pSS Group Research Articles

Inhomogeneity of the lacrimal glands is the most important ultrasound finding in primary Sjögren’s syndrome: a comprehensive study with 2D-Shear Wave Elastography

Aim: This study aimed to compare the diagnostic performance, interobserver reliability, and practical utility of two lacrimal gland ultrasound (LGUS) scoring systems – LGUS score I, a complex multi-parameter score, and LGUS score II, a simplified single-parameter score – for diagnosing primary Sjögren’s syndrome (pSS). The additional role of two-dimensionalshear wave elastography (2D-SWE) in assessing lacrimal gland stiffness was also evaluated.Material and methods: This observational, cross-sectional study included 35 pSS patients and 35 age- and sex-matched healthy controls. LGUS score I incorporated four grey-scale ultrasound parameters, while LGUS score II relied solely on glandular homogeneity. Both scoring systems were evaluated for diagnostic accuracy and interobserver agreement. SWE measurements of lacrimal gland elasticity were also recorded and compared between groups.Results: LGUS score II achieved diagnostic performance comparable to LGUS score I, with areas under the curve (AUC) of 0.831 and 0.829, respectively (p=0.961). Sensitivity was higher for LGUS score II (94.29%) than for LGUS score I (85.70%), with both scores demonstrating identical specificity (68.57%). Interobserver agreement was good for LGUS score II (κ=0.707) and moderate for LGUS score I (κ=0.553). SWE measurements showed no significant differences in mean elasticity values between the pSS and control groups (8.78±2.03 kPa vs. 9.27±2.07 kPa, p=0.158).Conclusion: LGUS score II (glandular homogeneity) offers a reliable, time-efficient diagnostic approach for pSS, providing similar accuracy to the more complex LGUS score I with enhanced interobserver reliability, while the potential of 2D-SWE remains limited by methodological inconsistencies and requires further standardization.

Establishment and evaluation of a risk prediction model for coronary heart disease in primary Sjögren's syndrome based on peripheral blood IL-6 and Treg percentages.

This study aims to establish and evaluate a risk prediction model for coronary heart disease (CHD) in patients with primary Sjögren's syndrome (pSS) based on peripheral blood levels of interleukin-6 (IL-6) and the percentage of regulatory T cells (Treg%). This model is intended to facilitate the timely identification of high-risk patients and the implementation of preventive measures. Clinical data were collected from 120 pSS patients who visited the Second Hospital of Shanxi Medical University between November 2021 and September 2023. Patients were classified into pSS and pSS-CHD groups according to CHD diagnostic criteria. Peripheral blood lymphocyte subsets and cytokine levels were assessed using flow cytometry. Univariate and multivariate logistic regression analyses were employed to identify independent risk factors, and a nomogram was constructed based on these factors. The model's discriminatory ability, calibration, and clinical utility were evaluated using receiver operating characteristic (ROC) curves, calibration curves, and decision curve analysis. The univariate and multivariate logistic regression analyses identified several independent risk factors for CHD in pSS patients: erythrocyte sedimentation rate (ESR) (OR=1.10, P=0.019), triglycerides (TG) (OR=3.67, P=0.041), IL-6 (OR=1.29, P=0.048), and Treg% (OR=0.25, P=0.004). A nomogram incorporating these factors demonstrated an area under the curve (AUC) of 0.96, indicating excellent predictive performance, and showed good calibration (P=0.599), suggesting significant clinical applicability. Furthermore, Treg% exhibited a negative correlation with cholesterol (CHOL) and low-density lipoprotein cholesterol (LDL-C) levels, while IL-6 showed a positive correlation with CHOL and LDL-C levels. TG was positively correlated with C-reactive protein (CRP). This study successfully developed a risk prediction model based on peripheral blood IL-6 and Treg% levels, providing critical evidence for the early identification and personalized prevention of CHD in pSS patients, with potential clinical implications.

