Prevalence of novel Sjögren's antibodies in a multi-center cohort of dry eye patients.

PURPOSE: To assess the prevalence of novel Sjögren's disease (SjD) autoantibodies in dry eye disease (DED) patients with or without SjD. PARTICIPANTS: DED patients were recruited from two tertiary care clinics and categorized by SjD status per the 2016 American College of Rheumatology and European Alliance of Associations for Rheumatology criteria. METHODS: Participants underwent a battery of DED evaluations (unanesthetized Schirmer's test, tear film break up time, corneal and conjunctival vital dye staining), and unstimulated salivary flow rate assessment. Blood specimens were tested for Salivary Protein-1 (SP-1), Carbonic Anhydrase VI (CA VI), and Parotid Secretory Protein (PSP) antibodies. Salivary gland biopsies were offered when necessary to determine SjD status. RESULTS: 304 participants completed bloodwork testing and 38 (12.5 %) were diagnosed with SjD. SjD participants had significantly higher positive rates of IgA SP-1 (21 % vs. 10 %; p = 0.049), any SP-1 autoantibody isotype (42 % vs. 24 %; p = 0.02), and a higher mean number of novel autoantibody-positive results (SjD 1.5 (1.1); non-SjD 1.0 (1.0); p = 0.005). The positive labial salivary gland biopsy group had a significantly higher rate of any PSP autoantibody isotype than the negative biopsy group (47 % vs. 22 %; p = 0.04). CONCLUSIONS: SjD participants had significantly higher rates of IgA SP-1, any SP-1 autoantibody isotype, and a higher number of positive novel autoantibodies in general. Participants with positive salivary gland biopsies had a significantly higher prevalence of any PSP autoantibody isotype. Positivity of these tests may indicate the inflammatory nature of dry eye in these patients and could be useful for informing treatment and follow-up.

Duke Scholars

Author Esen Karamursel Akpek Ophthalmology, Vitreoretinal Diseases & Surgery