Concise reports
Immunohistochemistry of minor salivary gland biopsy specimens
from patients with Sjögren's syndrome with and without hepatitis C
virus infection
a Department of Medicine,
Hospital del Mar-IMIM,
Barcelona, Spain , b Department of Medicine,
Hospital General Universitari de la Vall
d'Hebrón, Universidad Autónoma de
Barcelona, Barcelona, Spain
Correspondence to: Professor J Coll, Department of Medicine, Hospital del Mar, Paseo Marítimo 25-29, 08003 Barcelona, Spain.
Accepted for publication 10 March 1997
OBJECTIVES
To characterise phenotypically the
minor salivary glands of patients with clinical and histological
features of Sjögren's syndrome (SS) infected with hepatitis C virus (HCV).
PATIENTS AND METHODS75 consecutive patients
with SS (31 primary SS, 44 secondary SS) diagnosed by preliminary
European classification criteria. The presence of anti-HCV antibodies
was detected by commercial third generation ELISA and by a second
generation immunoblot assay. Presence of HCV genome in serum was
determined by polymerase chain reaction analysis. Expression of CD3,
CD4, CD8, CD20, HLA-DR, and CD25 molecules in lymphocytic and
epithelial cells on minor salivary glands was detected by
immunohistochemical assays. Expression of interferon 
and
interleukin 4 cytokines was determined by in situ hybridisation.
RESULTSSix of 31 primary SS (19%) and one of
44 secondary SS (2%) serum samples were positive for anti-HCV by
ELISA. Three samples were positive, three indeterminate, and one sample
corresponding to a secondary SS patient was negative by immunoblot. The
three immunoblot positive serum samples were also HCV-RNA positive by PCR assay. The study of lymphocytic cells in the diffuse infiltrate of
minor salivary glands showed a predominance of the CD3 lymphocytic population. A predominance of CD4 over CD8 T cells (ratio 2:1) was
observed in HCV and non- HCV infected patients. The analysis of the
lymphocytic focus showed that the HCV infected patients had a
predominance of CD20 positive cells. Activation molecules ( CD-25 and
HLA-DR ) were expressed in HCV and non-HCV infected patients in
lymphocytic and epithelial cells, however epithelial cell expression of
CD25 was low in HCV infected patients. As expected, a pronounced Th1
response was observed in the lymphocytic foci of HCV patients.
CONCLUSIONSHCV infected patients may develop an
autoimmune sialadenitis, similar to that described in primary SS.
© 1997 by Annals of the Rheumatic Diseases
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