Autoantibody against aquaporin-5 may be a new diagnostic biomarker for primary Sjögren’s syndrome

The study aims to assess the diagnostic and clinical significance of autoantibodies against aquaporin-1 (anti-AQP1) and aquaporin-5 (anti-AQP5) in primary Sjögren’s syndrome (pSS). A total of 163 participants were categorized into three groups: pSS group, other connective tissue diseases (CTD) group, and healthy control (HC) group. The levels of anti-AQP1 and anti-AQP5 autoantibodies in serum were determined using enzyme-linked immunosorbent assay (ELISA), and clinical data from patients were collected for statistical analysis. Our results showed that the level of anti-AQP1 in the pSS group was higher than in the HC group (P < 0.05), and no significant difference was observed between the pSS group and the CTD group (P > 0.05). ROC showed that the anti-AQP1 had no diagnostic value for pSS (P > 0.05). The anti-AQP5 level of 39 healthy adults was all below the cut-off value (14.10 ng/ml) (P < 0.05). The level of anti-AQP5 in the pSS group was higher than the CTD group (P < 0.05), the AUC was 0.86 (95% CI 0.80–0.93), with a sensitivity of 0.95 (95% CI 0.87–0.99) and a specificity of 0.70 (95% CI 0.58–0.84). No correlation was found between anti-AQP5 levels and the EULAR primary Sjögren’s syndrome disease activity index score, anti-SSA, anti-SSB, antinuclear antibodies, rheumatoid factor, anti-ds-DNA, salivary gland flow rate, complement 3, and lymphocyte count in pSS samples (P > 0.05), respectively. Therefore, the elevated anti-AQP5 may emerge as a novel diagnostic biomarker for pSS patients due to high sensitivity and specificity.Key Points• The elevated anti-AQP5 may emerge as a novel diagnostic biomarker for pSS patients due to high sensitivity and specificity.

Subjective Symptoms and Disease Activity Related to Serum Zinc Concentration in Primary Sjögren's Syndrome.

Background/Objectives: We examined the frequency of zinc deficiency in patients with Sjögren's syndrome (SS) and the relationship between zinc deficiency and each of the subjective symptoms and disease activity. Methods: We enrolled 164 patients aged ≥ 20 years with primary SS (pSS) based on the revised diagnostic criteria of the Ministry of Health, Labor and Welfare (1999) and 144 patients with RA diagnosed according to the ACR/EULAR classification criteria for RA (2010) as a comparison group. Subjective symptoms were confirmed using an original questionnaire, and disease activity was determined using the European League Against Rheumatism Sjögren's Syndrome Disease Activity Index (ESSDAI). The serum zinc concentrations were measured in both SS and RA patients. Results: The rate of zinc deficiency in the SS group was 26.1%, significantly higher than that in the RA group (7.6%). The rate of zinc deficiency was significantly higher in the pSS group compared with Japanese health checkup recipients reported in the literature. The mean serum zinc concentration in primary SS was 60.6 ± 7.3 µmol/L in the high disease activity group with an ESSDAI of ≥5 points, which was significantly lower than the concentration of 69.7 ± 10.2 µmol/L in patients with an ESSDAI of ≤4 points. Conclusions: The frequency of zinc deficiency was higher in patients with pSS than in patients with RA. Disease activity was also higher in patients with zinc deficiency, suggesting an association between zinc concentration and organ involvement in pSS.

A pilot study of skin barrier function in patients with systemic sclerosis and primary Sjögren's syndrome.

Although the close interactions between the epidermis and dermis of the skin have been widely explored, the skin barrier functions of the stratum corneum (SC) in patients with systemic sclerosis (SSc) and primary Sjögren's syndrome (pSS) are not well known. We aimed to investigate the biophysical characteristics of the skin, including transepidermal water loss (TEWL), the SC water content, erythema, and the melanin index, in patients with SSc and pSS. This case-control study included 34 patients with SSc, 31 patients with pSS, and 25 healthy controls. All parameters were measured on the extensor surface of the forearm and compared between patients and healthy controls. In patients with SSc, we performed subgroup analyses by disease subtype (diffuse and limited cutaneous SSc), the modified Rodnan skin sclerosis score (>6 or ≤6), and comorbid secondary SS status. In patients with pSS, subgroup analyses were performed by anti-Ro/SSA antibody status and the findings of salivary gland ultrasound. No statistically significant differences were observed in TEWL or skin hydration between patients with SSc and pSS and healthy controls. In the pSS group, only the erythema index was significantly increased compared to the control group. In subgroup analyses, no significant differences were observed in the extent of TEWL or skin hydration by disease subtype, severity, autoantibody profile, or comorbidities. Patients with SSc or pSS did not exhibit specific impairments of skin barrier function or skin hydration. Further studies with larger sample sizes and age-matched controls are required.

