Η σιελομετρία και ανίχνευση αντισωμάτων στο σίελο, ως διαγνωστικές παράμετροι στο σύνδρομο Sjogren
Sjogren's syndrome (Ss) is an autoimmune disease of unknown etiology characterized by severe dysfunction of the exocrine glands, including the salivary glands resulting in xerostomia. The hyperreactivity of the immune system is an integral component of primary Ss (1oSs), as exemplified by various serum autoantibodies [including antibodies to Ro(SSA) and La(SSB) cellular antigens] and the infiltration of the exocrine glands by activated lymphocytes. Previous studies have shown that these infiltrating lymphocytes produce large amounts of immunoglobulins and rheumatoid factors, however, the production of antibodies to Ro(SSA) and La (SSB) antigens has not been verified. The evaluation of xerostomia in 1oSs patients includes the estimation of the stimulated parotid flow rate. However, the diagnostic significance of these tests remains unclear. In addition, there is wide variation between the different investigators regarding the selection of the lower normal cut-off levels of these parameters. In this study, we sought to determine the reliability of the stimulated parotid and unstimulated whole saliva flow rates as diagnostic tests of xerostomia, in 81 1oSs patients, as well as in 188 sex and age matched healthy individuals in 1oSs. Further, we examined the presence of antibodies to Ro(SSA) and La(SSB) cellular antigens in paired samples of serum and whole saliva from 42 1oSs patients and 43 healthy individuals, attempting to investigate the origin of the autoantibodies in 1oSs and the diagnostic value of testing for autoantibodies in saliva. It was demonstrated that in more than 50% of healthy individuals the saliva flow rates are significantly reduced, resembling 1oSs. This finding indicates the non-specificity of the saliva flow rate tests for the evaluation of xerostomia and strongly suggests that these parameters are not valuable for the clinical evaluation of 1oSs patients. We were able to identify the presence of autoantibodies to Ro(SSA) and La(SSB) in the saliva samples of the majority (92%) of patients who had also autoantibodies in serum. However, the saliva samples of these patients contained increased amounts of albumin (increased albumin ratio of saliva/serum) indicating that leakage from blood to saliva due to gingival inflammation is undoubtfully implicated in the presence of autoantibodies in the saliva of 1oSs patients.
Ανοσολογικοί παράμετροι στο σίελο, Αυτοαντισώματα, Ξηροστομία, Σιελογόνοι αδένες, Σιελομετρία, Σίελος, Σιελοχημεία, Σύνδρομο Sjogren, Autoantibodies, Immunological parameters in the saliva, Saliva, Salivary glands, Sialochemistry, Sialometry, Sjogren's syndrome, Xerostomia, Ιατρική και Επιστήμες Υγείας, Κλινική Ιατρική, Medical and Health Sciences, Clinical Medicine
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