Relationship of Hla‐Dw3 and Hla‐B8 to Sjögren'S Syndrome

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Abstract
Nineteen patients with Sjögren's syndrome were evaluated for the presence of HLA‐B8 and HLA‐Dw3. HLA‐B8 was found in 57.8% of patients and 20.1% of 96 controls (P > 0.0001). HLA‐Dw3 was detected in 73.7% of the patients and 24.0% of controls (P > 0.00001). Statistical evaluation of the association of both antigens with Sjögren's syndrome revealed that the primary association was with HLA‐Dw3 (P > 0.005). Patients with HLA‐Dw3 had a lower mean parotid salivary flow rate (0.8 ± 0.3 ml/10 minutes/gland versus 5.6 ± 1.2 ml/10 minutes/gland, P < 0.00004) and a more intense lymphocytic infiltration into labial salivary glands (focus score 7.2 ± 0.9 versus 3.4 ± 0.9, P < 0.04) than did patients without HLA‐Dw3. The difference in the intensity of the lymphocytic infiltration was even more significant when patients with both HLA‐Dw3 and HLA‐B8 were compared with patients with neither antigen (focus score 7.5 ± 1.0 versus 2.8 ± 0.8, P < 0.02). In addition, all patients with severe keratoconjunctivitis sicca had both antigens. Our observations suggest that a number of genes may interact to determine susceptibility and severity in Sjögren's syndrome.

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