Performance of salivary glands ultrasonography, shear wave elastography and their combined use for the diagnosis of primary and secondary Sjögren's syndrome.

Sjögren's syndrome (SS) is a common rheumatic disease for which finding the right imaging tool remains a challenge. This study aimed to evaluate the performance of salivary gland ultrasonography (SGUS), shear wave elastography (SWE) and their combined use for the diagnosis of primary and secondary SS (pSS and sSS). This retrospective study included patients with dry symptoms who underwent routine examinations between May 2019 and December 2023. Patients were categorized into the pSS (n=41), sSS (n=26), and control (n=27) groups based on the American College of Rheumatology/European League Against Rheumatism classification criteria (2016). A comparison of SGUS and shear wave velocity (SWV) results was conducted among the three groups. The diagnostic capabilities of different ultrasound methods for SS were evaluated using receiver operating characteristic (ROC) curves and the area under the curve (AUC) for specificity. Compared to the control group, both the pSS (1.80±1.03vs. 0.67±0.48, p<0.001) and the sSS (1.85±0.88vs. 0.67±0.48, p<0.001) groups exhibited significantly elevated SGUS scores. However, there was no statistically significant difference between the pSS and sSS groups (p=0.849). The SWV values in both the pSS and sSS groups were significantly higher than those in the control group (all p<0.001). The AUC for diagnosing SS using only SGUS scores was 0.823 (95% confidence interval [CI]: 0.731-0.894). Combining SGUS scores and SWV values resulted in improved diagnostic accuracy (AUC: 0.883, 95% CI: 0.801-0.940). SGUS and SWE are pivotal in the diagnosis of Sjögren's syndrome, with their synergistic application poised to bolster diagnostic precision. This combined approach also furnishes substantial backing for the clinical assessment and management of Sjögren's syndrome.

Hydroxychloroquine is associated with lower seroconversion upon 17DD-Yellow fever primovaccination in patients with primary Sjögren’s syndrome

ABSTRACT The present study aimed at investigating whether the hydroxychloroquine (HCQ) treatment would impact the neutralizing antibody production, viremia levels and the kinetics of serum soluble mediators upon planned 17DD-Yellow Fever (YF) primovaccination (Bio-Manguinhos-FIOCRUZ) of primary Sjögren’s syndrome (pSS). A total of 34 pSS patients and 23 healthy controls (HC) were enrolled. The pSS group was further categorized according to the use of HCQ (HCQ and Non-HCQ). The YF-plaque reduction neutralization test (PRNT ≥1:50), YF viremia (RNAnemia) and serum biomarkers analyses were performed at baseline and subsequent time-points (Day0/Day3–4/Day5–6/Day7/Day14-D28). The pSS group showed PRNT titers and seropositivity rates similar to those observed for HC (GeoMean = 238 vs 440, p = .11; 82% vs 96%, p = .13). However, the HCQ subgroup exhibited lower seroconversion rates as compared to HC (GeoMean = 161 vs 440, p = .04; 69% vs 96%, p = .02) and Non-HQC (GeoMean = 161 vs 337, p = .582; 69% vs 94%, p = .049). No differences in YF viremia were observed amongst subgroups. Serum biomarkers analyses demonstrated that HCQ subgroup exhibited increased levels of CCL2, CXL10, IL-6, IFN-γ, IL1-Ra, IL-9, IL-10, and IL-2 at baseline and displayed a consistent increase of several biomarkers along the kinetics timeline up to D14–28. These results indicated that HCQ subgroup exhibited a deficiency in assembling YF-specific immune response elicited by 17DD-YF primovaccination as compared to Non-HCQ subgroup. Our findings suggested that hydroxychloroquine is associated with a decrease in the humoral immune response after 17DD-YF primovaccination.

Multi-Functional PEDOT:PSS as the Efficient Perovskite Solar Cells.

Poly(3,4-ethylenedioxythiophene) (PEDOT), particularly in its complex form with poly(styrene sulfonate) (PEDOT:PSS), stands out as a prominent example of an organic conductor. Renowned for its exceptional conductivity, substantial light transmissibility, water processability, and remarkable flexibility, PEDOT:PSS has earned its reputation as a leading conductive polymer. This study explores the unique effects of two additives, Bisphenol A diglycidyl ether (DGEBA) and Dimethyl sulfoxide (DMSO), on the PSS component of PEDOT:PSS films are shown. Both additives induce grain size growth, while DGEBA makes the PEDOT:PSS layer hydrophobic, which acts as a passivation to protect the perovskite layer, which is vulnerable to moisture. The other additive, DMSO, separates the PSS groups, resulting in increased conductivity through the free movement of holes. With these multi-modified p-type PEDOT:PSS, theITO/M-PEDOT:PSS/Perovskite/PCBM/Ag structured reverse structure solar cell has improved the power conversion efficiency (PCE) from 15.28% to 17.80% compared to the control cell with conventional PEDOT:PSS. It also maintains 90% for 500h at 60°C and 300h at 1 sun illuminating conditions.

