Secretory leukocyte proteinase inhibitor (SLPI) expression on lacrimal and salivary glands of patients with Sjogren's syndrome after pilocarpine hydrochloride tablets treatment.

Abstract

Abstract: : Purpose: To determine the expression of SLPI in lacrimal and salivary glands from patients with primary Sjogren's syndrome before and after oral pilocarpine treatment. Methods: Ten patients with Sjogren's syndrome and 10 healthy controls were used. After providing written informed consent, the patients with primary SS and clinically significant dry mouth and dry eyes were randomized to receive 5–mg pilocarpine, or placebo tablets 4 times daily for 20 weeks. All individuals underwent a systemic and ophthalmological evaluation, lacrimal and salivary glands biopsies were performed before and after pilocarpine treatment. Sections from the gland biopsies were stained with hematoxylin and eosin. Immunohistochemical (SLPI) and apoptosis staining was performed. Sialometry pre and post treatment were made. Results: The light microscopic examination revealed the presence of a mononuclear infiltration in the salivary and lacrimal glands of patients with Sjogren's syndrome before pilocarpine treatment, with intense SLPI and apoptosis staining results. Acinar expression was variable and weaker than that seen in ducts. In contrast, sections of healthy individuals and from patients with oral pilocarpine treatment revealed a weak immuno–staining and decreased lymphocyte infiltration. Conclusion: These results demonstrate complex and variable changes in ductal expression of SLPI in primary SS, which may be important in the control of lymphoid infiltration and help to attenuate potential inflammation during clearance of apoptotic cells and tissue remodelling.

Keywords: cornea: tears/tear film/dry eye • autoimmune disease • lacrimal gland