J Korean Med Sci.  2016 Feb;31(2):190-195. 10.3346/jkms.2016.31.2.190.

The Significance of Ectopic Germinal Centers in the Minor Salivary Gland of Patients with Sjogren's Syndrome

Affiliations
  • 1Division of Rheumatology, Department of Internal Medicine, Chonnam National University Medical School & Hospital, Gwangju, Korea. shinseok@chonnam.ac.kr
  • 2Department of Ophthalmology, Chonnam National University Medical School & Hospital, Gwangju, Korea.
  • 3Department of Pathology Chonnam National University Medical School & Hospital, Gwangju, Korea.

Abstract

We investigated the clinical and biological significance of germinal centers (GC) present in the minor salivary glands of patients with Sjogren's syndrome (SS). Minor salivary gland tissue biopsies from 93 patients with SS were used to identify GC-like structures, which were confirmed by CD21-positive follicular dendritic cell networks. Patients were compared based upon sociodemographics, glandular and extraglandular manifestations, and laboratory findings including autoantibody profiles, complement, and immunoglobulin levels; EULAR SS disease activity index (ESSDAI) and SS disease damage index (SSDDI) were also measured. GC-like structures were observed in 28 of 93 SS patients (30.1%). Mean focus scores and CRP levels were significantly higher in GC-positive patients than in GC-negative patients; GC-positive patients also exhibit a higher prevalence of rheumatoid factor and anti-SS-A/Ro antibodies compared to GC-negative patients. No differences in glandular or extra-glandular manifestations were evident between groups. In conclusion, SS patients with GC-like structures in the minor salivary glands exhibited laboratory profiles significantly different from those of their GC-negative counterparts. Long-term follow-up of these patients will be necessary to determine whether these laboratory abnormalities are predictive of clinical outcomes.

Keyword

Germinal Center; Sjogren's Syndrome; Biopsy; Salivary Glands

MeSH Terms

Adult
Autoantibodies/blood
C-Reactive Protein/analysis
Demography
Female
Germinal Center/*pathology
Humans
Immunohistochemistry
Male
Middle Aged
Receptors, Complement 3d/metabolism
Retrospective Studies
Salivary Glands, Minor/*pathology
Sjogren's Syndrome/immunology/metabolism/*pathology
Autoantibodies
C-Reactive Protein
Receptors, Complement 3d

Figure

  • Fig. 1 Immunohistochemical staining of minor salivary gland tissue from a patient with Sjögren’s syndrome. Germinal center was identified by morphology in H&E and confirmed by the positivity of CD21.


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