A new insight on evaluation of the fertility and pregnancy outcome in patients with primary Sjögren syndrome: a propensity score matched study in multi-IVF centers

BackgroundPrimary Sjögren syndrome (pSS) is often related to adverse neonatal outcomes. But it’s currently controversial whether pSS has an adverse effect on female fertility and clinical pregnancy condition. More importantly, it’s unclear regarding the role of pSS in oocyte and embryonic development. There is a lack of comprehensive understanding and evaluation of fertility in pSS patients.ObjectiveThis study aimed to investigate oocyte and embryonic development, ovarian reserve, and clinical pregnancy outcomes in Primary Sjögren syndrome (pSS) patients during in vitro fertilization (IVF) treatment from multi-IVF centers.MethodsWe performed a muti-central retrospective cohort study overall evaluating the baseline characteristics, ovarian reserve, IVF laboratory outcomes, and clinical pregnancy outcomes between the pSS patients and control patients who were matched by Propensity Score Matching.ResultsFollowing PSM matching, baseline characteristics generally coincided between the two groups. Ovarian reserve including anti-müllerian hormone (AMH) and antral follicle counting (AFC) were significantly lower in the pSS group vs comparison (0.8 vs. 2.9 ng/mL, P < 0.001; 6.0 vs. 10.0, P < 0.001, respectively). The pSS group performed significant reductions in numbers of large follicles, oocytes retrieved and MII oocytes. Additionally, pSS patients exhibited obviously deteriorate rates of oocyte maturation, 2PN cleavage, D3 good-quality embryo, and blastocyst formation compared to comparison. As for clinical pregnancy, notable decrease was found in implantation rate (37.9% vs. 54.9%, P = 0.022). The cumulative live birth rate (CLBR) following every embryo-transfer procedure was distinctly lower in the pSS group, and the conservative and optimal CLBRs following every complete cycle procedure were also significantly reduced in the pSS group. Lastly, the gestational weeks of the newborns in pSS group were distinctly early vs comparison.ConclusionPatients with pSS exhibit worse conditions in terms of female fertility and clinical pregnancy, notably accompanied with deteriorate oocyte and embryo development. Individualized fertility evaluation and early fertility guidance are essential for these special patients.

Increased risk of adverse gestational outcomes in pregnant women with primary Sjögren’s syndrome

ObjectivesThis study aimed to identify risk factors contributing to diverse pregnancy outcomes in primary Sjögren’s syndrome (pSS) cases.MethodsA retrospective analysis was conducted on pregnant individuals with pSS, who received outpatient...

Identification of key mitochondria-related genes and their relevance to the immune system linking Parkinson's disease and primary Sjögren's syndrome through integrated bioinformatics analyses

