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Salivary gland and peripheral blood T helper 1 and 2 cell activity in Sjögren’s syndrome compared with non-Sjögren’s sicca syndrome

J M van Woerkom¹, A A Kruize¹, M J G Wenting - van Wijk¹, E Knol², I C Bihari², J W G Jacobs¹, J W J Bijlsma¹, F P J G Lafeber¹, J A G van Roon¹

¹ Department of Rheumatology and Clinical Immunology, University Medical Centre Utrecht, The Netherlands
² Department of Dermatology/Allergology, University Medical Centre Utrecht, The Netherlands

Correspondence to:
Mr J M van Woerkom
Department of Rheumatology and Clinical Immunology, University Medical Centre Utrecht, The Netherlands, PO Box 85500, 3508 GA Utrecht, The Netherlands; j.vanwoerkom{at}azu.nl

Objectives: To investigate whether differences in T helper (Th) 1 and Th2 cell activity in salivary glands ("local") or ("peripheral") blood can discriminate between Sjögren’s syndrome (SS) and non-Sjögren’s sicca syndrome (nSS-sicca). Additionally, to study relationships of local and peripheral Th cell activities with each other and with disease activity measures.

Methods: 62 sicca patients (32 with SS, 30 with nSS-sicca) were studied. Local Th1 (interferon (IFN)) and Th2 (interleukin (IL) 4) activity were determined using immunohistochemistry. T cell production of IFN and IL4 in peripheral blood (PB) was determined by ELISA. Erythrocyte sedimentation rate (ESR) and serum IgG were considered disease activity measures.

Results: ESR and serum IgG were higher in patients with SS than in patients with nSS-sicca. Local Th1 cell activity was higher and PB Th1 activity lower in patients with SS than in those with nSS-sicca. Th2 cell activity did not differ significantly between the patient groups. The ratio IFN/IL4 was higher in salivary glands and lower in PB in patients with SS than in patients with nSS-sicca. Local and peripheral Th1 and Th2 cell activities correlated with ESR and serum IgG levels. ESR, serum IgG, and local or peripheral Th1 or Th2 cell activity did not discriminate between patients with SS and nSS-sicca.

Conclusions: An imbalance between Th1 and Th2 activity in sicca patients is clearly related to the severity of disease, but cannot be used to distinguish between patients with SS and those with nSS-sicca.

Abbreviations: DMEM, Dulbecco’s modified Eagle’s medium; ESR, erythrocyte sedimentation rate; IFN, interferon ; IL, interleukin; nSS-sicca, non-Sjögren’s sicca syndrome; PB, peripheral blood; PBS, phosphate buffered saline; pSS, primary Sjögren’s syndrome; RA, rheumatoid arthritis; SG, salivary gland; SLE, systemic lupus erythematosus; SS, Sjögren’s syndrome; sSS, secondary Sjögren’s syndrome; Th, T helper

Keywords: Sjögren’s syndrome; sicca syndrome; T helper cells; peripheral blood; salivary glands

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