Clinical Features And Absolute Number Of Lymphocyte Subsets In Peripheral Blood Of Primary Sj?gren’s Syndrome Patients With Hashimoto’s Thyroiditis

Objective:By analyzing the clinical features and absolute number of lymphocyte subsets in peripheral blood of patients with primary Sj?gren’s Syndrome(pSS)alone and pSS patients with Hashimoto’s Thyroiditis,to explore the clinical and immune characteristics of comorbidities between pSS and Hashimoto’s Thyroiditis.Methods:A total of 174 untreated inpatients who were diagnosed with pSS in our hospital from 2014 to 2019 were enrolled,of which 100 patients were diagnosed with pSS alone,and left 74 patients also diagnosed with Hashimoto’s Thyroiditis.We compared the basic and clinical data of the two groups.In addition,74 healthy people(HC)with matched age and sex were selected as control group.Then compared the differences in absolute number of lymphocyte subsets in peripheral blood among the three groups.We also analyzed the correlation between Th17/Treg and C3,C4 and IgG in patients with pSS and HT.Results:There were no significant differences in gender,age and disease duration in the pSS patients with or without Hashimoto’s Thyroiditis.Clinical symptoms,for example fatigue,tooth mass loss and interstitial lung disease,were more frequent in pSS patients with Hashimoto’s Thyroiditis.There were also no significant difference in the levels of erythrocyte sedimentation rate,C-reactive protein,and C3 between two groups.(P>0.05),but pSS patients without HT had higher level of IgG and lower level of C4(P<0.05).As for autoantibodies,ANA and SSA positive results were significantly more frequent among patients with hypothyroidism(P<0.05).Compared with HC,the absolute value of Treg cells were decreased in all pSS patients(P<0.001),and Th17/Treg ratio was increased(all P<0.05),and the absolute value of Th1 cells were increased(all P<0.001),and the absolute value of NK cells were decreased(P<0.001).Compared with the HC,the absolute value of Th17 cells were increased(P<0.01),and Th1/Th2 ratio was increased(P<0.001)in pSS patients without Hashimoto’s Thyroiditis.Compared with the HC,the absolute value of Th17 cells were increased(P<0.001),and Th1/Th2 ratio was increased(P<0.01)in pSS patients with Hashimoto’s Thyroiditis.Compared with the HC,the absolute value of B cells in the pSS patients without Hashimoto’s Thyroiditis was significantly increased(P<0.05),while the absolute value of B cells in the pSS patients with Hashimoto’s Thyroiditis was no difference compared with the HC.Compared with the pSS patients,the pSS with Hashimoto’s Thyroiditis patients had a decrease of Treg cells(P<0.01),and an increase of Th17 cells(P<0.01)and the Th17/Treg ratio(P<0.05).The ratio of Th17/Treg in pSS patients with Hashimoto’s Thyroiditis was negatively correlated with the levels of C3 and C4,and positively correlated with the level of IgG.Conclusion:In our study,Fatigue,tooth mass loss and interstitial lung disease were more frequent in pSS patients with Hashimoto’s Thyroiditis,and pSS-HT patients had higher autoantibodies(e.g.,ANA、SSA)rates than those without HT.Patients with pSS and HT had disorders of lymphocyte subsets in peripheral blood,especially the imbalance of Th17/Treg ratio,which is related to complements and IgG.