Diagnostic accuracy of blood B-cell subset profiling and autoimmunity markers in Sj?gren’s syndrome

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• 作者：Divi Cornec (33) (34)
  Alain Saraux (33) (34)
  Jacques-Olivier Pers (34)
  Sandrine Jousse-Joulin (33) (34)
  Thierry Marhadour (33)
  Anne-Marie Roguedas-Contios (35)
  Steeve Genestet (36)
  Yves Renaudineau (34)
  Valérie Devauchelle-Pensec (33) (34)
  
• 刊名：Arthritis Research & Therapy
• 出版年：2014
• 出版时间：February 2014
• 年：2014
• 卷：16
• 期：1
• 全文大小：251 KB
• 参考文献：1. Cornec D, Devauchelle-Pensec V, Tobón GJ, Pers JO, Jousse-Joulin S, Saraux A: B cells in Sj?gren’s syndrome: from pathophysiology to diagnosis and treatment. / J Autoimmun 2012, 39:161-67. CrossRef
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  12. Cornec D, Jousse-Joulin S, Pers J-O, Marhadour T, Cochener B, Boisramé-Gastrin S, Nowak E, Youinou P, Saraux A, Devauchelle-Pensec V: Contribution of salivary gland ultrasonography to the diagnosis of Sj?gren’s syndrome: toward new diagnostic criteria? / Arthritis Rheum 2013, 65:216-25. CrossRef
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• 作者单位：Divi Cornec (33) (34)
  Alain Saraux (33) (34)
  Jacques-Olivier Pers (34)
  Sandrine Jousse-Joulin (33) (34)
  Thierry Marhadour (33)
  Anne-Marie Roguedas-Contios (35)
  Steeve Genestet (36)
  Yves Renaudineau (34)
  Valérie Devauchelle-Pensec (33) (34)
  
  33. Service de Rhumatologie, Centre Hospitalier Régional et Universitaire de Brest, H?pital de la Cavale Blanche, BP 824, F-29609, Brest cedex, France
  34. EA 2216 Immunologie et Pathologie, Université de Brest, SFR ScinBios, Labex Imunotherapy, Graft, Oncology, BP 824, F-29609, Brest cedex, France
  35. Service de Dermatologie, Centre Hospitalier Régional et Universitaire de Brest, H?pital Morvan, BP 824, F-29609, Brest cedex, France
  36. Explorations Fonctionnelles Neurologiques, Centre Hospitalier Régional et Universitaire de Brest, H?pital de la Cavale Blanche, BP 824, F-29609, Brest cedex, France
  
• ISSN：1478-6354

文摘

Introduction The aims of this study were to evaluate the diagnostic accuracy of blood B-cell subset profiling and immune-system activation marker assays in primary Sj?gren’s syndrome (pSS) and to assess whether adding these tools to the current laboratory item would improve the American-European Consensus Group (AECG) criteria. Methods In a single-center cohort of patients with suspected pSS, we tested the diagnostic performance of anti-SSA, antinuclear antibody (ANA), rheumatoid factor (RF), gammaglobulins, IgG titers, and B-cell ratio defined as (Bm2-?Bm2-/(eBm5-?Bm5), determined using flow cytometry. The reference standard was a clinical diagnosis of pSS established by a panel of experts. Results Of 181 patients included in the study, 77 had pSS. By logistic regression analysis, only ANA ?:640 (sensitivity, 70.4%; specificity 83.2%) and B-cell ratio ? (sensitivity, 52.1%; specificity, 83.2%) showed independent associations with pSS of similar strength. In anti-SSA-negative patients, presence of either of these two criteria had 71.0% sensitivity but only 67.3% specificity for pSS; whereas combining both criteria had 96.2% specificity but only 12.9% sensitivity. Adding either of these two criteria to the AECG criteria set increased sensitivity from 83.1% to 90.9% but decreased specificity from 97.1% to 85.6%, whereas adding both criteria in combination did not substantially modify the diagnostic performance of the criteria set. The adjunction of RF-?ANA ?:320, as proposed in the new American College of Rheumatology (ACR) criteria, did not improve the diagnostic value of anti-SSA. Conclusions Blood B-cell subset profiling is a simple test that has good diagnostic properties for pSS. However, adding this test, with or without ANA positivity, does not improve current classification criteria.