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Clinical usefulness of anti-muscarinic type 3 receptor autoantibodies in patients with primary Sjögren’s syndrome


1, 2, 3, 4, 5, 6, 7, 8, 9, 10

 

  1. 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.
  2. Division of Critical Care Medicine, Department Anesthesiology, University of Florida College of Medicine, Gainesville, FL, USA.
  3. Department of Ophthalmology, Seoul National University Bundang Hospital, Seongnam-si, Republic of Korea.
  4. Division of Oral Medicine, Department of Oral and Maxillofacial Diagnostic Sciences, University of Florida College of Dentistry, Gainesville, FL, USA.
  5. Department of Microbiology, Dankook University College of Natural Science, Cheonan, Republic of Korea.
  6. Division of Periodontology, Department of Dentistry, Seoul National University Bundang Hospital, Seongnam-si, Republic of Korea.
  7. Division of Rheumatology, Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam-si, Republic of Korea.
  8. Division of Rheumatology, Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam-si, Republic of Korea.
  9. Division of Rheumatology, Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam-si, Republic of Korea.
  10. 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
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PMID: 33124573 [PubMed]

Received: 01/04/2020
Accepted : 22/06/2020
In Press: 06/10/2020

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.

Rheumatology Article

Rheumatology Addendum