BackgroundMitochondria are the metabolic hubs of cells, regulating energy production and antigen presentation, which are essential for activation, proliferation, and function of immune cells. Recent evidence indicates that mitochondrial antigen presentation may have an impact on diseases such as Parkinson's disease (PD) and autoimmune diseases. However, there is limited knowledge about the mechanisms that regulate the presentation of mitochondrial antigens in these diseases. MethodsIn the current study, RNA sequencing was performed on labial minor salivary gland (LSG) from 25 patients with primary Sjögren's syndrome (pSS) and 14 non-pSS aged controls. Additionally, we obtained gene expression omnibus datasets associated with PD patients from NCBI Gene Expression Omnibus (GEO) databases. Single-sample Gene Set Enrichment Analysis (ssGSEA), ESTIMATE and Spearman correlations were conducted to explore the association between mitochondrial related genes and the immune system. Furthermore, we applied weighted Gene Co-expression Network Analysis (WGCNA) to identify hub mitochondria-related genes and investigate the correlated networks in both diseases. Single cell transcriptome analysis, immunohistochemical (IHC) staining and quantitative real-time PCR (qRT–PCR) were used to verify the activation of the hub mitochondria-related pathway. Pearson correlations and the CIBERSORT algorithms were employed to further reveal the correlation between hub mitochondria-related pathways and immune infiltration. ResultsThe transcriptome analysis revealed the presence of overlapping mitochondria-related genes and mitochondrial DNA damage in patients with pSS and PD. Reactive oxygen species (ROS), the senescence marker p53, and the inflammatory markers CD45 and Bcl-2 were found to be regionally distributed in LSGs of pSS patients. WGCNA analysis identified the STING pathway as the central mitochondria-related pathway closely associated with the immune system. Single cell analysis, IHC staining, and qRT-PCR confirmed the activation of the STING pathway. Subsequent, bioinformatic analysis revealed the proportion of infiltrating immune cells in the STING-high and STING-low groups of pSS and PD. Furthermore, the study demonstrated the association of the STING pathway with innate and adaptive immune cells, as well as functional cells, in the immune microenvironment of PD and pSS. ConclusionOur study uncovered a central pathway that connects mitochondrial dysfunction and the immune microenvironment in PD and pSS, potentially offering valuable insights into therapeutic targets for these conditions.

Seronegative patients with primary Sjögren's syndrome and non-pSS sicca test positive for anti-SSA/Ro52 and -Ro60 in saliva

ObjectivesTesting for anti-SSA/Ro antibodies in serum is essential in the diagnostic work-up for primary Sjögren's syndrome (pSS). In this study, we aimed to validate our previous assay for detection of salivary anti-SSA/Ro52, and to develop assays for detection of salivary anti-SSA/Ro60 and for detection of anti-Ro52 and -Ro60 in plasma using the electric field-induced release and measurement (EFIRM) platform. MethodsWhole saliva samples from two independent Danish cohorts (DN1 and DN2) including 49 patients with pSS, 73 patients with sicca symptoms, but not fulfilling the classification criteria for pSS (non-pSS sicca), and 51 healthy controls (HC), as well as plasma samples from the DN1 cohort were analyzed using EFIRM to detect anti-SSA/Ro52 and -Ro60. ResultsIn the DN1 cohort, 100 % in the pSS group and 16 % in the non-pSS sicca group were serum anti-SSA/Ro positive by ELISA. EFIRM detected anti-SSA (Ro52 and/or -Ro60) in plasma and saliva in 100 % and 96 % patients with pSS, and 16 % and 29 % with non-pSS sicca. In the DN2 cohort, 80 % patients with pSS and 26 % with non-pSS sicca were serum anti-SSA/Ro positive. Salivary anti-SSA discriminated patients with pSS from HC and non-pSS sicca with an AUC range of 0.74–0.96 in the DN1 and DN2 cohorts. EFIRM discriminated pSS from non-pSS sicca with an AUC of 0.98 in plasma. ConclusionOur findings suggest that salivary anti-SSA/Ro antibodies are potential discriminatory biomarkers for pSS, which may also identify seronegative patients, addressing the unmet clinical need of early detection and stratification of pSS.

Differentiation of submandibular sialadenitis based on apparent diffusion coefficient.

This study aimed to quantify the submandibular gland in suppurative sialadenitis, primary Sjögren's syndrome (pSS) and radiation-induced sialadenitis using the apparent diffusion coefficient (ADC) for differential diagnosis. This retrospective study included 16 patients with suppurative sialadenitis (n = 9), pSS (n = 3) and radiation-induced sialadenitis (n = 4) who underwent magnetic resonance imaging between June 2006 and May 2022. The ADC of the submandibular glands in each state was calculated, and the differences were analysed using a one-way analysis of variance and Tukey's post hoc test. Receiver operating characteristic curves were used to assess the ability of the ADC to distinguish each condition. Statistical significance was set at p < 0.05. The mean ADC value (×10-3 mm2/s) ± standard deviation in the control (non-affected side of the suppurative sialadenitis group), suppurative sialadenitis, pSS and radiation-induced groups were 0.94 ± 0.16, 1.24 ± 0.16, 1.33 ± 0.13 and 1.5 ± 0.12, respectively (p < 0.001). The diagnostic value for distinguishing each group was ≥0.75. ADC values are useful for quantitatively assessing and distinguishing submandibular glands in suppurative sialadenitis, primary Sjögren's syndrome and radiation-induced sialadenitis.

