Am. J. Respir. Crit. Care Med.,
Volume 156, Number 2, August 1997, 637-641
CD4-Positive T-Lymphocytes Infiltrate the Bronchial
Mucosa of Patients with Sjögren's Syndrome
SPYROS A.
PAPIRIS,
MARINA
SAETTA,
GRAZIELLA
TURATO,
RENATO
LA CORTE,
LUCIO
TREVISANI,
CRISTINA E.
MAPP,
PIERO
MAESTRELLI,
LEONARDO M.
FABBRI,
and
ALFREDO
POTENA
Institute of Occupational Medicine, Department of Pulmonary Diseases, University of Padova, Department of Rheumatology,
Department of Internal Medicine, S. Anna Ferrara General Hospital, Section of Respiratory Diseases, Department of
Clinical and Experimental Medicine, University of Ferrara, and Section of Respiratory Pathophysiology,
S. Anna Ferrara General Hospital, Ferrara, Italy
To investigate the degree and the type of inflammation in the bronchial mucosa in patients with
Sjögren's syndrome, we examined lobar bronchial biopsies obtained from 10 patients with Sjögren's syndrome (six with primary and four with secondary) and eight control subjects. Histochemistry with
hematoxylin-eosin was performed both to identify the number of mononuclear cells and eosinophils and to measure the thickness of the basement membrane. Immunohistochemistry was performed to
identify neutrophils (neutrophil-elastase), macrophages (CD68), and T-lymphocyte subpopulations
(CD4 and CD8) in the submucosa. Subjects with Sjögren's syndrome presented a greater number of CD4-positive T-lymphocytes than did the normal control subjects (p = 0.0129). Instead, eosinophils,
neutrophils, macrophages, CD8 positive T-lymphocytes, and basement membrane thickness were similar in the two groups. There were no differences in cell counts between patients with primary
and those with secondary Sjögren's syndrome and between symptomatic and asymptomatic patients. No correlation was found between cell counts, symptoms, lung volumes, and disease duration.
This study has shown that patients with Sjögren's syndrome have an increased number of CD4 positive T-lymphocytes in the bronchial mucosa outside of the bronchial glands, supporting the concept
that, in the airways, Sjögren's syndrome involves also extraglandular tissues.
