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CD4 T lymphocyte autophagy is upregulated in the salivary glands of primary Sjögren’s syndrome patients and correlates with focus score and disease activity

  • Alessandri, Cristiano1
  • Ciccia, Francesco2
  • Priori, Roberta1
  • Astorri, Elisa1
  • Guggino, Giuliana2
  • Alessandro, Riccardo3
  • Rizzo, Aroldo4
  • Conti, Fabrizio1
  • Minniti, Antonina1
  • Barbati, Cristiana1
  • Vomero, Marta1
  • Pendolino, Monica1
  • Finucci, Annacarla1
  • Ortona, Elena5
  • Colasanti, Tania1
  • Pierdominici, Marina5
  • Malorni, Walter5
  • Triolo, Giovanni2
  • Valesini, Guido1
  • 1 Sapienza Università di Roma, Dipartimento di Medicina Interna e Specialità Mediche, Rome, Italy , Rome (Italy)
  • 2 Università degli Studi di Palermo, Dipartimento Biomedico di Medicina Interna e Specialistica, Palermo, Italy , Palermo (Italy)
  • 3 Università di Palermo, Dipartimento di Biopatologia e Biotecnologie Mediche e Forensi, Palermo, Italy , Palermo (Italy)
  • 4 Pathology Unit, Azienda Ospedaliera Ospedali Riuniti Villa Sofia-Cervello, Palermo, Italy , Palermo (Italy)
  • 5 Centro per la Medicina di Genere, Istituto Superiore di Sanità, Rome, Italy , Rome (Italy)
Published Article
Arthritis Research & Therapy
Springer Science and Business Media LLC
Publication Date
Jul 25, 2017
DOI: 10.1186/s13075-017-1385-y
Springer Nature


BackgroundPrimary Sjögren’s syndrome (pSS) is a common chronic autoimmune disease characterized by lymphocytic infiltration of exocrine glands and peripheral lymphocyte perturbation. In the current study, we aimed to investigate the possible pathogenic implication of autophagy in T lymphocytes in patients with pSS.MethodsThirty consecutive pSS patients were recruited together with 20 patients affected by sicca syndrome and/or chronic sialoadenitis and 30 healthy controls. Disease activity and damage were evaluated according to SS disease activity index, EULAR SS disease activity index, and SS disease damage index. T lymphocytes were analyzed for the expression of autophagy-specific markers by biochemical, molecular, and histological assays in peripheral blood and labial gland biopsies. Serum interleukin (IL)-23 and IL-21 levels were quantified by enzyme-linked immunosorbent assay.ResultsOur study provides evidence for the first time that autophagy is upregulated in CD4+ T lymphocyte salivary glands from pSS patients. Furthermore, a statistically significant correlation was detected between lymphocyte autophagy levels, disease activity, and damage indexes. We also found a positive correlation between autophagy enhancement and the increased salivary gland expression of IL-21 and IL-23, providing a further link between innate and adaptive immune responses in pSS.ConclusionsThese findings suggest that CD4+ T lymphocyte autophagy could play a key role in pSS pathogenesis. Additionally, our data highlight the potential exploitation of T cell autophagy as a biomarker of disease activity and provide new ground to verify the therapeutic implications of autophagy as an innovative drug target in pSS.

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