The value of MRI-based radiomics for evaluating early parotid gland injury in primary Sjögren's syndrome.

This study aimed to evaluate the value of machine learning models (ML) based on MRI radiomics in diagnosing early parotid gland injury in primary Sjögren's syndrome (pSS). A total of 164 patients (114 in the training cohort and 50 in the testing cohort) with pSS (n=82) or healthy controls (HC) (n=82) were enrolled. Itksnap software was used to perform two-dimensional segmentation of the bilateral parotid glands on T1-weighted (T1WI) and fat-suppressed T2-weighted imaging (fs-T2WI) images. A total of 1548 texture features of the parotid glands were extracted using radiomics software. A radiomics score (Radscore) was constructed and calculated. A t-test was used to compare the Radscore between the two groups. Finally, five machine learning models were trained and tested to identify early pSS parotid injury, and the performance of the machine learning models was evaluated by calculating the acceptance operating curve (ROC) and other parameters. The Radscores between the pSS and HC groups showed significant statistical differences (p<0.001). Among the five machine learning models, the Extra Trees Classifier (ETC) model performed high predictive efficacy in identifying early pSS parotid injury, with an AUC of 0.87 in the testing set. MRI radiomics-based machine learning models can effectively diagnose early parotid gland injury in primary Sjögren's syndrome.

Unveiling the age-related dynamics in Sjögren's syndrome: Insights from heart rate variability and autonomic function.

Sjögren's Syndrome (SS), mainly affecting women in their midlife, is characterized by persistent inflammation in glands producing tears and saliva, often leading to significant complications. This study investigates the differences in autonomic system functioning between individuals with SS and healthy controls. From April 2019 to December 2022, 329 diagnosed primary SS (pSS) patients and 30 healthy controls were enrolled at Taipei Veterans General Hospital, Taipei, Taiwan. The study assessed autonomic nervous system functioning using various HRV metrics. Participants were divided based on age and AECG criteria, including salivary gland biopsy and autoantibody status. Significant differences in Heart Rate Variability (HRV) were observed between pSS patients and healthy controls. The total power index was notably lower in pSS patients (4.98 ± 1.29) than in controls (5.54 ± 1.21, p = .022). Additionally, Vagal (VAG) activity was significantly reduced in the pSS group (4.95 ± 1.33) compared to the healthy control group (5.47 ± 1.19, p = .041). Age-stratified analysis highlighted that the ≤50 years pSS group had a higher heart rate (77.74 ± 10.42) compared to the >50 years group (73.86 ± 10.35, p = .005). This group also showed a higher total power index (5.78 ± 1.30) versus the >50 years group (4.68 ± 1.19, p < .001), and significantly lower VAG activity (4.70 ± 1.26, p = .007) compared to healthy controls. Furthermore, the Standard Deviation of Normal-to-Normal Intervals (SDNN) was greater in the ≤50 years SS group (44.45 ± 37.12) than in the >50 years group (33.51 ± 26.18, p = .007). In pSS patients, those positive for both salivary gland biopsy and autoantibodies demonstrated a lower Total Power (4.25 ± 1.32) and R-wave validity (93.50 ± 4.79, p < .05) than other groups, suggesting more severe autonomic imbalance. The R-R interval variation (RRIV) was also significantly higher in this dual-positive group (696.10 ± 975.41, p < .05). Additionally, the ESSPRI for dryness was markedly higher in the dual-positive group (8.10 ± 1.45, p < .05), indicating more severe symptoms. These findings reveal significant variations in autonomic function in SS patients, especially in those with dual-positive biopsy and autoantibody status. This study demonstrates significant autonomic dysfunction in pSS patients compared to healthy controls, particularly in those positive for both salivary gland biopsy and autoantibodies. The age-stratified analysis further emphasizes the impact of aging on autonomic system functioning in pSS, suggesting a need for age-specific management approaches in pSS patient care.

Gynecological symptoms in primary and secondary Sjögren's syndrome and the effect of the disease on sexuality.

