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Vatinee Y Bunya, Gui-Shuang Ying, Maureen G. Maguire, Eric Kuklinski, Ellen Peskin, Meng C Lin, Penny A Asbell; Prevalence of Novel Candidate Sjogren's Syndrome Antibodies in the Dry Eye Assessment and Management (DREAM©) Study. Invest. Ophthalmol. Vis. Sci. 2018;59(9):937.
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© ARVO (1962-2015); The Authors (2016-present)
The novel autoantibodies salivary protein 1 (SP-1), carbonic anhydrase 6 (CA-6), and parotid secretory protein (PSP) were described in a mouse model for Sjogren's syndrome (SS), but have not been well-characterized in dry eye disease (DED) patients, with or without SS. We evaluated the prevalence of these novel candidate SS antibodies at baseline among patients in the DRy Eye Assessment and Management (DREAM©) Study, a clinical trial designed to evaluate the effectiveness of omega-3 fatty acid supplements for the treatment of DED.
Baseline medical history questionnaire responses were used to categorize DREAM© patients into 3 groups: 1) no history of SS or other autoimmune disease (n=375); 2) no history of SS but with a history of other autoimmune disease (n=66); and 3) a history of SS (n=53). Ocular surface exams and serological testing for traditional and novel SS antibodies was performed. The chi-square test or Fisher exact test (count <5) was used to compare the antibody prevalence rate among the 3 groups and between Groups 1 and 3.
Among 494 DREAM© participants, 53 (10.7%) had a history of SS and had a significantly higher prevalence of the traditional SS antibodies compared to the other two groups (Table 1). The prevalence of each of the novel antibodies was similar between Group 1 (no SS) and Group 3 (SS) in that in each group approximately 20% had SP-1 antibodies (p=0.85); approximately 16% had anti-CA-6 antibodies (p=0.84), and 10% had anti-PSP antibodies (p= 1.00). Participants positive for both traditional and novel antibodies (n=91) had significantly worse corneal fluorescein staining (mean=5.2) than those who were positive for the traditional antibodies alone (mean=4.7), for the novel antibodies alone (mean=4.4), or were negative for both traditional and novel antibodies (mean=4.1; p=0.03).
In this large cross-sectional study, there was no difference in the prevalence rate of novel candidate SS antibodies in DED patients with or without SS. The novel antibodies may define a new class of DED patients with more severe ocular surface disease but not meeting the criteria for SS, but further studies are needed. Longitudinal changes in these antibodies in this cohort will be evaluated in the future and may yield useful insights into the patterns of prevalence in SS and non-SS DED patients.
This is an abstract that was submitted for the 2018 ARVO Annual Meeting, held in Honolulu, Hawaii, April 29 - May 3, 2018.
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