Value of Somatostatin Receptor Scintigraphy with 99mTc-HYNIC-TOC in Patients with Primary Sjögren Syndrome

Objectives: Primary Sjögren syndrome (SS) is diagnosed based on the American European Consensus Group (AECG) criteria, but lacks specificity, not only in the involvement of salivary glands, but also in extra-glandular involvement. Whole-body somatostatin receptor scintigraphy with 99mTc-HYNIC-TOC scintigraphy could overcome these limitations. The aims of this study were to evaluate salivary gland uptake of 99mTc-HYNIC-TOC in untreated patients with de-novo diagnosis of SS as compared to control subjects and as compared to conventional sialoscintigraphy with 99mTcO4−. We also aimed to evaluate the involvement of joints. Methods: 99mTc-HYNIC-TOC was used with SS patients and uptake in joints and salivary glands was analyzed semi-quantitatively. Patients also underwent 99mTcO4 sialoscintigraphy. The control group that we analyzed consisted of 30 patients with neuroendocrine tumors. Results: Fifty-two females and 10 males fully met the AECG criteria for SS, and were included. A target background ratio (TBR) >1.18 in submandibular glands correctly classified 93% of the patients with SS in comparison to 27% for 99mTcO4 sialoscintigraphy. The area under the curve (ROC) analysis for TBR in submandibular glands was 0.95. In joints there was a huge variety in uptake. The median TBR was significantly higher in salivary glands in patients with SS compared to controls. Conclusions: 99mTc-HYNIC-TOC scintigraphy identified active inflammatory processes not only in the salivary glands, but, unexpectedly, also in many joints in patients with primary SS, contrary to popular belief. This technique provides an objective parameter to evaluate the inflammation burden in salivary glands and joints and could be used to evaluate response to treatment.

Download Full-text

Role of Fractalkine in the Pathogenesis of Primary Sjögren Syndrome: Increased Serum Levels of Fractalkine, Its Expression in Labial Salivary Glands, and the Association with Clinical Manifestations

The Journal of Rheumatology ◽

10.3899/jrheum.130892 ◽

2014 ◽

Vol 41 (12) ◽

pp. 2425-2438 ◽

Cited By ~ 7

Author(s):

Jae Ho Lee ◽

Seung-Ki Kwok ◽

Seung Min Jung ◽

Jennifer Lee ◽

Jae-Seon Lee ◽

...

Keyword(s):

Epithelial Cells ◽

Confocal Microscopy ◽

Salivary Glands ◽

Proinflammatory Cytokines ◽

Sjögren Syndrome ◽

Control Group ◽

Sjogren Syndrome ◽

Clinical Effects ◽

Extraglandular Manifestations ◽

Primary Sjögren Syndrome

Objective.To investigate the expression of fractalkine and identify the clinical effects of fractalkine and its receptor (CX3CR1) in patients with primary Sjögren syndrome (pSS).Methods.Serum fractalkine levels were determined by ELISA. Immunohistochemical staining was done to compare the expression of fractalkine and CX3CR1 between salivary glands (SG) of patients with SS and controls. The cells to be merged with fractalkine were evaluated by confocal microscopy. Type of CX3CR1-expressing cells among infiltrating lymphocytes in SG was analyzed by confocal microscopy. Further, associations among fractalkine, proinflammatory cytokines, and clinical profiles were investigated.Results.Serum fractalkine levels in patients with pSS were higher than those in the control group (p = 0.026). SG expression of fractalkine and its receptor was upregulated in patients with pSS compared to that in the controls by immunohistochemistry. Higher histological grade was associated with more fractalkine-positive cells per total epithelial cells. Epithelial cells were the main fractalkine-expressing cell type in the SG. Serum fractalkine levels were significantly correlated with proinflammatory cytokines levels (interleukin 17: r = 0.685, p = 0.029; tumor necrosis factor-α: r = 0.444, p = 0.003), antinuclear antibody (r = 0.349, p = 0.022), and immunoglobulin G levels (r = 0.325, p = 0.044). Serum fractalkine levels in patients with extraglandular manifestations of pSS were significantly higher than in those without extraglandular manifestations (p = 0.026).Conclusion.Fractalkine and CX3CR1 may play a role in the pathogenesis of pSS, including extraglandular manifestations.

Download Full-text

IS THERE AN EARLY ULTRASONOGRAPHIC PATTERN IN SALIVARY GLANDS IN BOTH PRIMARY AND SECONDARY SJÖGREN SYNDROME?

Romanian Journal of Rheumatology ◽

10.37897/rjr.2017.1.6 ◽

2017 ◽

Vol 26 (1) ◽

pp. 30-37

Author(s):

Vasilia Iorgoveanu ◽

◽

Violeta Bojinca ◽

Madalina Gheorghe ◽

Diana Mazilu ◽

...

