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Background:Essential ω-3 and ω-6 fatty acids (FA) are natural modulators of inflammation activity; however, their role in primary Sjögren’s syndrome (pSS) is unknown.Objectives:To evaluate the intake and serum levels of ω-3 and ω-6 FA in patients with pSS, and to correlate them with ocular and oral signs and symptoms, disease activity as well as with the presence of a panel of inflammatory chemokines/cytokines in saliva and tears.Methods:We included 108 patients with pSS according to EULAR/ACG criteria. We excluded patients under ω-3 and ω-6 supplementation. Dietary information was obtained from a semiquantitative food frequency questionnaire of one-day reminder (applied by a trained interviewer), and processed using computerized nutritional analysis software. Fasting blood samples were collected. We measured the serum levels of ω-3 (α-linolenic acid [α-L], eicosapentaenoic acid [EPA], docosahexaenoic acid [DHA]) and ω-6 (linoleic acid [LA], arachidonic acid [AA]) using gas chromatography flame ionization. We assessed the ESSDAI score, ESPPRI, OSDI, tear film break-up time, Schirmer-I test and the SICCA Ocular Staining Score (OSS). In a subgroup of patients, we obtained tears and saliva samples that were frozen at -86°C until assayed. Once defrosted, the levels of CXCL8, CXCL10, CCL2, IL-22 and IL-21 in saliva and CXCL8, CXCL10, CCL2 and CXCL9 in tears were measured by Luminometry.Results:The median age was 56.12 ± 13.7 years, 94.4% women and median disease duration 10 years. The FA ω-3 and ω-6 intake was 0.43 g/day and 3 g/d, respectively. The levels of α-L were 6.6 μg/mL, DHA 26 μg/mL, total ω-3 (α-L +DHA) 25.4 μg/mL, LA 168.5 μg/mL, AA 34 μg/mL, and total ω-6 (LA+AA) 205 μg/mL. We did not find a correlation among serum levels and food intake. Thus, further analyses were focused on serum results. We found a negative correlation between α-L and the OSDI (ρ= -0.42, p= 0.01) and ESSDAI (ρ= -0.26, p=0.03) as well of DHA and ESSDAI (ρ= -0.30, p= 0.01). The rest of the variables were not associated. In tears, there was a positive correlation of AA and CXCL9 (ρ= 0.48, p= 0.04), whereas in saliva, we observed a negative correlation between α-L, DHA and total ω3 (α-L+DHA) with CCL2. We also observed a negative correlation between total ω6 (LA+AA) and IL-21, and the ω6/ω3 ratio with IL-22.Conclusion:Our pSS patients had deficient FA omega intake. We observed lower ocular symptoms, lower ESSDAI scores and salivary levels of CCL2 among patients with higher levels of FA ω-3. Our study suggest that low serum levels of ω-3 might be implicated in the perpetuation of chronic inflammation. Disclosure of Interests:None declared

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BackgroundPatients with primary Sjögrens' syndrome (PSS) suffer from severe alterations in both the quality and quantity of saliva and tears. Body water represents around 50–55% of the body weight. Tears contain 98% of water and saliva 99.5%.ObjectivesTo evaluate the percentage of total body water (TBW) among patients with PSS and to assess its correlation with sicca symptoms.MethodsWe included 85 patients with PSS and 85 historical non diabetic controls matched by gender, age (±3 years) and body mass index (±1kg/m2) (BMI). We assessed the presence of sicca symptoms, Schirmer-I test, non-stimulated whole salivary flow (NSWSF) and ocular staining. We also evaluated the ocular and oral domains of the ESSPRI, a validated scale for symptoms (a higher score implies worst symptoms). We obtained the TBW percentage with a bioelectric impedance analysis (BIA-SECA-514, Hamburgo).Results80% were women, mean age 54.8±13.7 years and mean disease duration 11.5±7.52 years. The percentage of TBW was similar among patients and controls (PSS 46.85±4.6 vs. 46.9±4.5, p=0.88). Among the patients, the TBW negatively correlated with age (ρ=-0.25, p=0.02), disease duration (ρ=-0.30, p=0.005), BMI (ρ=-0.78, p=0.001) and the ocular component of the ESSPRI (ρ=-0.28, p=0.01), but not with the NSWSF or the ESSPRI oral component. When we compared the patients in the 25% percentile (group with the lowest % of water) vs. the remaining patients, the former group was older (56.6±8.1 vs. 54±14.2, p=0.02), with longer disease duration (12.4±5.9 vs. 10.8±7.12, p=0.03), lower scores at the Schirmer test (1 (range 0–8) vs. 2 (range 0–9), p=0.01), higher BMI (31.1±5.1 vs. 23.7±2.9, p=0.001) as well as with higher ESSPRI ocular domain scores (8.3±1.4 vs. 6.7±2.5, p=0.007). With the linear regression analysis, the variables that remained associated with the TBW were disease duration (β -0.22, p=0.001), BMI (β-0.76, p<0.001) and the ocular domain of the ESSPRI (β-0.15, p<0.001).ConclusionsPatients with PSS had similar TBW percentage than controls. However among patients with PSS, the TBW had a negative correlation with the intensity of ocular symptoms independently of disease duration, age and BMI.References Guyton, Arthur C. (2006). Textbook of Medical Physiology (11th ed.). Philadelphia: W.B. Elsevier Saunders. p. 295. ISBN 0–7216–0240–1. Disclosure of InterestNone declared