Skip to main content
  • Original article
  • Open access
  • Published:

Salivary CXCL13 in relation to scintigraphy in early detection of secondary Sjogren’s syndrome

Abstract

Background

Sjogren’s syndrome (SS) is a systemic autoimmune disease in which immune cells attack and destroy the exocrine glands. CXCL13 directs B-cell chemotaxis and is elevated in several autoimmune diseases.

Objective

To assess the role of salivary CXCL13 level as a screening tool in early detection of secondary SS patients.

Patients and methods

Salivary CXCL13 levels using ELISA technique, Schirmer paper test and/or Lissamine green staining, and quantitative salivary scintigraphy excretion fraction were measured in 45 selected patients with primitive connective tissue disease (rheumatoid arthritis, systemic lupus erythematosus, or systemic sclerosis) and according to the American-European Consensus Group criteria, they were classified to three equal groups: group I were having SS; group II were having dryness manifestations but not completing the criteria for SS diagnosis (suspected SS); group III were having no SS, and 15 age-matched and sex-matched apparently healthy controls.

Results

A significantly higher salivary CXCL13 level on comparing SS patients to suspected, non-SS groups and controls (P<0.001). Salivary CXCL13 had a significant negative correlation with scintigraphy (P<0.01), a significant positive correlation with eye dryness signs (P<0.01), cutoff value of CXCL13 to diagnose SS was more than 40pg/ml and a cutoff value of salivary scintigraphy excretion fraction to diagnose SS was less than 33.1%.

Conclusion

Salivary CXCL13 is a sensitive biomarker for early detection of secondary SS.

References

  1. Delaleu N, Madureira AC, Immervoll H, Jonsson R. Inhibition of experimental Sjögren’s syndrome through immunization with HSP60 and its peptide amino acids 437-460. Arthritis Rheum 2008; 58:2318–2328.

    Article  CAS  Google Scholar 

  2. Zhong X, Gao W, Degauque N, Bai C, Lu Y, Kenny J, et al. Reciprocal generation of Th1/Th17 and T(reg) cells by B1 and B2 B cells. Eur J Immunol 2007; 37:2400–2404.

    Article  CAS  Google Scholar 

  3. Amft N, Bowman SJ. Chemokines and cell trafficking in Sjögren’s syndrome. Scand J Immunol 2001; 54:62–69.

    Article  CAS  Google Scholar 

  4. Kramer JM, Rothstein TL. CXCL13 in Sjogren’s syndrome: a novel biomarker of disease. Oral Surg Endodentol 2011; 111:e41.

    Google Scholar 

  5. Sherif NM, Arafa MM, Ibrahim SE, Moussa SG. CXC ligand 13 in rheumatoid arthritis and its relation to secondary Sjögren’s syndrome. Egypt Rheumatol 2013; 1:121–126.

    Article  Google Scholar 

  6. Pedro G, Gintaras J, Maria H, Guobis Z. Diagnostic approaches to Sjögren’s syndrome. J Oral Maxillofac Res 2012; 3:e3.

    Google Scholar 

  7. Vitali C, Bombardieri S, Jonsson R, Moutsopoulos HM, Alexander EL, Carsons SE, et al. Classification criteria for Sjogren’s syndrome: a revised version of the European criteria proposed by the American-European Consensus Group. Ann Rheum Dis 2002; 61:554–558.

    Article  CAS  Google Scholar 

  8. Kramer JM, Klimatcheva E, Rothstein TL. CXCL13 is elevated in Sjögren’s syndrome in mice and humans and is implicated in disease pathogenesis. J Leukoc Biol 2013; 94:1079–1089.

    Article  CAS  Google Scholar 

  9. Lee KE, Kang JH, Yim YR, Kim JE, Lee JW, Wen L, et al. Predictive significance of CCL21 and CXCL13 levels in the minor salivary glands of patients with Sjögren’s syndrome. Clin Exp Rheumatol 2017; 35:234–240.

    PubMed  Google Scholar 

  10. Segovia AD, Ibanez G, Hernandez-Ortiz Cetina JA, Gonzalel-Jimenez Y, Diaz-Jouanen E. Salivary gland involvement in diseases associated with Sjogren’s syndrome. 1. Radionuclide and roentgenographic studies. J Rheumatol 1974; 1:159–165.

    Google Scholar 

  11. Loutfi I, Nair MK, Ebrahim AK. Salivary gland scintigraphy: the use of semiquantitative analysis for uptake and clearance. J Nucl Med Technol 2003; 31:81–85.

    PubMed  Google Scholar 

  12. Adams BK, Al Attia HM, Parkar S. Salivary gland scintigraphy in Sjögren’s syndrome: are quantitative indices the answer? Nucl Med Commun 2003; 24:1011–1016.

    Article  CAS  Google Scholar 

  13. Klutmann S, Bohuslavizki K, Kröger S, Bleckmann C, Brenner W, Mester J, Clausen M. Quantitative salivary gland scintigraphy. J Nucl Med Technol 1999; 27:20–26.

    CAS  PubMed  Google Scholar 

  14. Shizukuishi K, Nagaoka S, Kinno Y, Saito M, Takahashi N, Kawamoto M, et al. Scoring analysis of salivary gland scintigraphy in patients with Sjögren’s syndrome. Ann Nucl Med 2003; 17:627–631.

    Article  Google Scholar 

  15. Nishikawa A, Suzuki K, Kassai Y, Gotou Y, Takiguchi M, Miyazaki T, et al. Identification of definitive serum biomarkers associated with disease activity in primary Sjögren’s syndrome. Arthritis Res Ther 2016; 18:106.

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Dalia M. E. El Mikkawy MD.

Additional information

This is an open access article distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 3.0 License, which allows others to remix, tweak, and build upon the work noncommercially, as long as the author is credited and the new creations are licensed under the identical terms.

Rights and permissions

This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Moussa, S.G., El-Hefnawy, H.E., El-Shishtawy, H.F. et al. Salivary CXCL13 in relation to scintigraphy in early detection of secondary Sjogren’s syndrome. Egypt Rheumatol Rehabil 45, 153–158 (2018). https://doi.org/10.4103/err.err_39_18

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.4103/err.err_39_18

Keywords