Abstract
Objective The aim of this study was to characterize the subsets of circulating CD56+ NK cells in pSS patients and their potential value in the diagnosis and/or prediction of prognosis in patients with pSS. Methods We included 52 pSS patients fulfilling the 2002 AECG criteria or 2012 ACR criteria and 20 age- and gender-matched healthy volunteers. The frequency and absolute number of NK cells and CD56 NK cell subsets in peripheral blood samples were detected by flow cytometry. Other laboratory parameters such as the IgG level and complement protein levels were extracted from the clinical system. Results Both the frequency and the absolute number of peripheral blood NK cells were reduced in pSS patients compared to healthy controls. The proportion of CD56bright NK cell subset was increased, and the proportion of CD56dim NK cell subset was decreased among NK cells, resulting in the ratio of CD56bright NK to CD56dim NK which was significantly elevated in pSS patients. ROC analysis indicated that the AUC of CD56bright NK/CD56dim NK ratio was 0.838, and the best diagnostic cut-off point was 0.0487 for pSS patients. Furthermore, this CD56bright NK/CD56dim NK ratio was positively correlated with the IgG level and negatively correlated with the complement protein C3 and C4 levels. More importantly, the CD56bright/CD56dim NK ratio was either slightly increased or not changed in other autoimmune diseases such as SLE and IgG4-related disease. Conclusion Our findings suggest that the ratio of blood CD56bright NK to CD56dim NK might have a diagnostic value relatively specific for pSS.
Highlights
Primary Sjögren’s syndrome is a slowly progressed autoimmune disorder characterized by lymphocytic infiltration of exocrine glands and subsequent significant loss of secretory function with oral or eye dryness [1,2,3]
In accordance with previous literature [3], human Natural killer (NK) cells defined as CD3–CD56+ lymphocytes in this study could be separated into CD56bright and CD56dim subsets in all Primary Sjögren’s syndrome (pSS) patients and healthy controls (HC) (Figure 1(a))
We have detected the expression of CD107a and intracellular IFN-γ, which reflect the function of CD56+ NK cell subsets in pSS patients
Summary
Primary Sjögren’s syndrome (pSS) is a slowly progressed autoimmune disorder characterized by lymphocytic infiltration of exocrine glands and subsequent significant loss of secretory function with oral or eye dryness [1,2,3]. Few studies have explored the role of innate immune indicators in the identification of pSS patients. Journal of Immunology Research increasing evidence has shown that NK cells play a critical role in both type I and type II IFN biologic functions resulting from their interaction with various dendritic cell (DC) subsets in pSS progression [11,12,13,14]. Taken together, these data suggest that NK cells play an important role in the pathogenesis of pSS
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