Pulmonary function abnormalities in Sjogren's syndrome and the sicca complex.

Segal, I; Fink, Gereon R.; Machtey, I; Gura, Victor; Spitzer, Simon

doi:10.1136/thx.36.4.286

Cited by 61 publications

(25 citation statements)

References 14 publications

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“…Most of these studies [3,6,8,11] have shown signs of restrictive pulmonary disease in accordance with our previous resuits [1]. Other studies [4,5] have shown signs of obstructive ventilatory disease.…”

Section: Discussionsupporting

confidence: 80%

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A follow-up study of pulmonary function in patients with primary Sjögren's syndrome

et al. 1990

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Twenty-seven patients (25 women, 2 men) with primary Sjögren's syndrome, previously reported to have reduced pulmonary diffusing capacities were reexamined in a 7-year follow-up in order to evaluate longitudinal alterations in pulmonary function. Primary Sjögren's syndrome was diagnosed according to the Copenhagen criteria. The present examination revealed normal and unchanged values for vital capacity, forced expiratory volume in 1 s, maximal expiratory flow at 50% of expired vital capacity (MEF50), and diffusing capacity per liter alveolar volume. Total diffusing capacity (P less than 0.01) and MEF75 (P less than 0.05), were, however, significantly reduced compared with the predicted values, indicating pulmonary involvement primarily affecting the small airways. The longitudinal examination, furthermore, showed increasing values for total diffusing capacity (P less than 0.02), diffusing capacity per liter alveolar volume (P less than 0.001), and MEF75 (P less than 0.02), suggesting an improvement in lung status in the course of time. No correlation was found between MEF75 and diffusing capacities, nor between alterations in pulmonary function and complaints of dyspnoea, tiredness, cough, expectoration, tobacco smoking, or medical treatment with bromhexine, glucocorticosteroids, essential fatty acids, or nonsteroid antiinflammatory drugs.

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Section: Discussionsupporting

confidence: 80%

“…Some authors [3,8,10] have demonstrated the presence of a restrictive lung disease affecting above all the small airways. Segal et al examined 20 patients with SS and concluded that airway obstruction was the most common abnormality [4].…”

Section: Introductionmentioning

confidence: 99%

A follow-up study of pulmonary function in patients with primary Sjögren's syndrome

et al. 1990

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“…In our patients, in accordance with the studies of Newball and Brahim [2], there is only a moderate restrictive syndrome. On the other hand, the injury of the diffusing ca pacity seems to be, more frequent and im portant, in accordance with what is sug gested by other authors [3,6], demonstrat ing a marked decrease in the interstitial gases exchange. The pathogenesis of this abnormality seems to reside, as suggested by the analysis of the BAL, in a lympho cytic infiltration of the lung's interstitium; there is then constantly present an alveoli tis, even if it is less serious than in other immunological disorders ( fig.…”

Section: Discussionsupporting

confidence: 79%

“…In conclusion, the pulmonary involve ment in SS is: constant and markedly higher than the 60% suggested by other au thors [2,6); unpredictable, indeed we have found no relation between the physiologi cal abnormalities, the BAL and the dura tion of the disease, which is of great clini cal-physiological importance, confirming the respiratory troubles that these patients often complain of [2,3]. At the same time we can say that the BAL seems to be, com pared to the clinical-roentgenographicphysiological analysis, more sensitive in pointing out the pulmonary involvement, and in providing new information for the understanding of the pathogenesis of the disease.…”

Section: Discussionmentioning

confidence: 72%

Pulmonary Involvement in Sjögren’s Syndrome

et al. 1984

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In this study we tried to value the frequency and the characteristics of the physiological abnormalities affecting the lungs in Sjögren’s syndrome (SS). We studied 18 female nonsmokers (average age 53 years). The diagnosis has been made on the presence of at least two of the following abnormalities: keratoconjunctivitis sicca (Schirm-er’s test), xerostomia (scanning of the salivary glands, lip biopsy) and collagen vascular disease. We made the following tests: clinical examination, chest roentgenogram, spirometry, TGV, RAW and SGAW valuation, study of the flow-volume curves, diffusion capacity test, bronchoalveolar lavage, bronchial biopsy. The physiological results have demonstrated the presence of a restrictive syndrome affecting above all the small airways (MEF25 -32.7%) and a decrease of the diffusion capacity (DLCO -25%). There is, moreover, a constant lymphocitic infiltration of the bronchial mucosa and of the lung’s interstitium. In conclusion the pulmonary involvement in SS seems to be constant, unpredictable and of remarkable clinical-physiological importance

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“…Differences between primary and secondary SS in terms of pulmonary involvement have been described [26,37]. Primary SS patients who are anti-Ro antibody positive often develop more systemic manifestations, with lung disease being commonly reported [6,9,15,29,33]. The most frequent pulmonary abnormalities are interstitial lung disease with interstitial pneumonia (SS-IP) and small airways disease.…”

Section: Introductionmentioning

confidence: 96%

Distribution of CXCR3- or CCR4-positive cells in interstitial pneumonia associated with primary Sj�gren?s syndrome

et al. 2004

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Patients with primary Sjogren's syndrome (SS) occasionally develop interstitial pneumonia (SS-IP), the prognosis of which is less grave compared with that of idiopathic pulmonary fibrosis (IPF). We examined distribution of helper T-cell subsets in open lung biopsy specimens from seven patients with SS-IP and, for comparison, ten patients with IPF. The expression of CXCR3 and CCR4, chemokine receptors associated in vitro with Th1 and Th2 cells, respectively, was analyzed in the mononuclear infiltrate using immunohistochemistry. The expression of CD4, CD8, and CD20 in the infiltrate was similarly examined. The positive cells were semiquantified in fibrosing areas and lymphoid clusters of both SS-IP and IPF. In fibrosing areas, CXCR3-positive cells were dominant over CCR4-positive cells in all cases of SS-IP, whereas the two types of cells showed no such difference in cases of IPF. Each of the CXCR3/CD4 and CXCR3/CCR4 ratios was significantly higher in SS-IP than in IPF ( P<0.05 and P<0.05, respectively). The CCR4/CD4 ratio showed a significantly lower value in SS-IP than in IPF ( P<0.05). In lymphoid clusters, prominent in SS-IP and few and small in IPF, CXCR3-positive cells predominated over CCR4-positive cells in both lung lesions. There was no significant difference of CXCR3/CCR4 ratio in lymphoid clusters between SS-IP and IPF ( P=0.33). These findings in SS-IP are in accordance with those reported in previous studies of the salivary glands of SS patients, where most of the infiltrating lymphocytes expressed CXCR3, and the expression of interferon-gamma was upregulated. In contrast, the Th2 cell dominance was reported in IPF in the previous studies. The present findings suggest that the pathogenesis of interstitial pneumonia is different between SS-IP and IPF in regard to the roles of helper T-cell subsets.

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Pulmonary function abnormalities in Sjogren's syndrome and the sicca complex.

Cited by 61 publications

References 14 publications

A follow-up study of pulmonary function in patients with primary Sjögren's syndrome

A follow-up study of pulmonary function in patients with primary Sjögren's syndrome

Pulmonary Involvement in Sjögren’s Syndrome

Distribution of CXCR3- or CCR4-positive cells in interstitial pneumonia associated with primary Sj�gren?s syndrome

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