Male patients with primary Sjögren's syndrome have unique clinical manifestations and circulating lymphocyte profiles

OBJECTIVES

We aimed to explore the relationship between clinical characteristics and circulating lymphocyte profiles in Chinese male patients with primary Sjögren's syndrome (pSS).

METHOD

Data from 397 patients with pSS were analyzed retrospectively. 37 were male, which is a prevalence of 9.3%. The clinical, laboratory, and immunophenotypic profiles of peripheral blood lymphocyte subsets were compared between male and female pSS patients.

RESULTS

Male patients with primary Sjögren's syndrome have unique clinical manifestations and circulating lymphocyte profiles. Male patients complained more about xerophthalmia and presented with more extra-glandular manifestations as compared with female patients. The CD4+/CD8+ ratio (P = 0.030), the prevalence of CD4-CD8- T cells in lymphocytes (P = 0.020), the absolute number of CD4-CD8- T cells (P = 0.035), the prevalence of CD4+ T cells in lymphocytes (P < 0.001), and the absolute number of CD4+ T cells (P = 0.023) were significantly lower in male patients compared to female patients. On the other hand, the prevalence of CD8+CD28+ T cells (P = 0.030) and CD4+CD25high T cells (P = 0.040) in lymphocytes was significantly higher in male patients than in female patients. Moreover, compared to females with pSS, an elevated serum IgG level, low C3 and C4 levels, anti-SSB positivity, and ANA titers of ≥ 1:160 positivity were more frequent in male with pSS.

CONCLUSIONS

Male patients with pSS have distinctive peripheral blood lymphocyte subpopulations, present with more severe clinical symptoms and immunological features, and have an unfavorable prognosis. Key Points • Male patients with pSS have more severe clinical symptoms and specific characteristics of peripheral blood lymphocyte subsets. • Male pSS patients exhibit a higher intensity of the disease (as evaluated by ESSDAI). • Male patients with pSS require individualized treatment regimens and closer follow-up.

Analysis of lymphocyte profile in lymph nodes, bronchoalveolar lavage fluid and peripheral blood in patients with stage II sarcoidosis

OBJECTIVE

To evaluate the lymphocyte profile (LP) in lymph node puncture fluid (LNPF) of mediastinal and hilar lymph nodes, bronchoalveolar lavage fluid (BALF), and peripheral blood (PB) involved in stage 2 sarcoidosis.

METHODS

After selection, 31 patients diagnosed with stage II sarcoidosis were finally included. Patients were further divided into symptomatic (n = 17) and asymptomatic (n = 14) groups according to the presence or absence of respiratory symptoms. The LP in lymph node puncture fluid (LNPF), bronchoalveolar lavage fluid (BALF), and peripheral blood (PB) were evaluated and compared using flow cytometry. The relationship between respiratory symptoms and LP was preliminarily analyzed.

RESULTS

The proportions of T cells and CD4 T cells, and CD4/CD8 ratio in BALF were significantly higher than that of LNPF with PB (all P < 0.05). The proportions of lymphocyte cells, CD8 T cells, NK cells, and CD4/CD8 ratio in LNPF and PB were significantly different (all P < 0.05). There were significant differences in CD4 T cells [72.40 (68.90,75.55) vs.46.30 (38.55,52.50), P = 0.004], CD8 T cells (9.9 ± 3.9 vs. 16.8 ± 6.8, P = 0.002), and CD4/CD8 ratio (7.9 ± 2.8 vs. 3.9 ± 1.5, P < 0.001) in BALF between the symptomatic group and asymptomatic group (all P < 0.05). The T cells (rs = 0.447, P = 0.011), CD4 (rs = 0.572, P = 0.002), and CD4/CD8 ratio (rs = 0.701, P < 0.001) in BALF were positively correlated with respiratory symptoms.

CONCLUSION

The LP in LNPF, BALF and PB were significantly different and the main index correlated with respiratory symptoms was CD4/CD8 ratio in BALF. The difference of LP in BALF and LNPF may help to deeply understand the pathophysiological process and may reflect the different degree of lung and lymph node lesion.