THU0274 QUALITATIVE AND QUANTITATIVE ANALYSIS OF THE INMUNOLOGIC CHARACTERISTICS OF THE MINOR SALIVARY GLAND BIOPSY IN SJÖGREN’S SYNDROME

Abstract

Background: Minor salivary gland biopsy (MSGB) is the most important diagnostic test of Sjogren’s Syndrome (SS). It demonstrates the presence of the inflammatory infiltration in the most affected site. It’s possible role as a biomarker in the disease is still unknown. The Inmunology Department of our center conducts a detailed analysis of the MSGB about the leukocyte infiltration and quantifies number of each cell. Objectives: To describe the inmunologic features of the MSGB and carry out an association analysis with clinical variables Methods: Clinical variables, ESSDAI index at the moment of diagnosis and laboratory parameters were recorded. As from the MSGB, number of infiltration focus (1, 2 or several), big infiltrations (>100 cells), number of B and T cells, CD4/CD8 ratio and presence of isolated lymphocyte were collected. Categorical variables were described as frequencies and analysed using Fisher exact test. T student and Wilcoxon Rank Sum Test were used for comparison of means (μ). Results: In 2017, a total of 104 MSGB were carried out in our center. Among them 58 were diagnosed as SS by medical and ACR/EULAR 2016 criteria. Finally 41 patients with SS and abnormal MSGB result were included for this study. Biopsy: Patients with active disease (ESSDAI≥2) had greater amount of cells (μ 159 cells vs 509 cells; p=0,055) as well as those with extraglandular disease (μ 160 vs 488; p=0.08). Patients with active disease also had larger number of infiltration focus (p= 0.062). The presence of isolated CD8+ T cells was observed in 13 patients and they had lesser cells (μ 136 vs 381; p=0.35). In those samples with predominance of T cells over B cells had larger number of infiltrate focus (7/20; 35% vs 12/21; 57.14%; p=0.155). No association with disease activity or extraglandular manifestation was found. Extraglandular manifestation and disease activity: 18 patients had extraglandular disease. Moderate or severe ESSDAI activity was found in 14 of these patients (34.2%, p=0.00). The biopsy of patients with extraglandular disease had larger amount of cells (μ 200 vs 145; p=0.01). Patients with active disease had more infiltratre focus (6/22 vs 11/19; p=0.047). Disease evolution time was similar with a mean duration of 8-9 years in both groups. Corticosteroids: There were 3 patients with active steroid treatment (≥prednisone 10mg/d) at the moment of the biopsy. All 3 of them had >1 focus in the sample and 2 of them had large infiltrate with >150 cells. Eight of them had received steroids in the last 5 years, 6 of them had large infiltate with >150 cells and 4 had >1 infiltrate focus in the biopsy. A study with more sample should be carried out to study the influence of steroids in the biopsy results. Conclusion: Patients with extraglandular disease have larger amount of cells in the composition of infiltration. Those with more disease activity had more number of infiltration focus. In 14 patients specific antibodies and antinuclear antibodies were negative. In these patients the biopsy is the most useful diagnostic test. Possible association of those variables that were statistically not signifcant should not be ruled out due to the small sample size of the study. Disclosure of Interests: HYE SANG PARK: None declared, LAURA MARTINEZ-MARTINEZ: None declared, Berta Magallares: None declared, Ivan Castellvi Consultant for: I received fees less than 5000USD as a consultant for Kern and Actelion, Paid instructor for: I received fees less than 2000 USD as a instructor for Boehringer -Ingelheim, Novartis and Gebro, Speakers bureau: ND, Cesar Diaz-Torne: None declared, Ana Laiz Consultant for: Lilly, Novartis, AbbVvie, MSD, UCB and Janssen, Speakers bureau: Lilly, Novartis, Abvvie, MSD, UCB and Janssen, Patricia Moya: None declared, Ana Milena Millan Arciniegas: None declared, Andrea Garcia-Guillen: None declared, Sycille Jeria: None declared, DAVID LOBO: None declared, Susana P. Fernandez-Sanchez: None declared, CONXITA PITARCH: None declared, MANEL RIERA: None declared, MARIA CARMEN HERNANDEZ LAFUENTE: None declared, Candido Juarez: None declared, Hector Corominas: None declared