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Clinical usefulness of anti-muscarinic type 3 receptor autoantibodies in patients with primary Sjögren’s syndrome
M. Mona1, S. Mondello2, J.Y. Hyon3, W. Saleh4, K. Han5, H.-J. Lee6, Y.-J. Ha7, E.H. Kang8, Y.J. Lee9, S. Cha10
- Division of Oral Medicine, Department of Oral and Maxillofacial Diagnostic Sciences, and Department of Oral Biology, University of Florida College of Dentistry, Gainesville, FL, USA.
- Division of Critical Care Medicine, Department Anesthesiology, University of Florida College of Medicine, Gainesville, FL, USA.
- Department of Ophthalmology, Seoul National University Bundang Hospital, Seongnam-si, Republic of Korea.
- Division of Oral Medicine, Department of Oral and Maxillofacial Diagnostic Sciences, University of Florida College of Dentistry, Gainesville, FL, USA.
- Department of Microbiology, Dankook University College of Natural Science, Cheonan, Republic of Korea.
- Division of Periodontology, Department of Dentistry, Seoul National University Bundang Hospital, Seongnam-si, Republic of Korea.
- Division of Rheumatology, Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam-si, Republic of Korea.
- Division of Rheumatology, Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam-si, Republic of Korea.
- Division of Rheumatology, Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam-si, Republic of Korea.
- Division of Oral Medicine, Department of Oral and Maxillofacial Diagnostic Sciences, and Department of Oral Biology, University of Florida College of Dentistry, Gainesville, FL, USA. scha@dental.ufl.edu
CER13391
2021 Vol.39, N°4
PI 0795, PF 0803
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PMID: 33124573 [PubMed]
Received: 01/04/2020
Accepted : 22/06/2020
In Press: 06/10/2020
Published: 08/07/2021
Abstract
OBJECTIVES:
To elucidate the clinical values of anti-M3R in Sjögren’s syndrome (SS) in the largest cohort for an anti-M3R study.
METHODS:
The plasma of 361 subjects (156 primary SS [pSS], 62 non-SS-sicca [SICCA], 40 systemic lupus erythematosus [SLE], 50 rheumatoid arthritis [RA], and 53 healthy controls [HC]) was screened using our modified On-Cell-Western assay. Saliva from pSS (n=37) compared to SICCA (n=26) was also analysed. The sensitivity and specificity of anti-M3R and its association with comprehensive clinical and laboratory features were determined.
RESULTS:
Plasma-anti-M3R was higher in pSS compared to other groups, differentiating pSS with good-to-excellent diagnostic power with a specificity of 85% and a sensitivity between 75% and 98%. pSS plasma-anti-M3R was positively correlated with ocular staining scores, anti-Ro/SSA, IgG, β2-microglobulin, ESR, and ESSDAI. It was negatively correlated with WBC, C4, and salivary scintigraphic indices. Saliva-anti-M3R was 3.59 times higher in pSS than in SICCA. Interestingly, the agreement between the 2002 American European Consensus Group criteria and the criteria substituted with plasma-anti-M3R for the lip biopsy reached 92%, with a significant kappa of 0.824.
CONCLUSIONS:
Anti-M3R enhances sensitivity and specificity for SS diagnosis, correlating with ocular dryness and glandular hypofunction, and the haematological/biological domains of the ESSDAI. Our findings also highlight the clinical significance of anti-M3R in SS diagnosis, especially where clinical assessments, such as lip biopsy, sialometry, or ocular evaluation, by multi-disciplinary specialists are limited.
