values of lymphocytes detection in parotid saliva were 77.5%, 100%, 100%, and 69%, respectively. The mean numbers of the total T-cell population, T-helper cells, and T-cytotoxic cells were 71.7%, 41.6%, and 53%, respectively. The immunophenotype of lymphocytes obtained by patients’ parotid flow resembles the immunophenotypes of glandular biopsies currently known. Our preliminary data suggest the use of saliva as an alternative and non-invasive method for evaluating the prognosis of Sjogren’s Syndrome.

Highlights

Xerostomia is one of the main symptoms of Sjogren’s syndrome and can suggest clinical diagnosis of the disease [1,2].Salivary glands (SGs) are one of the main target organs in Sjögren’s syndrome (SS), both in primary and secondary Sjogren’s syndrome, and the typical SG lesion is autoimmune sialadenitis [3]
Detection of lymphocyte phenotypes is currently applied to the study of primary immunodeficiencies [16,17]; otherwise, phenotyping of lymphocytes may be interested in different autoimmune disorders—in particular, SS phenotyping of lymphocytes obtained by salivary flow may be useful for diagnosis and be significant as a prognostic factor
In the present study we evaluated CD19+ B-cells which were previously described in parotid SG (PSG) biopsies [56], while in the parotid gland infiltrate CD19 negative and CD138 positive plasma cells are present which play a significant role in pathological process [57]

Summary

Introduction

Salivary glands (SGs) are one of the main target organs in Sjögren’s syndrome (SS), both in primary (pSS) and secondary (sSS) Sjogren’s syndrome, and the typical SG lesion is autoimmune sialadenitis [3]. In the salivary and lacrimal glands, focal lymphocytic infiltration is associated with an imbalance of cellular immune responses and chronic inflammatory reaction that can lead to lymphoid neogenesis and the formation of a tertiary lymphoid tissue. Detection of lymphocyte phenotypes is currently applied to the study of primary immunodeficiencies [16,17]; otherwise, phenotyping of lymphocytes may be interested in different autoimmune disorders—in particular, SS phenotyping of lymphocytes obtained by salivary flow may be useful for diagnosis and be significant as a prognostic factor

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