Sjögren’s Syndrome (SS): The Role of Traditional (SS-A/SS-B) and Novel Antibodies in Diagnosis

Mohammed Bari¹, Anam Shaikh², Valerie Comissiong¹, Bivin Varghese² and Steven E. Carsons², ¹Department of Medicine, Winthrop-University Hospital, Stony Brook University School of Medicine, Mineola, NY, ²Division of Rheumatology, Allergy and Immunology Winthrop-University Hospital, Stony Brook University School of Medicine, NY, USA, Mineola, NY

Meeting: 2016 ACR/ARHP Annual Meeting

Date of first publication: September 28, 2016

Keywords: Sjogren's syndrome and Sjӧgrens

Session Information

Date: Sunday, November 13, 2016

Title: Sjögren's Syndrome - Poster I: Translational Science

Session Type: ACR Poster Session A

Session Time: 9:00AM-11:00AM

Background/Purpose:

Diagnosing SS is often challenging, particularly distinguishing patients with primary SS from xerostomia and xerophthalmia (sicca). Recently, an IL-14 transgenic murine model led to the discovery of autoantibodies directed against exocrine gland antigens. These antibodies termed salivary protein-1 (SP-1), carbonic anhydrase VI (CA-6), and parotid secretory protein (PSP) were found to precede traditional antibodies and normalize once the diagnosis is established. Our goal is to explore the initial diagnostic role of these antibodies in patients suspected of having SS.

Methods:

Serum concentrations of SS-A, SS-B, and SP-1, CA-6, PSP isotypes (IgG/A/M) were examined in 94 patients being evaluated for SS. The results were recorded and analyzed. Charts were reviewed. Patients were divided among four antibody patterns: I) novel and traditional Ab +, II) novel Ab – traditional Ab +, III) novel Ab + traditional Ab -, and IV) novel and traditional Ab -. The relationship of these antibody patterns was examined in relation to diagnosis. Patients with primary SS met American-European Consensus criteria, whereas patients labeled “sicca” had nonspecific ocular and oral symptoms.

Results:

Among 94 patients, 43 (45.74%) had abnormal novel antibodies of any isotype. 27 (28.7%) were CA6+, 18 (19.10%) were SP-1+, and 15 (16.0%) were PSP+ , The IgG isotype response was the strongest: Anti CA-6 IgG was 10.4 (+/- 0.9) EU/ml, whereas SP-1 and PSP IgG were 5.1 (+/- 0.8) and 4.8 (+/- 0.6) EU/ml, respectively (P<0.0001; K-W test). The antibody patterns differed significantly between the diagnostic groups (P <0.0001,- Fisher’s exact test). The traditional antibodies showed a sensitivity, specificity, PPV, and NPV of 86.53%, 92.85%, 93.75%, 84.78% compared to 32.69%, 35.71%, 38.63%, 42.85%, for the novel antibodies. Patients with abnormal novel antibodies had significantly (P<0.05; K-W test) shorter duration of symptoms in years (6.1 +/- 1.4) compared with abnormal traditional antibodies (12.8 +/-1.5).

Conclusion:

The pattern of Sjögren’s associated antibodies differs between primary SS and xeropthalmia/xerostomia. Traditional antibodies have excellent sensitivity and specificity for patients clinically diagnosed with primary SS, however, novel antibodies are more prevalent in the xerophthalmia/xerostomia group and may identify a subset with early SS.

Disclosure: M. Bari, None; A. Shaikh, None; V. Comissiong, None; B. Varghese, None; S. E. Carsons, None.

To cite this abstract in AMA style:

Bari M, Shaikh A, Comissiong V, Varghese B, Carsons SE. Sjögren’s Syndrome (SS): The Role of Traditional (SS-A/SS-B) and Novel Antibodies in Diagnosis [abstract]. Arthritis Rheumatol. 2016; 68 (suppl 10). https://acrabstracts.org/abstract/sjogrens-syndrome-ss-the-role-of-traditional-ss-ass-b-and-novel-antibodies-in-diagnosis/. Accessed .

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