Usefulness of rheumatoid factor as an immunological and prognostic marker in PSS patients

• Published in: Clinical rheumatology Vol. 38; no. 5; pp. 1301 - 1307
• Main Authors: Maślińska, Maria, Mańczak, Małgorzata, Kwiatkowska, Brygida
• Format: Journal Article
• Language: English
• Published: London Springer London 01.05.2019; Springer Nature B.V
• Subjects: Adult; Aged; Antibodies, Antinuclear - blood; APRIL protein; Autoantibodies; Autoimmune Collection 2018; Autoimmune diseases; Biomarkers - blood; Biopsy; BLyS protein; CD19 antigen; CD3 antigen; CD4 antigen; Complement component C3; Complement component C4; Conjunctivitis; Cryoglobulins; Female; Fluorescent Antibody Technique, Indirect; Humans; Immunology; Lymphocytes B; Male; Medicine; Medicine & Public Health; Middle Aged; Original Article; Predictive Value of Tests; Rheumatoid factor; Rheumatoid Factor - blood; Rheumatology; Salivary gland; Salivary Glands, Minor - pathology; Sjogren's syndrome; Sjogren's Syndrome - diagnosis; Sjogren's Syndrome - pathology; Prognostic factor; Rheumatoid factor; Sjögren’s syndrome
• ISSN: 0770-3198; 1434-9949; 1434-9949
• DOI: 10.1007/s10067-019-04438-z

Introduction The rheumatoid factor (RF) is present in numerous autoimmune disorders, although its role in many of them remains a subject of research. The study assesses the role of RF as an immunological and prognostic factor in the primary Sjögren’s syndrome (pSS). Methods Seventy-five pSS patients (mean age 50.03 ± 15.1), 65 (87%) females, and 10 (13%) males. WBC, CRP, RF, ESR, gammaglobulins, C4, C3 component of complement, cryoglobulins, ANA, anti-SS-A, and anti-SS-B antibodies were determined. The disease activity assessed with ESSDAI. Minor salivary gland biopsy (focus score and immunochemistry) was conducted. Results were analyzed with U Mann-Whitney (continuous variables) tests, correlations between quantitative variables assessed with the Spearman correlation coefficient with statistical significance set at p  < 0.05. The approval of the Bioethics Committee was obtained. Results Two subgroups I-RF(+) (61%) and II-RF(−) (39%) were established, with lower WBC ( p  = 0.012) and higher ESR ( p  = 0.016), gammaglobulin concentration ( p  = 0.007) in group I. Conjunctivitis sicca was more severe in group I. There was positive correlation between RF and lnANA (rho = 0.496), anti-SS-A, anti-SS-B antibodies (rho = 0.448; rho = 0.397 respectively). There was higher disease activity ESSDAI in group I than in group II (Me, 3.0 vs 2.0; p  < 0.003). RF correlated negatively with WBC (rho = − 0.374). RF did not correlate with serum concentrations of BAFF, APRIL, CRP, and C3, C4 and with CD19+, CD3+, CD4+, CD 21+, and CD35+. Conclusions RF should be considered as a prognostic, but not diagnostic, factor in patients with pSS, as it is associated with more severe disease course (sicca eye symptoms, ESSDAI) and parameters (production of gammaglobulins, ANA, anti SS-A, anti-SS-B autoantibodies) indicating increased B cell activity.