Immunoassay Detects Salivary Anti-SSA/Ro-52 Autoantibodies in Seronegative Patients with Primary Sjögren's Syndrome.
Immunoassay Detects Salivary Anti-SSA/Ro-52 Autoantibodies in Seronegative Patients with Primary Sjögren's Syndrome.
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DOI：
10.4049/immunohorizons.2300043
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发表时间：
2023-07-01
期刊：
影响因子：
--
通讯作者：
Wong DTW
中科院分区：
文献类型：
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作者：
Kamounah S;Tayob N;Chiang S;Wei F;Park JK;Kwon HM;Feng Z;Chia D;Pedersen AML;Song YW;Wong DTW
干燥综合征的诊断工作是具有挑战性和复杂性的，包括测试血清自身抗体SSA/Ro和唇唾液腺活检。此外，诊断往往被延误。在这项研究中，我们测试的假设，抗SSA/Ro自身抗体是可检测的原发性干燥综合征（pSS）患者的唾液中，因为这种疾病影响唾液腺，这些自身抗体显示更大的区分性能在唾液中比血清。SSA/Ro-52 Ags被用于开发据我们所知的一种新的基于电化学的定量免疫分析：电场诱导释放和测量（EFIRM）平台。通过测量pSS和干燥症患者（n = 34）、无pSS的干燥症患者（n = 35）和健康受试者（n = 41）的唾液抗SSA/Ro-52自身抗体来确定临床效用。判别力的统计分析包括受试者工作特征曲线下面积。在94%（32/34）的pSS患者中检测到唾液抗SSA/Ro-52自身抗体，其中85%（29/34）血清阳性。5例血清阴性pSS患者中有4例在唾液中有EFIRM可测量的抗SSA/Ro-52自身抗体。此外，60%（35例中的21例）的无pSS的血清阴性干燥症患者在唾液中具有EFIRM可检测的SSA/Ro-52自身抗体，表明自身免疫性疾病的发作。41名健康对照受试者中有2名在其唾液中具有EFIRM可检测的SSA/Ro-52自身抗体。唾液SSA/Ro-52自身抗体显著区分pSS患者或自身免疫性疾病初始阶段患者与健康受试者，受试者工作特征曲线下面积为0.91。我们的研究结果表明，拟议的唾液SSA/Ro-52免疫测定提高了pSS血清阴性患者和早发性自身免疫性疾病患者的早期和准确的诊断。
The diagnostic work-up for Sjögren’s syndrome is challenging and complex, including testing for serum autoantibodies to SSA/Ro and a labial salivary gland biopsy. Furthermore, the diagnosis is often delayed. In this study, we tested the hypothesis that anti-SSA/Ro autoantibodies are detectable in the saliva of patients with primary Sjögren’s syndrome (pSS) because the disease affects the salivary glands, and these autoantibodies display greater discriminatory performance in saliva than in serum. SSA/Ro-52 Ags were used to develop what is, to our knowledge, a novel quantitative electrochemical-based immunoassay: the electric field–induced release and measurement (EFIRM) platform. The clinical utility was determined by measuring salivary anti-SSA/Ro-52 autoantibodies in patients with pSS and sicca (n = 34), patients without pSS with sicca (n = 35), and healthy subjects (n = 41). The statistical analysis of discrimination included the area under the receiver operating characteristic curve. Salivary anti-SSA/Ro-52 autoantibodies were measured in 94% (32 of 34) of patients with pSS with 85% (29 of 34) seropositivity. Four of the five seronegative patients with pSS had EFIRM-measurable anti-SSA/Ro-52 autoantibodies in saliva. Additionally, 60% (21 of 35) of the seronegative patients without pSS who had sicca had EFIRM-detectable SSA/Ro-52 autoantibodies in saliva, indicating the onset of autoimmune disease. Two of the 41 healthy control subjects had EFIRM-detectable SSA/Ro-52 autoantibodies in their saliva. Salivary SSA/Ro-52 autoantibodies significantly discriminated patients with pSS or patients with the initial stage of autoimmune disease from healthy subjects with an area under the receiver operating characteristic curve of 0.91. Our findings suggest that the proposed saliva SSA/Ro-52 immunoassay improves early and accurate diagnosis of seronegative patients with pSS and patients with early-onset autoimmune disease.