Keyword(s):

Parotid Gland ◽

Salivary Glands ◽

Early Period ◽

Sjögren Syndrome ◽

Biological Data ◽

Inflammatory Disorder ◽

Sjogren Syndrome ◽

Parotid Glands ◽

Submandibular Glands ◽

Left And Right

Background. Sjögren syndrome (SS) is a systemic chronic inflammatory disorder characterized by lymphocytic infiltrates in exocrine organs. Ultrasonography (US) demonstrates specificity and sensibility in major salivary glands (SG) evaluation. Recent data confirm US might be used as primary evaluation technique for its ability to show structural alterations of parenchyma (1). Objective. To assess the gray scale (GS) parenchymal inhomogeneity of major SG in patients with established primary and secondary SS and correlate with clinical and biological data. Methods. Consecutive patients with SS were recruited and SG US was performed. Inhomogeneity of glandular parenchyma was quantified binary on each gland. ESSDAI and ESSPRI scores were calculated. Statistics was performed with SPSS. Results. Twenty one (42.85% primary SS, 90.47% female) consecutive patients were included. Mean age was 53.66+/-12.99 years and disease duration 5.33+/-3.74 years. Antibody SSA/SSB presence was found in 85.7% (18/21). ESSDAI mean was 8.67+/-8.9 (0-29), ESSPRI 10.13+/-5.59(0-20). There were no differences regarding ESSDAI and ESSPRI in the two groups (primary and secondary SS). Right parotid gland showed alterations in 71.4% patients (77% with primary SS, 66% with secondary SS). Frequently inhomogeneity was found in all major SG (33%, 22% left and right submandibular, 77%, 44.4% left and right parotid glands) in primary SS. Both submandibular glands were symmetrically involved (p<0.02). Duration of disease was negatively correlated to inhomogeneity of right parotid gland (p<0.02). Conclusion. Inhomogeneity in major SG in GS US was found in the majority of patients with primary and secondary SS. The symmetrical involvement of submandibular glands was significant. The inhomogeneity appears in the early period of diagnosis. No major differences were found between two groups.

Download Full-text

The role of albumin-to-globulin ratio in undifferentiated arthritis: Rheumatoid arthritis versus primary Sjögren syndrome

Archives of Rheumatology ◽

10.46497/archrheumatol.2022.8742 ◽

2021 ◽

Author(s):

Reyhan Köse Çobanoglu ◽

Taşkın Şentürk

Keyword(s):

Rheumatoid Arthritis ◽

Sjögren Syndrome ◽

Control Group ◽

Sjogren Syndrome ◽

Healthy Controls ◽

Undifferentiated Arthritis ◽

Characteristic Analysis ◽

Primary Sjögren Syndrome ◽

Significant Difference ◽

Albumin To Globulin Ratio

Objectives: This study aims to compare initial albumin-to-globulin ratio (AGR) in patients with rheumatoid arthritis (RA) and primary Sjögren syndrome (pSS) presenting with undifferentiated arthritis (UA) and to investigate whether there was a difference in terms of AGR between the two patient groups and healthy controls. Patients and methods: Between January 2019 and December 2019, a total of 177 patients including 96 RA (10 males, 86 females; mean age: 53.6±10.8 years; range, 21 to 74 years) and 81 pSS (5 males, 76 females; mean age: 53.2±14.1 years; range, 23 to 79 years) and 82 healthy controls (20 males, 62 females; mean age: 50.5±13.6 years; range, 20 to 79 years) were included in this case-control study. Demographic characteristics, albumin, and globulin levels of all participants were recorded. The AGR, erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), rheumatoid factor (RF), anti-nuclear antibody (ANA), and anti-citrullinated protein antibodies (ACPA) were assessed. Results: The mean AGR was 1.50±0.16 in the control group, 1.48±0.24 in the RA group, and 1.30±0.23 in the pSS group, indicating a significant difference between the pSS and the other two groups (p<0.001). The receiver operating characteristic analysis revealed that the cut-off value for AGR was 1.39 (area under the curve=0.736) with a sensitivity of 0.642 and a specificity of 0.646 (p<0.001). The ESR and CRP values were higher (p<0.001), and ANA (p<0.001) and RF (p=0.003) positivity were lower in the RA group, compared to the pSS group. Conclusion: This study findings indicate that AGR is a helpful tool in the differential diagnosis of RA and pSS presenting with UA at the time of admission, and Sjögren syndrome should be considered in case of AGR ≤1.39.

