PDF(Pubmed)
Abstract：
Primary Sjögren\'s Syndrome (pSS) falls within the category of connective tissue diseases, characterized by the presence of autoantibodies such as antinuclear antibodies (ANA). However, according to the classification criteria for pSS, some patients may exhibit a negative result for autoantibodies. Patients with a negative result for autoantibodies may lack typical features of connective tissue diseases, and the immunological state as well as the extent of organ involvement and damage may differ from those with positive autoantibodies. This study aims to compare the clinical phenotypes of patients with positive and negative autoantibodies, providing insights for disease classification and treatment selection for clinicians. Patients with pSS were grouped based on the presence and titers of their autoantibodies. Subsequently, differences in organ damage and laboratory indicators were compared between these groups, aiming to analyze the value of autoantibody titers in assessing the condition of pSS. (1) Patients with positive ANA exhibited elevated levels of inflammatory indicators, including ESR, IgG levels, lip gland biopsy pathology grade, and overall organ involvement, in comparison with patients with negative ANA (P < 0.05). Furthermore, ANA-positivity correlated with a higher occurrence of multi-organ damage, particularly affecting the skin, mucous membranes, and the hematological system (P < 0.05). (2) As ANA titers increased, patients demonstrated elevated levels of IgG and an escalation in organ involvement (P < 0.05). (3) Patients in the positive autoantibody group (positive for antinuclear antibodies, anti-SSA, or anti-SSB antibodies) had higher IgG levels compared to the negative group (P < 0.05). (4) Patients with positive anti-SSA and anti-SSB antibodies exhibited higher levels of inflammatory indicators and IgG compared to other patients (P < 0.05); however, no significant differences were observed in terms of organ involvement and organ damage. Patients with positive ANA in pSS typically exhibit higher levels of inflammation and an increased likelihood of experiencing multi-organ damage. Furthermore, as the ANA titers increase, both inflammation levels and the risk of multi-organ damage also escalate. Additionally, the presence of anti-SSA and anti-SSB antibodies may contribute to an elevated risk of increased inflammation levels, but does not increase the risk of organ damage.
摘要：
原发性干燥综合征（pSS）属于结缔组织疾病的范畴，其特征在于存在自身抗体,例如抗核抗体(ANA)。然而,根据PSS的分类标准，一些患者可能表现出自身抗体阴性结果。自身抗体阴性的患者可能缺乏结缔组织疾病的典型特征，免疫状态以及器官受累和损伤的程度可能与自身抗体阳性的患者不同。本研究旨在比较自身抗体阳性和阴性患者的临床表型,为临床医生提供疾病分类和治疗选择的见解。pSS患者根据自身抗体的存在和滴度进行分组。随后，比较了这些组之间器官损伤和实验室指标的差异，目的分析自身抗体滴度在评估pSS病情中的价值。(1)ANA阳性患者炎症指标水平升高,包括ESR,IgG水平，唇腺活检病理分级,和整体器官受累，与ANA阴性患者比较(P<0.05)。此外，ANA阳性与多器官损伤发生率较高相关，特别是影响皮肤，粘膜,血液系统（P<0.05）。（2）随着ANA滴度的增加，患者表现出IgG水平升高和器官受累升级(P<0.05).（3）自身抗体阳性组患者（抗核抗体阳性，抗SSA,或抗SSB抗体）的IgG水平高于阴性组（P<0.05）。(4)抗SSA和抗SSB抗体阳性的患者与其他患者相比，炎症指标和IgG水平较高(P<0.05)；在器官受累和器官损伤方面没有观察到显著差异.pSS中ANA阳性的患者通常表现出更高水平的炎症和经历多器官损伤的可能性增加。此外，随着ANA滴度的增加，炎症水平和多器官损伤的风险也在上升.此外,抗SSA和抗SSB抗体的存在可能导致炎症水平升高的风险升高，但不会增加器官损伤的风险。
