title: Investigation of novel autoantibodies in Sjogren's syndrome utilizing Sera from the Sjogren's international collaborative clinical alliance cohort.
abstract: BACKGROUND
  Sjogren's syndrome (SS) is a chronic autoimmune disease mainly affecting salivary and lacrimal glands. Current diagnostic criteria for SS utilize anti-Ro and anti-La as serological markers. Animal models for SS have identified novel autoantibodies, anti-salivary gland protein 1 (SP1), anti-carbonic anhydrase 6 (CA6) and parotid secretory protein (PSP). These novel antibodies are seen in the animals at an earlier stage of SS than anti-Ro and anti-La. The current studies were designed to evaluate these novel autoantibodies in the sera of well-characterized patients with dry eyes and dry mouth and lip biopsies from the Sjogren's International Collaborative Clinical Alliance (SICCA) to determine if they indeed identify SS with less severe disease than patients expressing anti-Ro and anti-La.
  
  
  METHODS
  Sera were obtained from SICCA registry in patients for whom lymphocytic foci per 4 mm(2) on the lip biopsies was either 0 (F = 0), <1 (F <1) or > 3 (F >3). ELISA assays were utilized to evaluate these sera for anti-Ro, anti-La, anti-SP1, anti-CA6, and anti-PSP.
  
  
  RESULTS
  In patients with dry eyes and dry mouth but F = 0, increased expression of anti- CA6 was noted compared to the F <1 group (p = .032) or the F > 3 group (p = .006). Neither anti-PSP nor anti-SP1 reached statistical significance because of the small numbers in the F0 group, although there was a trend for their expression to be higher in the F0 group. On the other hand, the expression of anti-Ro was significantly reduced in the F0 group compared to the F <1 (p = .0021) and F > 3 (p = .0003) groups. The reduced expression of anti-La in the F0 group compared to the F <1 and F > 3 groups did not quite reach statistical significance.
  
  
  CONCLUSIONS
  Anti-Ro and anti-La identify patients with SS and more severe disease than anti-SP1, anti-CA6, and anti-PSP. More studies are needed to identify the timing in the course of SS when these different autoantibodies are expressed and/or whether they are expressed in patients with different clinical manifestations.
authors.affiliation: Immco Diagnostics, Buffalo, NY, USA. lsuresh@immco.com.|Department of Oral Diagnostic Sciences, SUNY at Buffalo School of Dental Medicine, 3435 Main Street, Buffalo, NY, 14214, USA. lsuresh@immco.com.
authors.forename: Lakshmanan
authors.initials: L
authors.lastname: Suresh
authors.affiliation: Immco Diagnostics, Buffalo, NY, USA. Kishore@immco.com.
authors.forename: Kishore
authors.initials: K
authors.lastname: Malyavantham
authors.affiliation: Department of Medicine, SUNY at Buffalo School of Medicine, Buffalo, NY, USA. shenl@buffalo.edu.
authors.forename: Long
authors.initials: L
authors.lastname: Shen
authors.affiliation: Department of Medicine, SUNY at Buffalo School of Medicine, Buffalo, NY, USA. jambrus@buffalo.edu.|Division of Allergy, Immunology and Rheumatology, SUNY at Buffalo School of Medicine, Room C281, Buffalo General Hospital, 100 High Street, Buffalo, NY, 14203, USA. jambrus@buffalo.edu.
authors.forename: Julian L
authors.initials: JL
authors.lastname: Ambrus
mesh_terms: D000818:Animals; D001323:Autoantibodies / Q000097:blood*; D015415:Biomarkers / Q000097:blood*; D004195:Disease Models, Animal; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007765:Lacrimal Apparatus / Q000473:pathology*; D008297:Male; D051379:Mice; D008822:Mice, Transgenic; D008875:Middle Aged; D012859:Sjogren's Syndrome / Q000097:blood* / Q000473:pathology
chemical_list: D001323:Autoantibodies; D015415:Biomarkers