SAT0445 The correlation between the type of cells in minor salivary glands infiltrates and the selected immunological, clinical and laboratory parameters, in primary sjogren’s syndrome patients with history of epstein – barr virus infection
Authors: M. Maślińska, M. Prochorec-Sobieszek, B. Kwiatkowska
Journal: Annals of the Rheumatic Diseases (2018)

<h3>Background</h3> The number of inflammatory mononuclear cell foci is crucial in primary Sjogren's syndrome (pSS) diagnosis, with their cellular composition changing in subsequent inflammation stages. The Epstein -Barr virus (EBV) infection is believed to play a role in the pathogenesis of pSS. <h3>Objectives</h3> Establishing the correlation of selected clinical, immunological and laboratory parameters with cellular composition of minor salivary glands infiltrations. <h3>Methods</h3> 41 pSS patients, 34 female (83%), 7 men (17%), average age 52 y.o, SD=15, with history of EBV infection, divided into two age groups (45&lt;;≥45). The diagnostics: white blood count (WBC), rheumatoid factor (RF), erythrocyte sedimentation rate (ESR), CRP, serum concentration of γ-globulins, antinuclear antibodies ANA(IF); anti-SS-A and anti-SS-B antibodies (semi-quantitative immunoblotting evaluation), standard ELISA assays of serum cytokines levels (BAFF, APRIL, FLT-3L, LT-α, IL-21), minor salivary gland biopsy with the histopathological evaluation (focus score-FS), immunochemistry assessment of the CD3 +, CD4 +, CD19 +, CD21 +, CD35 +cells presence, ocular tests: Schirmer's test and ocular staining score (OSS); ELISA assay of antibodies against EBV specific proteins (viral capsid antigen, early antigen and Epstein-Barr nuclear antigen), ESSDAI evaluation. The Bioethics Committee aproval was obtained. Statistic: U Mann-Whitney test and Spearman correlation coefficient with statistical significance set at p&lt;0.05. <h3>Results</h3> In infiltrates CD3 +, CD4 +and CD19+cells dominated, WBC negatively correlated with CD 35+cells (rho=-0,323). CD3 +and CD4+absolute cell count correlated positively with anti-SS-A antibodies, but not with ANAs and anti-SS-B antibodies. The CD19 +, CD3 +and CD4+absolute cell count correlated positively with the serum LT-α concentration (respectively rho=0.349, 0.488, 0.483) and moderately negatively with Schirmer test, but not with OSS. There were no differences in FS grade between age groups. In the younger group all cell types were found, including CD21 + (p=0.042) and CD35 + (p=0.036); the older subgroup lacked dendritic cell markers. The ESSDAI positively correlated with CD3 +, CD4 +, CD19 +and CD21+cells (respectively rho=0.320, 0.329, 0.28, 0.241). <h3>Conclusions</h3> <b>a)</b>Leukopenia may be associated with the dendritic cells (CD35 +) presence in the disease subsequent stage. <b>b)</b> The positive correlation of mononuclear cells with LT-α confirms the LT-α effect on the immune response in peripheral lymphatic organs and on T and B lymphocytes. <b>c)</b> The presence of CD21 +and CD 35+cells observed in younger group, may indicate an active and early phase of inflammation and the activity of both T and B-lymphocytes and dendritic cells. <b>d)</b> The positive correlation ESSDAI with all studied cell types confirms the observation, that organ-related complications correlate with inflammatory activity expressed in mononuclear cell infiltrates. <b>e)</b> The effect of EBV reactivation/previous infection on FS, CD3 +, CD4 +, CD19 +, CD21 +, CD35 +was not demonstrated. <h3>Disclosure of Interest</h3> None declared