Clinicopathoiogical Analysis Of CSS And Establishmentof CSS-like Animal Model Via Induction Of MDP

Objectives:Investigate and summarize clinicopathological characteristics of ChronicSclerosing Sialadenitis, CSS, and try to establish CSS-like animal model via inductionof MDP (Muramyl Dipeptide, MDP).Methods:1. Retrospective analysis and diagnosis were taken to64patients with chronicsialadenitis among January2005to January2014. Select13CSS as experimentalgroup and51nonspecific chronic sialadenitis as contral group by immunochemicalstaining of IgG and IgG4. We contrast clinicopathological manifestation, and analyzeCD68immunochemical staining results in these two groups;2. Inject mixture of MDP and immunologic adjuvant to the right submandibularglands of rats in experimental group once a week, while those in control group weretaken injection of mixture of MDP and PBS in the right submandibular glands. After4,6,8weeks, we took peripheral blood and bilateral submandibular glands, parotidglands and pancreases of rats for blood routine analysis, ELISA, and histologicalanalysis.Results：1. There is no obvious difference between groups in age and gender. CSS group:most patients asked for treatment because of painless unilateral or bilateral swelling insalivary glands.4patients had other organs involved except salivary gland.(1waspancreas,3were lacrimal glands). CSS group revealed the characteristics asfibroplasia rich in cells of plasma cells and lymphocytes. Moreover,11showedproliferation of lymphoid follicles with unregular germinal centers. There are plentyof CD68positive cells infiltrating in the tissues.The control groups: patients showedrepeated pain salivary gland swelling. No one had other organs problems. Theinfiltration of lymphocytes also can be found in control groups, but there were less ornone cells inthe fibroplasia. Except for one, others had proliferation of lymphoidfollicles with regular germinal centers. There are CD68positive cells in the tissues of some patients.2. These right submandibular glands of both experimental and control rats hadincreased. After injection, on the hand, experimental rats had higher percent ofmonocyte in peripheral blood4weeks later (P<0.05) and8weeks later (P<0.01); onthe other hand, the control group revealed much more lymphocytes (P<0.05)8weekslater. Moreover,8weeks later, IgG1in the serum of experimental group showedhigher concentration than that of control group (P<0.05), which was opposite inIgG2b (P<0.05). Since4weeks, we have found fibroplasia and inflitration oflymphocytes in bilateral submandibular glands of experimental rats. Particularly theinflammation changes in left submandibular glands of experimental rats revealedmuch more obvious than these in control group.Conclusion:1. There is no obvious difference between CSS and nonspecific chronicsialadenitis in clinical manifestation. Even with the characteristics of infiltration oflymphocytes and fibroplasia, it is hard to distinguish CSS and nonspecific chronicsialadenitis. We still need immunochemical staining for IgG4and IgG to make adiagnosis.2. Macrophage may contribute to the pathogenesis of CSS.3. The rats show similar manifestation to human CSS after immunized by MDP,MDP possibly plays role in the pathogenesis of CSS, by promoting abnormal innateimmunity response with monocyte-macrophage system. It is possible to establishCSS-like animal model via induction of MDP (Muramyl Dipeptide, MDP).