IMMUNOBIOLOGICAL STUDIES ON ORAL LESION OF SJOGREN'S SYNDROME

最近的研究表明，在NFS/sld模型小鼠中，120kl α-fodrin被认为是自身抗原，这可能是干燥综合征的疾病模型。本实验采用精制α-fodrin和人重组α-fodrin的Western blot方法，拟与干燥综合征（Sjogren’s syndrome， SS）患者血清反应。然而，由于材料数量有限，我们无法得到充分的结果。本文对120例经日本修订标准（1999）诊断的原发性和继发性SS的各项检查结果进行了比较。两组间无显著性差异。因此，我们建议原发性和继发性SS可以用相同的诊断标准诊断。对设备的诊断准确性进行了检验。该研究显示灵敏度为96.0%，特异性为90.5%。诊断准确率高达94.5%。采用IPAP-Win系统对25例SS患者125例唇唾液腺活检标本进行浸润淋巴细胞的定量测定，该系统将显微镜与个人计算机连接。唇腺平均面积2.77mm^2，小叶平均面积0.55mm^2，病灶平均面积0.0638mm^2，病灶平均淋巴细胞数345个。磁共振唾液造影是一种无创的成像方法，无需插入导管和造影剂。通过与常规x线唾液造影的比较，探讨了磁共振唾液造影的有效性。两种方法相关性极显著（rcc=0.885, p<0.0001）， MR-sialography可能取代传统方法。修订后的日本标准包括唾液测定法，其中要么采用口香糖测试，要么采用撒克逊测试。通过研究口香糖试验的可重复性、诊断为hypohypovation的临界值以及口香糖试验与Saxon试验的相关性，对口香糖试验进行了研究。

Recent studies indicate that 120kl) α-fodrin has been estimated as the autoantigen in NFS/sld model mouse which seems to be the disease model of the Sjogren's syndrome. In this study, the reaction with the serum of Sjogren's syndrome (SS) patient was planned by Western blot method of refined α-fodrin and human recombinant α-fodrin. However, we could get the sufficient result because of the limited number of the material. The result of various examinations in diagnosing SS was compared between primary SS and secondary SS diagnosed by revised Japanese criteria (1999) in 120 cases. No significant difference was observed between them. Therefore, it is suggested that both primary and secondary SS can be diagnosed by the same diagnostic criteria. As for the diagnostic accuracy of facilities were examined. The study showed 96.0% in sensitivity and 90.5% in speificity. The diagnostic accuracy was as high as 94.5%.The quantitative measurement of the infiltrating lymphocyte was made by the IPAP-Win system in which the microscope was linked with the personal computer in 125 samples of labial salivary glands biopsies from 25 SS patients. Average area of a labial gland was 2.77mm^2, that of a lobulus was 0.55mm^2, that of a focus was 0.0638mm^2, and average lymphocyte number in a focus was 345. The MR-sialography is non-invasive method of imaging without the insertion of catheter and the contrast media. The usefulness of MR-sialography was examined by comparing with the conventional X-ray sialography. There was a highly significant correlation between the two methods (rcc=0.885, p<0.0001), and MR-sialography may be able to replace the conventional method. The revised Japanese criteria include sialometry in which either the chewing gum test or the Saxon test is adopted. Studies on the chewing gum test were performed by investigating the reproducibility, the cutoff value in diagnosing as hyposalivation, and the correlation between the chewing gum test and the Saxon test.