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Microchimerism in Sjögren's syndrome
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  1. R Giacomelli1,
  2. M Matucci-Cerinic2,
  3. S Bombardieri3
  1. 1Internal Medicine, University of L'Aquila, School of Medicine, Italy
  2. 2Internal Medicine, University of Florence, School of Medicine, Rheumatology, Italy
  3. 3University of Pisa, School of Medicine, Italy
  1. Correspondence to:
    Professor R Giacomelli, Department of Internal Medicine, University of L'Aquila, School of Medicine, via Vetoio, 67100 L'Aquila, Italy;
    roberto.giacomelli{at}cc.univaq.it

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The evidence of microchimerism both lends support to and raises doubts about its specific role in SS

The advent of molecular biology techniques has led to the recognition that cells travel in both directions between mother and fetus. Fetal stem cells traverse the placenta and may persist in the maternal circulation for decades. Similarly, maternal cells may pass into the fetal circulation and persist into adult life.1 The persistence of genetically different cells in the same person has been called chimerism. When low levels of donor cells are present the term microchimerism is applied.

Clinical and immunological features of different autoimmune diseases strikingly resemble chronic graft versus host disease, which occurs in some patients after allogeneic bone marrow transplantation, a known condition of chimerism.2 The recent finding that increased amounts of fetal cells, which persisted after pregnancy, can be detected in autoimmune diseases3–8 has raised the possibility that an allogeneic process rather than an autologous breakdown in self tolerance may be involved in the pathogenesis of these diseases.9

Microchimerism has recently been investigated in Sjögren's syndrome (SS),10–15 a disease in which some histological patterns mirror the lesions seen in chronic graft versus host disease. In this issue of the Annals Kuroki and coworkers present their data concerning the presence of maternal fetal microchimeric cells in the salivary glands and lung tissue from 56 female patients with SS, 36 with primary SS, and 20 with SS associated with another autoimmune disease.16 Using both nested polymerase chain reaction (PCR) and fluorescence in situ hybridisation (FISH) techniques, they showed that male DNA were present in 10/28 …

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