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In Rheumatology (Oxford, England)

OBJECTIVES : Sjögren's syndrome is an autoimmune disease most commonly diagnosed in adults but can occur in children. Our objective was to assess the presence of chemokines, cytokines, and biomarkers (CCBMs) in saliva from these children that were associated with lymphocyte and mononuclear cell functions.

METHODS : Saliva was collected from 11 children diagnosed with Sjögren's syndrome prior to age 18 years and 16 normal healthy children. 105 CCBMs were detected in multiplex microparticle-based immunoassays. ANOVA and t test (0.05 level) were used to detect differences. Ingenuity Pathway Analysis (IPA) was used to assess whether elevated CCBMs were in annotations associated with immune system diseases and select leukocyte activities and functions. Machine learning methods were used to evaluate the predictive power of these CCBMs for Sjögren's syndrome and were measured by receiver operating characteristic (ROC) curve and area under curve (AUC).

RESULTS : 40.9% (43/105) CCBMs were different (p < 0.05) in children with Sjögren's syndrome compared to the healthy study controls and could differentiate the two groups (p < 0.05). Elevated CCBMs in IPA annotations were associated with autoimmune diseases and with leukocyte chemotaxis, migration, proliferation, and regulation of T-cell activation. The best AUC value in ROC analysis was 0.93, indicating that there are small numbers of CCBMs that may be useful for diagnosis of Sjögren's syndrome.

CONCLUSION : While 35/43 CCBMs have been previously reported in Sjögren's syndrome, 8 CCBMs had not. Additional studies focusing on these CCBMs may provide further insight into disease pathogenesis and may contribute to diagnosis of Sjögren's syndrome in children.

Gomez Hernandez M Paula, Starman Emily E, Davis Andrew B, Harishchandra Hikkaduwa Withanage Miyuraj, Zeng Erliang, Lieberman Scott M, Brogden Kim A, Lanzel Emily A


Sjögren’s syndrome, biomarkers, chemokines, children, cytokines, saliva