Abstract
Objective
Sjögren's syndrome (SS) is characterized by autoimmune infiltration and focal accumulation of lymphocytes in the exocrine glands, with a predominance of CD4‐positive T cells. Since these histologic findings are nonspecific, determination of clinical and serologic abnormalities contribute to the diagnosis. The aim of this study was to identify a novel, disease‐specific, immunologically relevant marker for SS.
Methods
To analyze disease‐related and tissue‐specific expression of candidate markers, we examined biopsied minor salivary glands and peripheral blood mononuclear cells from patients with primary and secondary SS (n = 26) as well as from patients with sicca symptoms without autoimmune sialadenitis (n = 15). Expression of the Th1/Th2‐related chemokines CCL3 (macrophage inflammatory protein 1α) and CCL2 (monocyte chemoattractant protein 1), CXCL7 (neutrophil‐activating peptide 2 [NAP‐2]), interleukin‐1β, inducible costimulator, and the proteasome subunits α3 (C9) and β5i (LMP7) was analyzed at the messenger RNA (mRNA) level using real‐time polymerase chain reaction techniques. Immunohistochemical analysis was used to identify the β5i (LMP7)–expressing cell populations in minor salivary glands.
Results
The expression profiles revealed a significant up‐regulation of β5i (LMP7) exclusively in the salivary glands of SS patients. Immunohistochemistry confirmed expression of the immunoproteasome subunit β5i (LMP7) within the acinar and ductal epithelial cells. No significant difference in the distinct histologic focus scores was evident for the expression of the markers investigated. In the peripheral blood compartment, the expression of CXCL7 was up‐regulated both in primary and in secondary SS.
Conclusion
Tissue‐specific up‐regulation of β5i (LMP7) mRNA was shown to be characteristic of SS, indicating a disease‐specific modulation of the proteasome system. Expression of β5i (LMP7) represents an independent parameter that can be used in addition to the focus score to distinguish SS in biopsied labial salivary glands.