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Inicio Medicina Clínica Anti-parietal cell antibodies as a potential biomarker for interstitial lung dis...
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Vol. 162. Issue 1.
Pages 1-8 (January 2024)
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Vol. 162. Issue 1.
Pages 1-8 (January 2024)
Original article
Anti-parietal cell antibodies as a potential biomarker for interstitial lung disease associated with primary Sjögren's syndrome
Anticuerpos contra las células parietales como biomarcadores potenciales de enfermedad pulmonar intersticial relacionada con el síndrome de Sjögren primario
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Na Zhanga,b,1, Hui Wanga,b,1, Wenwen Suna,b, Hou Houa,b, Jun Dua,b, Jiaojiao Xua,b, Wei Weia,b,
Corresponding author
tjweiwei2003@163.com

Corresponding author.
a Department of Rheumatology and Immunology, Tianjin Medical University General Hospital, Tianjin 300052, China
b Tianjin Clinical Research Center for Rheumatic and Immune Diseases, Tianjin 300052, China
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Tables (5)
Table 1. Demographic and APCA levels of patients with primary Sjögren's syndrome (pSS) and healthy controls (HCs).
Table 2. Clinical characteristics of patients with pSS between APCA negative and positive groups.
Table 3. Pulmonary involvement characteristics of patients with pSS between APCA negative and positive groups.
Table 4. Comparisons of clinical characteristics in pSS patients with/without ILD.
Table 5. Logistic regression analysis of risk factors for ILD in pSS.
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Abstract
Background

ILD is a common manifestation in pSS and is associated with an increased risk of death. APCA are strongly expressed by hyperplastic alveolar epithelial cells in the fibrotic lung and are associated with an accelerated decline in lung function in IPF. In the present study, we aimed to evaluate the clinical utility of APCA in ILD patients with pSS.

Methods

Clinical, laboratory, PFTs and imaging data from pSS patients were reviewed, and the ESSDAI was utilized to evaluate disease activity. HRCT semiquantitative scoring was conducted. We compared the clinical characteristics of pSS patients with and without ILD and carried out logistic regression analysis of risk factors for ILD in pSS.

Results

A total of 74 patients with pSS and 40 HCs were included in the study. ILD was more commonly observed in the APCA-positive group than in the APCA-negative group. The quantitative levels of APCA were positively correlated with the imaging score. Multivariate analysis found that the long disease duration, elevated APCA and elevated KL-6 level were independent risk factors for ILD in pSS patients. The area under ROC curve for APCA was 0.6618, and the threshold concentration was 153.82ng/ml (sensitivity 45.24%, specificity 87.50%).

Conclusion

APCA level is an independent risk factor and might be a potential biomarker for ILD in patients with pSS.

Keywords:
Interstitial lung disease
Primary Sjögren's syndrome
Anti-parietal cell antibodies
Risk factor
Biomarker
Resumen
Antecedentes

La enfermedad pulmonar intersticial (EPI) es una manifestación común del síndrome de Sjögren primario (SSp) y está relacionada con un mayor riesgo de muerte. Los anticuerpos anticélulas parietales (AACP) están fuertemente expresados por células epiteliales alveolares proliferantes en los pulmones fibróticos y están relacionados con la disminución acelerada de la función pulmonar en la gibrosis pulmonar idiopática. En este estudio, pretendemos evaluar la aplicación clínica de la AACP en pacientes con EPI con SSp.

Método

Se revisaron los datos clínicos, de laboratorio, de función pulmonar e imágenes de los pacientes con SSp y se utilizó la ESSDAI para evaluar la actividad de la enfermedad en general. Se registraron 5 características principales de imagen pulmonar de la EPI y 2 radiólogos ciegos experimentados realizaron una puntuación semicuantitativa de HRCT de forma independiente. Comparamos las características clínicas de los pacientes con y sin EPI con SSp y realizamos un análisis de regresión logística de los factores de riesgo de EPI en SSp.

Resultados

Un total de 74 pacientes con SSp y 40 controles sanos fueron incluidos en el estudio. La EPI es más común en el grupo positivo de AACP que en el grupo negativo de APCA. El nivel cuantitativo de AACP, está positivamente relacionado con la puntuación de imagen. El análisis multifactorial encontró que la larga duración, el aumento de los niveles de AACP y el aumento de los niveles de KL-6 fueron factores de riesgo independientes para la EPI en pacientes con SSp. El área bajo la curva ROC de AACP es de 0,6618 y la concentración umbral fue de 153,82 ng/ml (sensibilidad 45,24% y especificidad 87,50%).

Conclusiones

Los niveles de AACP son un factor de riesgo independiente y pueden ser biomarcadores potenciales de EPI en pacientes con SSp.

Palabras clave:
Enfermedad pulmonar intersticial
Síndrome de Sjögren primario
Anticuerpos anticélulas parietales
Factores de riesgo
Biomarcadores

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