Download Full-text

The Interleukin 33/ST2 Axis in Patients with Primary Sjögren Syndrome: Expression in Serum and Salivary Glands, and the Clinical Association

The Journal of Rheumatology ◽

10.3899/jrheum.140234 ◽

2014 ◽

Vol 42 (2) ◽

pp. 264-271 ◽

Cited By ~ 8

Author(s):

Seung Min Jung ◽

Jaeseon Lee ◽

Seung Ye Baek ◽

Jae Ho Lee ◽

Jennifer Lee ◽

...

Keyword(s):

Salivary Glands ◽

Activity Index ◽

Disease Activity Index ◽

Serum Levels ◽

Interferon Γ ◽

Sjögren Syndrome ◽

Epithelial Cell Line ◽

Sjogren Syndrome ◽

Interleukin 33 ◽

Primary Sjögren Syndrome

Objective.To evaluate the expression of interleukin 33 (IL-33) and its receptor in sera and salivary tissues of patients with primary Sjögren syndrome (pSS), and to investigate the association with clinical profiles.Methods.Serum IL-33 and soluble ST2 (sST2) of 55 patients with pSS and 48 controls were determined by ELISA and assessed for clinical correlation. The expression of IL-33/ST2 in salivary tissues was investigated by immunohistochemical staining and was further characterized by confocal microscopy. We also measured IL-33 production in salivary glandular epithelial cells by proinflammatory stimuli.Results.Serum levels of IL-33 and sST2 were higher in patients with pSS compared to those in controls (p = 0.018 and p < 0.0001, respectively). Among patients with pSS, sST2 concentration was associated with thrombocytopenia (p = 0.029) and correlated with disease duration (p = 0.013) and the European League Against Rheumatism Sjögren Syndrome Disease Activity Index (p = 0.042). The expression of IL-33 and ST2 was elevated in salivary glands of patients with pSS with grade 2 inflammation, and diminished in advanced inflammation. In patients with pSS, IL-33 was mainly observed in epithelial and endothelial cells of glandular tissue. The production of IL-33 mRNA by salivary gland epithelial cell line increased under stimulation with interferon-γ.Conclusion.The expression of IL-33 and its receptor was elevated in sera and salivary tissues of patients with pSS. These results suggest that the IL-33/ST2 axis might have a role in the pathogenesis of pSS.

Download Full-text

Activation of Nitric Oxide Signaling through Muscarinic Receptors in Submandibular Glands by Primary Sjögren Syndrome Antibodies

Clinical Immunology ◽

10.1006/clim.1998.4640 ◽

1999 ◽

Vol 90 (2) ◽

pp. 190-195 ◽

Cited By ~ 17

Author(s):

Claudia Pérez Leirós ◽

Leonor Sterin-Borda ◽

Osvaldo Hubscher ◽

Roberto Arana ◽

Enri S. Borda

Keyword(s):

Nitric Oxide ◽

Muscarinic Receptors ◽

Sjögren Syndrome ◽

Sjogren Syndrome ◽

Submandibular Glands ◽

Nitric Oxide Signaling ◽

Primary Sjögren Syndrome

Download Full-text

Central sensitisation in primary Sjögren Syndrome and its effect on sleep quality

Modern Rheumatology ◽

10.1093/mr/roab075 ◽

2021 ◽

Author(s):

Burcu Metin Ökmen ◽

Koray Ayar ◽

Lale Altan ◽

Özgür Yeşilöz

Keyword(s):

Sleep Quality ◽

Quality Index ◽

Pittsburgh Sleep Quality Index ◽

Demographic Data ◽

Sjögren Syndrome ◽

Control Group ◽

Sjogren Syndrome ◽

Central Sensitisation ◽

Primary Sjögren Syndrome ◽

Significant Difference

ABSTRACT Objective The aim of the present study is to evaluate the presence and frequency of central sensitisation (CS) in primary Sjögren Syndrome (pSS) and to determine the effect of CS on sleep quality. Materials and Methods In this cross-sectional study, 50 patients diagnosed with pSS between the ages of 18 and 75 were included. The healthy control group was composed of 43 healthcare workers. Each participant underwent a physical examination, and demographic data and the medications they used were recorded. Central sensitisation inventory and Pittsburgh Sleep Quality Index questionnaires were filled in to garner data on CS and sleep quality, respectively, from all participants. Results While central sensitisation inventory >40 was detected in 74% of pSS patients, it was 25.6% in healthy controls, and there is a statistically significant difference between the groups (p < .05). A correlation analysis of the central sensitisation inventory and Pittsburgh Sleep Quality Index values of all participants revealed a statistically significant correlation between all parameters other than the duration of sleep (p < .05). Conclusions CS was found to have a negative effect on sleep quality in patients with pSS. We suggest that the cause of widespread pain seen in patients with pSS as the possible development of CS should be considered.

Download Full-text