Antibodies against carbamylated proteins are present in primary Sjögren's syndrome and are associated with disease severity.
Herein, we investigate the presence and prognostic value of autoantibodies against carbamylated proteins (anti-CarP) in the serum of patients with primary Sjögren's syndrome (pSS).



Serum levels of anti-CarP antibodies were measured in Norwegian patients with pSS (n=78) and corresponding controls (n=74) using ELISA and analysed in relation with exocrine gland function, degree of salivary gland inflammation, signs of ectopic germinal centre (GC) formation and immunological markers. For univariate comparisons, the Mann-Whitney U test and χ(2) or Fisher's exact tests were used. Correlations were assessed with Spearman's rank testing. Multivariate regression analyses were used to assess the effect of anti-CarP positivity on clinical manifestations.



Of the patients with pSS, 27% were positive for anti-CarP IgG antibodies. Levels of anti-CarP correlated positively with total IgG, IgM, rheumatoid factor and β2-microglobulin. Importantly, after adjusting for confounding factors, patients positive for anti-CarP had significantly higher focus score. Furthermore, positive anti-CarP status coincided with 9.2-fold higher odds of having developed GC-like structures in the minor salivary glands. As a patient group considered having worse disease outcome, individuals with ectopic GC-like structures also presented with significantly higher levels of anti-CarP antibodies.



Presence of anti-CarP in patients with pSS is strongly associated with increased focal lymphocytic infiltration, formation of ectopic GC-like structures in minor salivary glands, and diminished salivary gland function. Even taking into consideration our relatively small cohort we believe that anti-CarP antibodies offer new possibilities for identifying patients with more active disease and at risk of developing additional comorbidity.
Broegelmann Research Laboratory, Department of Clinical Science, University of Bergen, Bergen, Norway.
Brith
B
Bergum
Broegelmann Research Laboratory, Department of Clinical Science, University of Bergen, Bergen, Norway.
Catalin
C
Koro
Broegelmann Research Laboratory, Department of Clinical Science, University of Bergen, Bergen, Norway.
Nicolas
N
Delaleu
Department of Clinical Science, University of Bergen, Bergen, Norway.
Magne
M
Solheim
Broegelmann Research Laboratory, Department of Clinical Science, University of Bergen, Bergen, Norway Małopolska Centre of Biotechnology, Jagiellonian University, Krakow, Poland.
Annelie
A
Hellvard
Broegelmann Research Laboratory, Department of Clinical Science, University of Bergen, Bergen, Norway.
Veronika
V
Binder
Broegelmann Research Laboratory, Department of Clinical Science, University of Bergen, Bergen, Norway.
Roland
R
Jonsson
Department of Clinical Medicine, Centre of Health Science, Federal University of Espírito Santo, Vitoria, Brazil.
Valeria
V
Valim
Department of Rheumatology, Haukeland University Hospital, University of Bergen, Bergen, Norway.
Daniel S
DS
Hammenfors
Broegelmann Research Laboratory, Department of Clinical Science, University of Bergen, Bergen, Norway Department of Clinical Dentistry, Section for Oral and Maxillofacial Radiology, University of Bergen, Bergen, Norway.
Malin V
MV
Jonsson
Broegelmann Research Laboratory, Department of Clinical Science, University of Bergen, Bergen, Norway Małopolska Centre of Biotechnology, Jagiellonian University, Krakow, Poland.
Piotr
P
Mydel
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001323:Autoantibodies / Q000097:blood*; D015415:Biomarkers / Q000097:blood; D002219:Carbamates / Q000276:immunology*; D016022:Case-Control Studies; D002828:Choristoma / Q000276:immunology; D005260:Female; D018858:Germinal Center / Q000276:immunology; D006801:Humans; D007108:Immune Tolerance; D007074:Immunoglobulin G / Q000097:blood; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012720:Severity of Illness Index; D012859:Sjogren's Syndrome / Q000175:diagnosis / Q000276:immunology*
D001323:Autoantibodies; D015415:Biomarkers; D002219:Carbamates; D007074:Immunoglobulin G
Autoantibodies; Inflammation; Sjøgren's Syndrome