Cluster of differentiation 30 expression in lacrimal gland and conjunctival tissues in patients with Sjögren's syndrome: Case series

Medicine (Baltimore). 2019 Jul;98(29):e16390. doi: 10.1097/MD.0000000000016390.

Abstract

Introduction: Sjögren's syndrome (SS) often causes lymphoproliferative disorders such as malignant lymphoma and macroglobrinemia. Approximately 5% of long-term follow-up SS patients develop malignant lymphoma. Recently, the tumor necrosis factor receptor superfamily cluster of differentiation 30 (CD30) has been thought to be implicated in malignant cells in organs affected by Hodgikin lymphoma or in a prognostic marker of diffuse large B cell lymphoma. In this study, we investigated CD30 expression in lacrimal gland and conjunctiva in patients with SS.

Methods: We examined lacrimal gland and conjunctival tissues for the diagnosis from 3 female SS patients with a median age of 51 and 3 female chronic graft-versus-host disease (cGVHD) patients with a median age of 41. Histological analysis of these tissues of the remaining samples was conducted by methods including immunohistochemistry and electron microscopy (#20090277). We analyzed the expression and localization of cluster of differentiation 4 (CD4), cluster of differentiation 8 (CD8), cluster of differentiation 20 (CD20), CD30, and Interferon-γ in tissue sections prepared from lacrimal glands and conjunctiva in 3 each of SS and cGVHD patients.

Results: There were more B cells and plasma cells in lobules of SS-affected lacrimal glands than in those of their cGVHD-affected counterparts. Interferon-γ was expressed on endothelia of capillaries in SS-affected lacrimal gland and conjunctival tissues whereas it was expressed on fibroblasts in their GVHD-affected equivalents. Furthermore, lacrimal glands and conjunctiva disordered by SS had a greater number of CD30 cells than those disordered by cGVHD.

Conclusion: Our results suggest that CD30 cells are increased in lacrimal glands and conjunctiva affected by SS and that a subset of SS patients are thereby at risk of development malignant lymphoma.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • B-Lymphocytes / immunology
  • Conjunctiva* / immunology
  • Conjunctiva* / pathology
  • Female
  • Graft vs Host Disease* / diagnosis
  • Graft vs Host Disease* / immunology
  • Graft vs Host Disease* / pathology
  • Humans
  • Immunohistochemistry
  • Interferon-gamma / blood
  • Ki-1 Antigen* / analysis
  • Ki-1 Antigen* / immunology
  • Lacrimal Apparatus* / immunology
  • Lacrimal Apparatus* / pathology
  • Lymphoma / diagnosis*
  • Microscopy, Electron / methods
  • Middle Aged
  • Peptide Fragments / blood
  • Plasma Cells / immunology
  • Prognosis
  • Sjogren's Syndrome* / diagnosis
  • Sjogren's Syndrome* / immunology
  • Sjogren's Syndrome* / pathology

Substances

  • Ki-1 Antigen
  • Peptide Fragments
  • interferon gamma (1-39)
  • Interferon-gamma