A non-invasive model for diagnosis of primary Sjogren’s disease based on salivary biomarkers, serum autoantibodies, and Schirmer’s test

Abstract Background Minor salivary gland (MSG) biopsy is a critical but invasive method for the classification of primary Sjögren’s disease (pSjD). Here we aimed to identify salivary proteins as potential biomarkers and to establish a non-invasive prediction model for pSjD. Methods Liquid chromatogr...

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Main Authors: Xinwei Zhang, Zhangdi Liao, Yangchun Chen, Huiqin Lu, Aodi Wang, Yingying Shi, Qi Zhang, Ying Wang, Yan Li, Jingying Lan, Chubing Chen, Chaoqiong Deng, Wuwei Zhuang, Lingyu Liu, Hongyan Qian, Shiju Chen, Zhibin Li, Guixiu Shi, Yuan Liu
Format: Article
Language:English
Published: BMC 2024-12-01
Series:Arthritis Research & Therapy
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Online Access:https://doi.org/10.1186/s13075-024-03459-7
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Summary:Abstract Background Minor salivary gland (MSG) biopsy is a critical but invasive method for the classification of primary Sjögren’s disease (pSjD). Here we aimed to identify salivary proteins as potential biomarkers and to establish a non-invasive prediction model for pSjD. Methods Liquid chromatography-tandem mass spectrometry was conducted on whole saliva samples from patients with pSjD and non-Sjögren control subjects (non-pSjD). Proteins involved in immune processes were upregulated in the pSjD group, such as complement C3 (C3), complement factor B (CFB), clusterin (CLU), calreticulin (CALR), and neutrophil elastase (NE), which were further confirmed by ELISA. Multivariate logistic regression analyses were performed to identify markers that differentiated pSjD from non-pSjD; receiver operating characteristic (ROC) curves were constructed. A diagnostic model based on the combination of salivary biomarkers (CFB, CLU, and NE), serum autoantibodies (anti-SSA /Ro60 and anti-SSA/Ro52), and Schirmer’s test was evaluated in 186 patients (derivation cohort) with replication in 72 patients (validation cohort). Results In multivariate analyses, CFB, CLU, and NE were independent predictors of pSS. A model based on the combination of salivary biomarkers (CFB, CLU, and NE), serum autoantibodies (anti-SSA and anti-Ro52), and Schirmer’s test achieved significant discrimination of pSS. In the derivation cohort, the area under curve (AUC) of the ROC was 0.930 (95% CI 0.877–0.965, P < 0.001), with a sensitivity and specificity of 84.85% and 92.45%, respectively. Notably, similar results were obtained in a validation cohort. Conclusion The 6-biomarker panel could provide a novel non-invasive tool for the classification of pSjD.
ISSN:1478-6362