The Study On Immunophenotypes Of Lymphocytes In The Labial Gland Of Patients With Primary Sj(?)gren’s Syndrome

Objective:We aimed to investigate consistency of lymphocyte immunophenotype between labial gland and peripheral blood in patients with primary Sj?gren’s syndrome(pSS).Methods:Seventy-one pSS patients and 35 patients with maxillofacial trauma were included in the study.Based on the ratio of CD20 to CD3 in labial gland from 71 pSS patients,they were divided into the high(n=48)and low CD20 expression group(n=23).Lymphocyte immunophenotypes in labial glands,course of disease,erythrocyte sedimentation rate(ESR),C-reactive protein,immunoglobulin,complement and cytokines levels were analyzed.Results:1.CD20 was detected in labial gland samples of all pSS patients,in which CD3 was positive in 66(93.0%)patients,and negative in 5(7.0%).2.The serum levels of IgG,IgA,IgM,CRP,and ESR were higher,but serum C4 level was lower in pSS patients than in the control group(all P <0.01).3.The serum levels of IL-6,IL-6R,BAFF,BAFF-R were higher in pSS patients than in the control group(all P <0.01).4.In the labial gland,the levels of IgG,IgA,IgM,C3 c,BAFF and BAFF-R were higher(all P < 0.05),but C1 q was lower in pSS group than the control(P<0.01).5.There were no significant differences on the mean age,the course of disease,proportion of dry mouth patients,proportion of patients with leukopenia,and SSA/SSB antibody positive rate between the high CD20 expression group and the low expression group(all P>0.05).6.Serum ESR and IgG levels were higher in the high CD20 expression group than in the low expression group(both P <0.05).7.The serum level of BAFF was higher,but serum IL-2 level was lower in the high CD20 expression group than in the low expression group(both P <0.05).8.In the labial gland,the levels of IgG,C1 q and BAFF-R were higher in the high CD20 expression group than in the low expression group(all P < 0.01).Conclusion:1.Both CD3+ T lymphocytes and CD20+ B lymphocytes were found in the lower lip salivary gland of pSS patients and primarily expressed CD20 may be due to a more serious disease.2.There was abnormal humoral immune response and elevated inflammatory response in the peripheral blood of pSS patients.Moreover,The high CD20 expression group had higher disease activity.3.Not only lymphocyte infiltration but also immunoglobulin deposition was present in the exocrine glands of pSS patients,and IgG predominant pSS is severe.4.There were effects of complement activation on the occurrence and development of Sj?gren’s syndrome.5.C3 c level in the lower lip salivary gland was not associated with the expression of CD20/CD3.6.Complement activation in pSS patients may proceed via the alternative activation pathway.The classic pathway may also cause tissue injuries when the infiltrating lymphocytes are predominantly CD20 positive cells.In severe pSS,the classic and bypass pathways may be activated simultaneously in the labial glands.7.The high expression of CD20 in labial gland may be related to the increase of B cell activity in peripheral blood.8.Abnormal BAFF and BAFF-R may be involved in the pathogenesis of pSS.BAFF may play a major role in peripheral blood,while BAFF-R may be predominant in glands.9.Activation of B lymphocytes and deposition of immune complex may be the main causes of injury of labial gland tissue in pSS.The analysis of lymphocyte subsets in pSS labial gland is helpful to the assessment of the disease.