title: Clinical significance and diagnostic usefulness of anti-centromere antibody in Sjögren's syndrome.
abstract: Anti-SS-A/Ro antibody (SS-A) and anti-SS-B/La antibody (SS-B) are important serologic markers in the diagnostic criteria for Primary Sjögren's syndrome (SS). Although anti-centromere antibody (ACA)-positive SS is frequently experienced, ACA is not included in these criteria. The purpose of this study was to identify the clinical features of ACA-positive SS and discuss the usefulness of ACA in diagnosing SS. Forty-five patients with SS were divided into the following three groups: SS-A only-positive group (n = 17), SS-A and SS-B both-positive group (n = 18), and ACA only-positive group (n = 10). As a control, 54 patients without SS who were negative for antinuclear antibodies were also evaluated. The following items were compared among groups: Saxon's test, unstimulated whole salivary flow (UWSF), salivary gland scintigraphy (SGS), histopathologic examination of the minor salivary glands, Schirmer's test, and fluorescein staining of the cornea. In the ACA only-positive group, Saxon's test was 0.21 ± 0.26 g/2 min (mean ± SD) and UWSF was 0.16 ± 0.25 ml/10 min (mean ± SD), showing a significant decrease in salivary secretion (p < 0.05; vs. non-SS). On SGS, accumulation and disappearance of (99m)TcO                            (4)                                      (-)                          were significantly decreased (p < 0.05; vs. non-SS). Histopathologic examination showed moderate or severe lymphocytic infiltration and tissue destruction in all cases, similar to that in the SS-A- and/or SS-B-positive groups. Schirmer's test and fluorescein staining were positive in 60% and 80%, respectively. Impaired lacrimal secretion and keratoconjunctivitis sicca were similar to those in SS-A- and/or SS-B-positive groups. These results suggest that ACA is an autoantibody reflecting impairment in the salivary and lacrimal glands and may be a useful serologic marker for SS.
authors.affiliation: Department of Oral and Maxillofacial Surgery and Systemic Medicine, Graduate School of Life Dentistry at Niigata, The Nippon Dental University, 1-8 Hamaura-cho, Chuo-ku, Niigata 951-8580, Japan. tkita@ngt.ndu.ac.jp
authors.forename: Tetsutaro
authors.initials: T
authors.lastname: Kitagawa
authors.forename: Koichi
authors.initials: K
authors.lastname: Shibasaki
authors.forename: Shuji
authors.initials: S
authors.lastname: Toya
mesh_terms: D000368:Aged; D001323:Autoantibodies / Q000097:blood*; D015415:Biomarkers / Q000097:blood; D002503:Centromere / Q000276:immunology* / Q000473:pathology; D005260:Female; D006801:Humans; D008875:Middle Aged; D010306:Parotid Gland / Q000000981:diagnostic imaging / Q000378:metabolism / Q000473:pathology; D011877:Radionuclide Imaging; D012463:Saliva / Q000378:metabolism; D012470:Salivary Glands, Minor / Q000378:metabolism / Q000473:pathology / Q000503:physiopathology; D012859:Sjogren's Syndrome / Q000175:diagnosis* / Q000276:immunology* / Q000503:physiopathology
chemical_list: D001323:Autoantibodies; D015415:Biomarkers