Work

Increased risk of malignancy and osteoporosis in primary Sjögren’s syndrome with thyroid diseases: potential implication from T cells

Year: 2024

Type: article

Abstract: OBJECTIVES: To evaluate the impact of thyroid diseases (TDs) on the comorbidities incidence and immune system of patients with primary SS (pSS). METHODS: A total of 329 patients diagnosed with pSS who were admitted between January 2018 and September 2023 were evaluated. The patients were divided into two groups: those with and without TD. Clinical data at the onset of SS were recorded. Kaplan-Meier method and Cox proportional hazards model were utilized for survival analysis. Flow cytometry and immunofluorescence measurements were used to analyse the lymphocyte subtypes. RESULTS: Of the 329 patients, 109 had TD. The most common types of TD were thyroid nodules (40.4%) and autoimmune thyroid diseases (AITDs) (28.4%). Patients with TD exhibited a significantly elevated incidence risk of malignancy (14.7% vs. 6.4%, P = 0.01) and osteoporosis (OP) (23.9% vs. 14.1%, P = 0.03). TD comorbidity was an independent risk factor of malignancy (HR 4.7, 95% CI 1.1-19.3, P = 0.03) and OP (HR 3.7, 95% CI 1.3-10.2, P = 0.01). Patients with SS and TD exhibited a higher ratio of programmed death-1 (PD1) + subsets of total CD3+ T cells, Th and Tc cells (all P = 0.03), as well as a lower ratio of unswitched memory B cells (P = 0.01) in peripheral blood. The ratio of PD1+ subsets of Th cells in salivary glands also exhibited a significantly increase in these patients compared with those without TD (P = 0.03) and the controls (P < 0.01). CONCLUSION: The incidence risk of malignancy and OP was significantly elevated in pSS patients with TD. The significant elevated proportions of PD1+ T cells may influence the occurrence of this process.

Source: Lara D. Veeken

DOI: 10.1093/rheumatology/keae627