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Objective: To investigate serum and salivary neopterin and interferon-γ as possible markers of immune system activation in primary Sj&omul;gren's Syndrome (pSS). Methods: Serum and salivary neopterin and interferon-γ concentrations were determined in 30 untreated patients with pSS and matched with several other clinical and laboratory parameters. Results: The mean concentration of neopterin was significantly higher in pSS patients (8.12±3.36 nmol/L in serum and 9.50±7.61 nmol/L in saliva) than in normal controls (p<0.05). Significant correlations were found between serum neopterin and β2-microglobulin, serum IgG as well as lip biopsy score. Salivary neopterin concentration was inversely related to Shirmer-I test, tear break-up time and stimulated salivary flow rate. Serum and salivary levels of interferon-c were normal and no correlation with the other parameters was found. Conclusion: In pSS patients serum neopterin may represent a useful marker of cell-mediated immunity. On the other hand, salivary neopterin seems to reflect the glandular damage. [ABSTRACT FROM AUTHOR]

Objective: To investigate the sensitivity and specificity of anti-alpha-fodrin antibodies in patients with primary Sjögren's syndrome (pSS)., Methods: IgA and IgG anti-alpha-fodrin antibodies were measured in the sera of 80 patients with pSS, 60 blood donors matched for age and sex, 50 patients with systemic lupus erythematosus (SLE), 30 with rheumatoid arthritis (RA), 20 with systemic sclerosis (SSc), and 10 with polymyositis or dermatomyositis (PM/DM) by an ELISA method employing recombinant human alpha-fodrin as antigen., Results: The sensitivity of IgA and IgG anti-alpha-fodrin antibodies for pSS was 32.50% and 21.25%, respectively. When the prevalence of these antibodies in patients with SLE, RA, SSc, and PM/DM was evaluated, we observed specificity of these antibodies of 68.18% and 79.09%, respectively. The sensitivity and specificity for pSS of the combined determination of IgA and IgG anti-alpha-fodrin antibodies were 40% and 58.18%, respectively., Conclusion: The prevalences of IgA and IgG anti-alpha-fodrin antibodies in our patients with pSS and other chronic autoimmune diseases have induced us to doubt their use as diagnostic markers of pSS.

Infliximab is a chimeric anti-tumor necrosis factor alpha (anti-TNF-alpha) monoclonal IgG1 antibody successfully used for the treatment of active rheumatoid arthritis (RA) not completely controlled with methotrexate or other disease modifying anti-rheumatic drugs. We evaluated both clinical efficacy and safety of infliximab in 63 patients with persistently active RA (Disease activity score > or = 3.7). All the patients received infliximab (3 mg/Kg) at week 0, 2, 6 and then every 5 weeks in combination with methotrexate (7.5-10 mg/week) in an open label study. At week 14th, ACR 20% response criteria have been fulfilled by 43 (91.4%) out of 47 patients, 31 (72%) of them achieving also an ACR 50% and 9 (21%) an ACR 70% response. At the time of this report 33 patients touched 22 weeks of treatment: ACR 20% response was achieved in 95%, while ACR 50% and ACR 70% were respectively found in 78% and 39% of the cases. Only 1 case of bronchopulmonary mycosis and 2 of mild urticaria were observed. The initiation of infliximab therapy in patients with active RA resulted in a rapid and sustained improvement of articular manifestations and quality of life. Even though, major adverse events were rare, clinicians should be aware of this possibility.