Sjögren's syndrome (SS) is an autoimmune systemic disease affecting many organs and systems, such as genital system. This study aimed to present the gynecological symptoms of patients who were followed up in an outpatient clinic because of primary Sjögren's syndrome (pSS) and secondary Sjögren's syndrome (sSS) and to show how the disease affected sexuality. This study is a cross-sectional study conducted between 2019 and 2020. The study sample consisted of 60 pSS patients, 42 sSS patients, and 52 healthy control subjects. All the participants were questioned about sexuality, and completed the 36-item Short Form Survey, Hospital Anxiety and Depression Scale, Health Assessment Questionnaire, and Modified Hill questionnaire. The patients had a mean age of 55.6 ± 11.85years in pSS, 59.39 ± 11.18years in sSS, and 56.1 ± 10.46years in healthy control subjects. Vaginal and vulvar dryness and dyspareunia were present at a significantly higher rate in SS, especially in pSS, compared with the control subjects. The Health Assessment Questionnaire score was significantly lower in the pSS group than in the sSS group. Arthralgia, myalgia, and fatigue were prominent in all SS patients. Gynecological symptoms, sexual ability, and the effects of the disease on sexuality should be questioned in all SS patients. It is very important that we evaluate the gynecological symptoms of both pSS and sSS patients and the effect of the disease on these symptoms. The small number of patients and healthy control subjects is a limitation. The gynecological and musculoskeletal symptoms negatively affected sexuality in patients with pSS and sSS, and the negative effect of the disease on sexuality was more pronounced in the pSS group.

Homogeneity Gut microbiome Characteristics in Autoimmune Epithelitis: Primary Biliary Cholangitis and Primary Sjögren’s Syndrome.

Background : Accumulating studies had revealed that dysbiosis of the gut microbiome was involved in the occurrence and development of Primary biliary cholangitis (PBC) and Primary Sjögren’s syndrome (pSS). Aims : To examine the similarities and differences in gut microbiome as well as the relationship with pathogenesis in PBC and pSS. Methods : High throughput sequencing was conducted to analyze the 16S rDNA V3-V4 region of fecal microbial samples from 109 subjects including PBC (n=38), pSS (n=41) and healthy controls (HC, n=30) from the Affiliated Hospital of Qingdao University. The composition, diversity and markers of gut microbiome were compared between PBC, pSS and HC. Inter-group comparisons were conducted using analysis

CXCL9 may serve as a potential biomarker for primary Sjögren’s syndrome with extra-glandular manifestations

BackgroundPrimary Sjögren's syndrome (pSS) is an autoimmune condition that causes harm to exocrine glands and also has extra-glandular manifestations (EGM). pSS patients with EGM have a worse prognosis than those with only sicca symptoms. Previous studies have shown that the minor salivary glands (MSG) of pSS patients exhibit a unique profile of cytokines and chemokines compared to healthy controls. However, there is a lack of research comparing pSS with EGM (pSS-EGM) and pSS without EGM (pSS-non-EGM). This study aims to explore potential biomarkers associated with pSS, particularly pSS with EGM.MethodsBy utilizing RNA sequencing, we conducted an analysis on the gene expression profiles of MSG in 63 patients diagnosed with pSS, as well as 12 non-pSS individuals. Furthermore, we also investigated the MSG of pSS patients, both with and without EGM. Through bioinformatics analysis, we identified genes with differential expression (DEGs) and determined the core hub genes using PPI network. We then analyzed the top 20 DEGs and their correlation with the patients' clinical characteristics, and validated our findings using peripheral blood plasma.ResultsA total of 725 differentially expressed genes (DEGs) were identified in the comparison between pSS and non-pSS groups, and 727 DEGs were observed between pSS-EGM and pSS-non-EGM. It is noteworthy that the expression levels of CXCL9 were higher in both pSS patients and pSS-EGM when compared to the control group. Taking into consideration the significance of the top 20 DEGs in relation to clinical parameters and the central hub genes, we ultimately chose CXCL9. In comparison to the non-pSS group, pSS patients exhibited notably greater expression of the CXCL9 gene in the MSG, as well as higher levels of CXCL9 protein in their plasma (p < 0.001). Furthermore, the expression of the CXCL9 gene and levels of CXCL9 protein were notably higher in pSS patients accompanied by EGM and those with SSA antibodies. Additionally, a correlation was found between the expression of the CXCL9 gene and the EULAR Sjogren’s Syndrome Disease Activity Index (ESSDAI), as well as with immunoglobulin G (IgG) levels and erythrocyte sedimentation rate (ESR). Meanwhile, the protein levels of CXCL9 were found to be correlated with IgG levels and ESSDAI.ConclusionCXCL9 proves to be a valuable biomarker in pSS, specifically due to its strong ability to differentiate between pSS patients with EGM and those without EGM. There is a significant correlation between CXCL9 and various clinical parameters both at the gene and protein level. Therefore, CXCL9 could be a potential target for future treatment of pSS.

