DIFFERENTIAL IMMUNOLOGICAL ABERRATIONS IN PATIENTS WITH PRIMARY AND SECONDARY SJOGRENS-SYNDROME

The aim of the present study was to analyse possible differences in im munological features between patients with primary and secondary Sjogr en's syndrome (SS). Ten patients with primary SS and 10 patients with secondary SS also suffering from rheumatoid arthritis, were identified according to established criteria for SS. Ten healthy, age-matched wo men served as controls. The authors analysed the phenotypic characteri stics of lymphocytes in peripheral blood as well as in focal inflammat ory infiltrates of minor salivary gland biopsies. Functional analyses of T lymphocytes were performed after stimulation with mitogens and an tigen. B cell activity was determined at the single cell level by spon taneous and mitogen induced immunoglobulin production. Serum levels of IL-4, IL-6 and IFN-gamma were also analysed. Patients with primary SS displayed a significantly higher degree of salivary gland inflammatio n and reduced salivary flow than did patients with secondary SS. Decre ased in vitro T cell responses to antigen and mitogens were evident in both patient groups. The CD4/CD8 ratios in both peripheral blood and salivary gland lesions were significantly lower in primary SS compared with secondary SS patients. Polyclonal B cell activation, measured as the frequency of spontaneous immunoglobulin producing cells, was most prominent in primary SSI whereas a diminished response to poke-weed m itogen (PWM), a T cell dependent B cell mitogen, was more pronounced i n secondary SS. The results reveal certain immunological aberrations i n the whole group of patients with SS. In addition, the authors demons trated distinct differences in immune dysfunction between patients wit h primary and secondary SS, indicating that they may constitute separa te entities.