CD-4-POSITIVE T-LYMPHOCYTES INFILTRATE THE BRONCHIAL-MUCOSA OF PATIENTS WITH SJOGRENS-SYNDROME

To investigate the degree and the type of inflammation in the bronchia l mucosa in patients with Sjogren's syndrome, we examined lobar bronch ial biopsies obtained from 10 patients with Sjogren's syndrome (six wi th primary and four with secondary) and eight control subjects. Histoc hemistry with hematoxylin-eosin was performed both to identify the num ber of mononuclear cells and eosinophils and to measure the thickness of the basement membrane. Immunohistochemistry was performed to identi fy neutrophils (neutrophil-elastase), macrophages (CD68), and T-lympho cyte subpopulations (CD4 and CD8) in the submucosa. Subjects with Sjog ren's syndrome presented a greater number of CD4-positive T-lymphocyte s than did the normal control subjects (p = 0.0129). Instead, eosinoph ils, neutrophils, macrophages, CD8 positive T-lymphocytes, and basemen t membrane thickness were similar in the two groups. There were no dif ferences in cell counts between patients with primary and those with s econdary Sjogren's syndrome and between symptomatic and asymptomatic p atients. No correlation was found between cell counts, symptoms, lung volumes, and disease duration. This study has shown that patients with Sjogren's syndrome have an increased number of CD4 positive T-lymphoc ytes in the bronchial mucosa outside of the bronchial glands, supporti ng the concept that, in the airways, Sjogren's syndrome involves also extraglandular tissues.