Anticentromere Antibodies Can Serve as Diagnostic Marker for Sjögren Syndrome

Anticentromere antibodies (ACAs) can serve as a diagnostic serologic marker for Sjögren syndrome, and patients with ACA-positivity should be examined for Sjögren syndrome, noted the authors of a study published in Journal of Oral Science.

Recent reports have shown that some individuals with ACA positivity exhibit xerophthalmia (dry eyes) and xerostomia (dry mouth), both of which are characteristic of Sjögren syndrome.

To demonstrate the benefits of early diagnosis of ACA-positive Sjögren syndrome, the clinical symptoms, laboratory test results, and pathologic features of the labial glands of patients with ACAs were compared with those with anti-Ro/SSA and/or anti-La/SSB autoantibodies.

Researchers conducted a review of medical records of individuals with subjective sicca symptoms and those who had a labial gland biopsy between 2015 and 2020. A total of 80 participants were divided into 2 groups (anti-SSA/SSB positivity, n=56 and ACA positivity, n=24). The mean participant age was 57.0±16.3 years; 97.5% were women.

The presence of xerophthalmia and xerostomia was evaluated using the Schirmer’s test (score of ≤5 mm/5 min defined as positive for tear deficiency), ocular staining, and Saxon’s test (score of ≤2.0 g/2 min defined as positive for hyposalivation) at the initial visit.

Subjective findings with respect to xerostomia were assessed based on the following
5 features that represent intraoral conditions – dryness, stickiness, painful tongue, difficult chewing dry foods, and difficulty swallowing. A score of 0 indicated “strongly disagree” and a score of 3 indicated “strongly agree.” Mucosal moisture volume was evaluated, and pathologic findings of the labial gland were assessed according to Japanese criteria. An enzyme-linked immunosorbent assay (ELISA) routinely used in clinical practice measured participants’ serum levels of ACA, anti-SSA/Ro antibodies, and anti-SSB/La antibodies.

At the initial visit, those with ACA-positivity were significantly older than those with anti-SSA/SSB-positivity. No significant differences were observed between the 2 groups regarding subjective and objective findings on xerophthalmia and xerostomia. Among participants in both groups, the oral mucosal moisture scores were lower than the reference value (>30), although the difference was not statistically significant.

The degree of ocular and oral dryness was similar among both patients with ACA- and SSA/SSB-positivity. The number of positive Saxon’s tests tended to be higher in the ACA group compared with the anti-SSA/SSB group. In both the anti-SSA/SSB and the ACA groups, patients’ labial glands demonstrated dense periductal infiltration of lymphocytes, with a higher positive rate in the ACA group; however, the difference was not statistically significant.

The researchers concluded that “ACA status should be considered as a diagnostic serological marker for [Sjögren] syndrome in future research.”

Disclosure: One of the study authors has declared affiliations with biotech, pharmaceutical, and/or device companies. Please see the original reference for a full list of the author’s disclosures.

Reference

Kitagawa M, Sugimoto T, Ogawa I, Miyauchi M, Hirata S, Sugiyama E. Importance of anti-centromere antibodies in the diagnosis of Sjögren’s syndrome. J Oral Sci. Published online September 12, 2022. doi:10.2334/josnusd.22-0231