原发性干燥综合征外分泌腺体评估新技术

New techniques for evaluating exocrine glands in primary Sjögren’s syndrome

原发性干燥综合征(primary Sjögren’s syndrome,pSS)是一种慢性、全身性、炎症性、系统性的自身免疫性疾病,其病理学特征为淋巴细胞浸润引起的外分泌腺进行性损害。其外分泌腺损害主要表现为唾液腺和泪腺的功能受损,临床表现为口干和眼干,以及腺体外多系统受累表现,如周围神经病变、关节炎、肺部疾病等。正是因为pSS的临床表现多样,体征不特异,导致pSS的诊断困难。侵袭性小、特异性高的唇腺活检,作为目前最常用的评估腺体受累的方法。通过评估唇腺的组织病理学特征,不仅可以辅助诊断,也可用来评估生物制剂治疗效果。最近,外分泌腺评估的新技术逐渐兴起,本文将综述唇腺的组织病理学特征、潜在生物标志物,以及评估外分泌腺的新技术。

Primary Sjögren’s syndrome is a chronic,systemic,inflammatory,systemic autoimmune disease characterized pathologically by progressive damage to the exocrine glands caused by lymphocytic infiltration.The damage to theexocrine glands mainly manifests as dysfunction of the salivary and lacrimal glands,clinically presenting with dryness of the mouth and eyes,and extrinsic glandular multisystem involvement,including neuropathies,arthritis and pulmonary manifestations.The diagnosis of pSS remains difficult,since the clinical manifestations of pSS are varied and the signs are not specific.Currently,minor salivary gland biopsy is the most common method to determine the salivary gland composition in pSS in clinical setting due to its minimal invasiveness and disease specificity.It not only aids in diagnosis through the histopathological evaluation of the minor glands but is also used to judge the efficacy of biological agents.Recently,new techniques for the evaluation of exocrine glands have gradually emerged.In this review,we summarized the histopathological characteristics of the minor salivary glands,potential biomarkers,and potential technologies for assessing the exocrine glands in pSS.