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Ann Rheum Dis. Jul 2005; 64(7): 1050–1055.
Published online Jan 7, 2005. doi:  10.1136/ard.2004.030643
PMCID: PMC1755548

Correlation of serum B lymphocyte stimulator and ß2 microglobulin with autoantibody secretion and systemic involvement in primary Sjögren's syndrome

Abstract

Background: In primary Sjögren's syndrome (pSS), extraglandular involvement might result from more intense stimulation of autoreactive B cells. Thus markers of B cell activation could be useful in the clinical assessment of this disease.

Objective: To investigate the association of serum B lymphocyte stimulator (BLyS) and ß2 microglobulin with autoantibody production and extraglandular involvement in pSS.

Methods: Serum concentrations of BLyS and ß2 microglobulin were analysed in 177 patients with pSS according to the American–European consensus group criteria. Serum ß2 microglobulin was determined serially in 25 patients.

Results: Autoantibody secretion (presence of anti-SSA antibody alone or of both anti-SSA and anti-SSB) was associated with increased serum BLyS and ß2 microglobulin. No correlation was found between BLyS and ß2 microglobulin levels (p = 0.36). Serum concentrations of ß2 microglobulin and C reactive protein and positive anti-SSB antibody results were associated with extraglandular involvement on univariate analysis (p<10–4, p = 0.003, and p = 0.004, respectively). Serum ß2 microglobulin was also significantly increased in patients with extraglandular involvement without autoantibodies (mean (SD): 1.75 (0.7) v 1.39 (0.5) mg/l, p = 0.039). Multivariate analysis showed that extraglandular involvement was associated only with increased serum ß2 microglobulin (p = 0.035, odds ratio = 2.78 (95% confidence interval, 1.07 to 7.22)). Among the 25 patients who had serial determinations of serum ß2 microglobulin, the concentrations were increased in all those with disease flare and decreased in three following treatment. Serum BLyS, gamma globulin, IgG, and rheumatoid factor levels were not associated with features of systemic involvement.

Conclusions: Serum ß2 microglobulin and BLyS reflect B cell activation in different ways in pSS. Serum ß2 microglobulin assessment could be helpful as an activity marker in pSS.

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Figures and Tables

Figure 1
 Serum ß2 microglobulin (ß2m) and B lymphocyte stimulator (BLys) concentrations according to the presence of anti-SSA/SSB antibodies.
Figure 2
 ß2 microglobulin concentrations in patients with extraglandular involvement and in patients with glandular involvement only.
Figure 3
 Mean serum ß2 microglobulin value in 154 patients with primary Sjögren's syndrome according to the presence of extraglandular involvement and of anti-SSA/SSB antibodies.

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