Meibomian gland dropout of upper eyelids as a novel biomarker for early diagnosis of primary Sjögren's syndrome: a pilot study.

Early diagnosis of primary Sjögren's syndrome (pSS) remains difficult due to its insidious onset. To identify whether meibomian gland dropout (MGD) is a sensitive and noninvasive predictor of pSS by studying its association with histopathology in labial salivary gland biopsy in patients with clinically suspected pSS. Prospective, randomized, multicenter, comparative effectiveness study. The study was conducted from July 2022 to July 2023. In all, 56 eligible participants with clinically suspected pSS were recruited from three combined ophthalmology medicine/rheumatology SS clinics. All participants with suspected pSS were evaluated and diagnosed by ophthalmology and rheumatology consultants and underwent infrared imaging of the meibomian glands using Keratograph 5M and histopathological evaluation of labial salivary gland biopsies. The length, width, and tortuosity of the meibomian glands were measured; the dropout rate in the nasal, temporal, and total eyelids was analyzed; and the dropout score was calculated using meibography grading scales. Among the 56 participants, 34 were identified with pSS, and 22 were diagnosed with non-SS dry eye (NSSDE) and served as the control group. We recorded significant differences in the temporal and total MGD rates of the upper eyelids between the pSS and NSSDE groups (all p < 0.01). Improved prediction accuracy was achieved with the temporal and total MGD rates in the upper eyelids, with area under the curve values of 0.94 and 0.91, and optimal cutoff points of 0.78 and 0.75, respectively. MGD in the upper eyelids, especially in the temporal portion, is strongly associated with the histopathological outcome of labial salivary gland biopsy in pSS and is proposed as a highly predictive and noninvasive biomarker for the early diagnosis of pSS. ClinicalTrials.gov identifier: ChiCTR2000038911.

Washable and Eco-Friendly PEDOT:PSS Coated Silk Yarn Based-Transpiration-Driven Electrokinetic Power Generator with Tremendous Energy Generation

Since the importance of eco-friendly technologies and environmental consideration has been increased gradually, energy harvesting technologies that generate electricity from ambient has been gained attentions, including a solar cell, a piezoelectric, a triboelectric, and a thermoelectric device. However, since the relative low energy generation efficiency has been considered as the obstacle, the research on a novel energy harvesting technology is necessary.A transpiration driven-electrokinetic power generator (TEPG), one of the hydro-electric nanogenerators, has been developed recently and researched due to the abundant energy resource (water), the ability to generate energy continuously, no sensitivity to ambient condition, etc. The basic concept is based on the transpiration process where the water flows from roots to leaves by water gradient in the plants. The water gradient in TEPG system is formed with dropping water at one side of the device. There are two main components, including a conductive material and a hydrophilic substrate. The conductive materials with high surface area capture the cations in solution to decrease a surface energy, leading to formation of the electrical double layer. The hydrophilic substrate promotes the flow of solution along the substrate, leading to the transfer of electrons in the conductive material.Herein, we utilize the PEDOT:PSS as conductive material and silk yarn as hydrophilic material. A silk yarn is a natural and biodegradable material with the high mechanical properties, lightweight, and biocompatibility. PEDOT:PSS is promising candidate for TEPG device because its negative charged PSS groups attract the cations selectively via electrostatic interaction, leading to the increase of potential difference between wet/dry region. However, the low washing resistance of PEDOT:PSS is the limitation for practical wearable devices since the cleanness is essential. During the cleaning process, the PEDOT:PSS is easily detached from the substrate. Therefore, the research on the PEDOT:PSS with sufficient water resistance is essential for its wider utilization. In general, an ethylene glycol (EG) is commonly used for improving water resistance of PEDOT:PSS through hydrogen bonding with PSS parts. However, it is also known as the agent to enhance electrical conductivity via removal of excess PSS. Thus, we introduce the divinyl sulfone (DVS) as a covalently cross-linker for enhancing washing resistance of PEDOT:PSS. In this work, we compare the energy generation performance and washing resistance of various PEDOT:PSS coated TEPGs without and with EG or DVS, named as PS-TEPG, PES-TEPG, and PDS-TEPG, respectively.