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

Jan Maarten van Woerkom ^1*, Aike A Kruize ¹, Marion JG Wenting - van Wijk ¹, Edward Knol ¹, Ilse C Bihari ¹, Johannes WG Jacobs ¹, Johannes WJ Bijlsma ², Floris PJG Lafeber ¹ and Joel AG van Roon ¹

¹ University Medical Center Utrecht, Netherlands
² UMC Utrecht, Netherlands

^* To whom correspondence should be addressed. E-mail: j.vanwoerkom{at}azu.nl.

Accepted 15 March 2005

Abstract

Objectives: To investigate whether differences in T helper (Th) 1 and Th2 cell activity in salivary glands ('local') or ('peripheral') blood could discriminate Sjögren's syndrome (SS) from non-Sjögren's sicca syndrome (nSS-sicca). Moreover, relationships of local and peripheral Th activities to each other and to disease activity parameters were studied.

Methods: Sixty-two sicca patients (32 SS and 30 nSS-sicca patients) were studied. Local Th1 (IFNg) and Th2 (IL-4) activity were determined using immunohistochemistry. T cell production of IFNg and IL-4 in peripheral blood was determined by ELISA. Erythrocyte Sedimentation Rate (ESR) and serum IgG were considered disease activity parameters.

Results: ESR and serum IgG were higher in SS patients compared to nSS-sica pcatients. Local Th1 cell activity was higher whereas peripheral blood Th1 activity was lower in SS compared to nSS-sicca patients. Th2 cell activity was not significantly different between both patients groups. The ratio IFNg over IL-4 was higher in salivary glands and lower in PB in SS patients compared to nSS-sicca patients. Local and peripheral Th1 and Th2 cell activities correlated with ESR and serum IgG levels. However, neither ESR, serum IgG nor local or peripheral Th1 or Th2 cell activity discriminated between SS and nSS-sicca patients.

Conclusions: This study is the first to describe both local and peripheral Th cell activity in SS compared to nSS-sicca patients. Results demonstrate that an imbalance between Th1 and Th2 activity in sicca patients is clearly related to severity of disease, but cannot be used to discriminate between SS versus nSS- sicca patients.

Keywords: Sjögren's syndrome, T helper cells, peripheral blood, salivary glands, sicca syndrome

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