QUANTITATIVE ASSESSMENT OF SALIVARY-GLAND INFLAMMATORY INFILTRATION IN PRIMARY SJOGRENS-SYNDROME - ITS RELATIONSHIP TO DIFFERENT DEMOGRAPHIC, CLINICAL AND SEROLOGICAL FEATURES OF THE DISORDER

The aim of this study was to investigate the possible relationship bet ween the degree of inflammatory infiltration of salivary glands in Sjo gren's syndrome (SS) and the different demographic, clinical and serol ogical features of the disease. A quantitative assessment of the exten sion of the infiltrates was performed on histology samples from the la bial salivary glands (LSG) of 82 patients with primary SS, by calculat ing the ratio of the infiltrated area to the total area of glandular t issue in the samples. The correlations between the amount of inflammat ory infiltrate and the main features of the disorder were then analyse d. A significant negative correlation between the degree of LSG infilt ration and the patient's age at disease onset was observed (P < 0.05). In contrast, the percentage of infiltrate did not correlate with the disease duration. A significant correlation was found between the degr ee of infiltration of the salivary tissue and (i) the total number of extraglandular features (P < 0.01) and (ii) the presence of specific e xtraglandular features such as Raynaud's phenomenon (P < 0.05), vascul itis (P < 0.0001), lymph node or spleen enlargement (P < 0.05) and leu copenia (P < 0.02). Finally, patients with antinuclear antibodies, ant i-SSA/Ro antibodies, or anti-SSA/Ro plus anti-SSB/La antibodies showed a more widespread inflammatory infiltration in the LSG tissue than pa tients without these autoantibodies (P < 0.01). The degree of infiltra tion in the salivary tissue was significantly greater in those patient s with anti-SSA/Ro plus anti-SSB/La antibodies in their sera than in p atients with anti-SSA/Ro antibodies alone (P < 0.05). In conclusion, p atients with SS and active inflammatory infiltration of the salivary g lands usually experience an earlier disease onset and a larger number of systemic extraglandular manifestations. In addition, the antibodies directed against certain nuclear/cytoplasmic specificities, and parti cularly those which react with the SSB/La antigen, seem to play a key role in enhancing the autoimmune process in the salivary glands.