Elevated CXCL13 in primary Sjögren’s syndrome and its correlation with disease activity: a systematic review and meta-analysis

Abstract

CXCL13 levels have been reported to be elevated in primary Sjögren's syndrome (pSS) patients. This study investigated alterations involving the CXCL13/CXCR5 axis in pSS patients and explored the correlation between CXCL13 expression and disease severity. Six databases, including PubMed, Web of Science, Embase, Ovid Medline, China National Knowledge Infrastructure, and Wanfang, were searched. The quality of the included studies was assessed using the Newcastle-Ottawa Scale criteria. We analyzed CXCL13 concentrations in the serum and saliva of pSS patients and healthy controls (HCs). Next, we analyzed the percentage of CXCR5+CD4+ T cells among CD4+ T cells in pSS patients and HCs. Correlations between CXCL13 levels and serological, clinical, and histological parameters of patients were also assessed. Publication bias was determined using funnel plots and Egger's test. Twenty-three articles were included; of these, 14 studies reported CXCL13 levels, and 5 reported CXCR5+CD4+ T cell count of pSS patients and HCs. Nine articles covering 32 studies reported correlations between serum CXCL13 levels and serological, clinical, and histological parameters in pSS patients. Expressions of CXCL13 and CXCR5+CD4+ T cell count were significantly increased in pSS patients compared with those in HCs. There was a positive correlation between CXCL13 levels and serum IgG levels, disease activity indices, and focus score in minor salivary gland biopsy of patients. CXCL13 abundance was evidently elevated in pSS patients and correlated with disease activity and can therefore probably be employed as a robust biomarker to monitor and diagnose pSS. Key Points • Serum CXCL13 is significantly elevated in primary Sjögren's syndrome patients. • CXCL13 level correlates with disease severity and activity of primary Sjögren's syndrome. • CXCL13 can probably be used as a robust biomarker to monitor and diagnose primary Sjögren's syndrome.