Cell-mediated immunity in Sjögren's syndrome.

The triad of keratoconjunctivitis sicca (KCS), salivary gland involvement (increase in size or xerostomia), and rheumatoid arthritis was described by Sjogren (1933) as a rare syndrome. Any two of the triad were sufficient to make the diagnosis. Subsequently the syndrome has been extended to include disseminated lupus erythematosus (Morgan, 1954; Ramage and Kinnear, 1956; Bain, 1960), systemic sclerosis (Schaposnik, Bergna, and Conti, 1955), polyarteritis nodosa (Shearn, 1960), and polymyositis (Shearn, 1960), instead of rheumatoid arthritis. More recently it has been described in liver diseases not necessarily associated with an arthropathy (Golding, Bown, Mason, and Taylor, 1970). An immune basis has been suggested for this syndrome, and there is good evidence of altered circulating autoantibodies (Bloch, Bunim, Wohl, and Zvaifler, 1960). Sjogren showed histological evidence of small round cell infiltration in the parotid and sublingual glands, but little work has so far been carried out on specific cell-mediated immunity. In this study the leucocyte migration test has been used to investigate cell-mediated immunity to parotid and liver antigens in patients with Sj6gren's syndrome, with rheumatoid arthritis, and with autoimmune liver disease (chronic active hepatitis and primary biliary cirrhosis). In selected patients buccal salivary gland histology has been studied.