scholarly journals Salivary Gland Ultrasonography in Sjögren's Syndrome: A European Multicenter Reliability Exercise for the HarmonicSS Project

2020 ◽  
Vol 7 ◽  
Author(s):  
Alen Zabotti ◽  
Sara Zandonella Callegher ◽  
Annarita Tullio ◽  
Arso Vukicevic ◽  
Alojzija Hocevar ◽  
...  
Keyword(s):  
Salivary Gland ◽  
Sjögren’S Syndrome ◽  
Sjögren's Syndrome ◽  
Scoring Systems ◽  
Sjogren’S Syndrome ◽  
Sjogren's Syndrome ◽  
Rater Reliability ◽  
Significant Difference ◽  
Different Levels ◽  
Sjögren‘S Syndrome

Objectives: Salivary gland ultrasonography (SGUS) is increasingly applied for the management of primary Sjögren's syndrome (pSS). This study aims to: (i) compare the reliability between two SGUS scores; (ii) test the reliability among sonographers with different levels of experience.Methods: In the reliability exercise, two four-grade semi-quantitative SGUS scoring systems, namely De Vita et al. and OMERACT, were tested. The sonographers involved in work-package 7 of the HarmonicSS project from nine countries in Europe were invited to participate. Different levels of sonographers were identified on the basis of their SGUS experience and of the knowledge of the tested scores. A dedicated atlas was used as support for SGUS scoring.Results: Twenty sonographers participated in the two rounds of the reliability exercise. The intra-rater reliability for both scores was almost perfect, with a Light's kappa of 0.86 for the De Vita et al. score and 0.87 for the OMERACT score. The inter-rater reliability for the De Vita et al. and the OMERACT score was substantial with Light's Kappa of 0.75 and 0.77, respectively. Furthermore, no significant difference was noticed among sonographers with different levels of experience.Conclusion: The two tested SGUS scores are reliable for the evaluation of major salivary glands in pSS, and even less-expert sonographers could be reliable if adequately instructed.

Autoantibody and Biopsy Grading Are Associated with Expression of ICAM-1, MMP-3, and TRAIL in Salivary Gland Mononuclear Cells of Chinese Patients with Sjögren’s Syndrome

2009 ◽  
Vol 36 (5) ◽  
pp. 989-996 ◽  
Author(s):  
WEI-SHENG CHEN ◽  
KUAN-CHIA LIN ◽  
CHUN-HSIUNG CHEN ◽  
HSIEN-TZUNG LIAO ◽  
HON-PIN WANG ◽  
...  
Keyword(s):  
Salivary Gland ◽  
Sjögren’S Syndrome ◽  
Mononuclear Cells ◽  
Sjögren's Syndrome ◽  
Sjogren’S Syndrome ◽  
Sjogren's Syndrome ◽  
Cell Infiltration ◽  
Significant Difference ◽  
Grade Iii ◽  
Sjögren‘S Syndrome

Objective.Sjögren’s syndrome (SS) is an inflammatory autoimmune disease. We investigated important factors associated with the expression of inflammation-related molecules in minor salivary gland (MSG) mononuclear cells in patients with SS.Methods.Thirty-four patients with SS with a MSG biopsy grading of either grade III (10 patients) or grade IV (24 patients) were enrolled. The age, sex, autoantibodies, cell infiltration, and intercellular adhesion molecule-1 (ICAM-1), matrix metalloproteinase-3 (MMP-3), tumor necrosis factor-related apoptosis-inducing ligand (TRAIL), or CXCR3 expression were also analyzed.Results.Ten of the 34 patients with SS were diagnosed with secondary SS; in these patients, the diagnosis of rheumatoid arthritis was confirmed in 8 and systemic lupus erythematosus in 2. TRAIL and ICAM-1 were overexpressed in patients with antinuclear antibodies (ANA) > 1:160, compared to those with titer < 1:160 (45.1 ± 4.4 vs 41.2 ± 3.9, p = 0.021, and 15.2 ± 5.7 vs 10.8 ± 3.3, p = 0.018, respectively). Higher erythrocyte sedimentation rate (ESR; ≥ 20) was associated with higher TRAIL expression and CD20 cell infiltration in contrast to lower ESR (< 20; p < 0.05). ICAM-1, TRAIL, and MMP-3 were expressed more predominantly in anti-SSA-positive than in anti-SSA-negative patients with SS. There was a significant difference in CD20 cell infiltration and MMP-3 expression between primary SS and secondary SS. Biopsy of a grade IV showed a significantly increased expression of TRAIL (44.9 ± 4.5 vs 40.8 ± 3.6, p = 0.013) and MMP-3 (62.7 ± 6.3 vs 54.4 ± 7.3, p = 0.003) in mononuclear cells as compared to those of grade III.Conclusion.In our study, pathologic grading with a higher grade (grade IV) and the presence of SSA or a higher titer of ANA were significantly associated with the overexpression of TRAIL, MMP-3, or ICAM-1 in the salivary gland mononuclear cells in patients with SS.

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