• J F Meilof and R J Smeenk.
• Department of Autoimmune Diseases, Central Laboratory of The Netherlands Red Cross Blood Transfusion Service, Amsterdam.
• Neth J Med. 1992 Apr 1; 40 (3-4): 140147140-7.

AbstractThe subject of this review is the humoral autoimmune response in Sjögren's syndrome. Autoantibodies in this disease are primarily directed against the Ro/SS-A and La/SS-B autoantigens and against IgG (rheumatoid factor). The Ro/SS-A and La/SS-B autoantigens consist of a number of antigenic proteins coupled to small RNA molecules. These RNA-protein particles are present in all human cells and are strongly conserved throughout various species. Anti-Ro/SS-A and anti-La/SS-B autoantibodies can be detected using counter-immunoelectrophoresis, immunoblotting technique, ELISA or RNA precipitation assays. The preferred method of screening for anti-Ro/SS-A antibodies in human sera is counter-immunoelectrophoresis; anti-La/SS-B antibodies are best detected with the immunoblotting technique. Anti-Ro/SS-A antibodies are found in 60% of patients with Sjögren's syndrome, but are not specific markers for this disease. Anti-La/SS-B antibodies are present in approximately 40% of patients with Sjögren's syndrome; the only other disease where the antibody has been detected is systemic lupus erythematosus (15% positive). The origin and possible pathogenetic role of autoantibodies in Sjögren's syndrome is still unclear. Our view is that the current evidence supports a mechanism whereby autoantibodies are the product of an oligoclonal B-cell proliferation. The only instance where autoantibodies probably play a direct pathogenetic role is the occurrence of congenital heart block in the offspring of anti-Ro/SS-A and anti-La/SS-B positive mothers.

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