title: Detection of HTLV-1 in the labial salivary glands of patients with Sjögren’s syndrome: a distinct clinical subgroup?
abstract: OBJECTIVE
  To examine whether patients with Sjögren's syndrome (SS) can be distinguished based on the expression of human T cell lymphotrophic virus type I (HTLV-1) and, if so, whether the subgroups differ in their clinical features and serological measures.
  
  
  METHODS
  Polymerase chain reaction (PCR) and nested PCR were used to amplify viral DNA from peripheral blood mononuclear cells (PBMC) in 53 patients with SS, using primers from the HTLV-1 pX, p19, pol, and tax regions. Minor salivary gland biopsy specimens from 33 patients with SS were examined for the presence of HTLV-1 p19 or tax proteins immunohistochemically. The sociodemographic, glandular, and extraglandular manifestations, and laboratory findings including autoantibodies, complement, and immunoglobulin levels, were analyzed.
  
  
  RESULTS
  The HTLV-1 tax gene was detected in PBMC samples from 2 of 53 patients (3.8%), whereas the HTLV-1 pX, p19, and pol genes were not expressed. As well, 100% of PBMC samples from 4 family members of patients in whom the tax gene was detected also expressed the tax gene. Immunohistochemical staining for HTLV-1 p19 and tax was seen in 10 out of 33 (30.3%) patients with SS each. Overall, 14 (42.4%) patients expressed HTLV-1 p19 or tax proteins, and they had lower rheumatoid factor and C3 levels (p = 0.015 and p = 0.005, respectively) and higher lymphocyte counts (p = 0.016). The prevalence of glandular and extraglandular manifestations did not differ between the HTLV-1-positive and negative patients.
  
  
  CONCLUSIONS
  Our findings suggest that HTLV-1 in the salivary glands is involved in the pathogenesis of a subpopulation of SS, and HTLV-1-associated SS might have different immunological patterns than idiopathic SS.
authors.affiliation: Department of Rheumatology, Chonnam National University Medical School, 5 Hak-Dong, Dong-gu, Gwangju 501-746, Republic of Korea.
authors.forename: Sung-Ji
authors.initials: SJ
authors.lastname: Lee
authors.forename: Ji Shin
authors.initials: JS
authors.lastname: Lee
authors.forename: Myung-Geun
authors.initials: MG
authors.lastname: Shin
authors.forename: Yuetsu
authors.initials: Y
authors.lastname: Tanaka
authors.forename: Dong-Jin
authors.initials: DJ
authors.lastname: Park
authors.forename: Tae-Jong
authors.initials: TJ
authors.lastname: Kim
authors.forename: Yong-Wook
authors.initials: YW
authors.lastname: Park
authors.forename: Shin-Seok
authors.initials: SS
authors.lastname: Lee
mesh_terms: D000328:Adult; D000368:Aged; D015415:Biomarkers / Q000032:analysis / Q000378:metabolism; D003176:Complement C3 / Q000378:metabolism; D004279:DNA, Viral / Q000235:genetics / Q000378:metabolism; D005260:Female; D016356:Gene Products, tax / Q000378:metabolism; D015490:HTLV-I Infections / Q000150:complications / Q000175:diagnosis*; D015368:Human T-lymphotropic virus 1 / Q000235:genetics / Q000302:isolation & purification* / Q000378:metabolism; D006801:Humans; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D012217:Rheumatoid Factor / Q000378:metabolism; D012470:Salivary Glands, Minor / Q000378:metabolism / Q000473:pathology / Q000821:virology*; D012680:Sensitivity and Specificity; D012859:Sjogren's Syndrome / Q000175:diagnosis* / Q000276:immunology / Q000821:virology*; D055815:Young Adult; D054301:gag Gene Products, Human Immunodeficiency Virus / Q000378:metabolism
chemical_list: D015415:Biomarkers; D003176:Complement C3; D004279:DNA, Viral; D016356:Gene Products, tax; D054301:gag Gene Products, Human Immunodeficiency Virus; C060955:p19 protein, Human T-lymphotropic virus 1; C514970:tax protein, Human T-lymphotrophic virus 1; D012217:Rheumatoid Factor