Relationship between lymphocytic infiltration grading in lacrimal glands and concentration of tear lactoferrin of the patients with sjogren's syndrome

Purpose: Decrease of reflex tearing with lymphocytic infiltration in lacrimalglands of patients with Sjogren's syndrome (SS) and decrease of tearproteinin dry eye syndrome have been reported, however, relationship between severity of the iymphocyticinfiltrationand concentration of the tear protein in SS is unclear. Thus the present study was designed to explore whether grading of iymphocyticinfiltration is related to the concentration of tear lactof errin as a major tear protein in S S. Methods: The patients were divided into two groups; 1 ) SS is diagnosed by modified Fox's criteria with severe lymphocytic infiltration (Greenspan grade 3 or 4) (n=6; female: age55.5 y/o, defined positive serum auto-antibodies) and 2) borderline SS (BSS) is diagnosed by the same criteria with none or mild Iymphocyticinfiltration (Greenspan grade 0 or 1) (n=5; female: age 53.2 y -o. defined or mild positive serum auto-antibodies, including ANA or RF: 40-SQx). The concentration of the lactoferrin was estimated by LACTOPLATETM (JDC, Netherlands) and tear volumes of the two groups ware measured by Schirm er 1 test (S 1 ) and Schirm er test with nasal stimulation(NST) (Tsubota, 1992). Results: There were significant differences between the concentration of lactof errin of SS (0.22+/-0.24 mg/ml) and of BSS (1.43+' 1.17 mg/ml)(p< 0-01). However, there were no significant differences between SS and BSS intheresultof theSl reading (3.9+/ 2.6mm and4.6+/ 3.0 mm) (p>0.05) and the percentage of positive NST (25% and 33%) (p>0.05). Conclusion: The severity of lymphocyticinfiltrationinlacrimalgland is related to the decrease of tear lactoferrin concentration. For evaluation of the function of lacrimalgland with Iymphocyticinfiltration, measuring of concentration of tear lacioferrin might be important.