Serological Influences on Dry Eye: Insights from the Sjögren's International Collaborative Clinical Alliance
Purpose: To define associations between serologies, specifically Sjögren syndrome–related antigen A (SSA) antibody and immunoglobulin (Ig) levels, on ocular profiles in patients enrolled in the Sjögren's International Collaborative Clinical Alliance (SICCA) cohort. Design: A retrospective cohor...
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Elsevier
2025-11-01
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| Series: | Ophthalmology Science |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2666914525001411 |
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| author | Chloe Shields, BS Pragnya Rao Donthineni, MD Rohit Muralidhar, BS Shreya Bhatt, MS Ema V. Karakoleva, BS Alan Baer, MD Robert Fox, MD Sara S. McCoy, MD, PhD Anat Galor, MD, MSPH |
| author_facet | Chloe Shields, BS Pragnya Rao Donthineni, MD Rohit Muralidhar, BS Shreya Bhatt, MS Ema V. Karakoleva, BS Alan Baer, MD Robert Fox, MD Sara S. McCoy, MD, PhD Anat Galor, MD, MSPH |
| author_sort | Chloe Shields, BS |
| collection | DOAJ |
| description | Purpose: To define associations between serologies, specifically Sjögren syndrome–related antigen A (SSA) antibody and immunoglobulin (Ig) levels, on ocular profiles in patients enrolled in the Sjögren's International Collaborative Clinical Alliance (SICCA) cohort. Design: A retrospective cohort study. Subjects: Individuals from the SICCA cohort (n = 3514). Methods: A retrospective analysis to examine relationships between dry eye (DE) symptoms and signs and serologic status, including SSA (SSA+ Sjögren disease [SjD], SSA− SjD, non-SjD) and Ig (G, A, M) levels (low, normal, and high). Main Outcome Measures: Univariate analyses using analysis of variance and chi-square tests examined differences in ocular profiles by serologies. Multivariable analyses were then performed to account for potential confounding variables, including other serological measures. Results: The mean age of the SICCA cohort was 53 ± 13 years, with the majority identifying as female (91%, n = 3185) and White (54%, n = 1894). The presence of SSA impacted ocular profiles, with the SSA+ SjD group reporting less severe symptoms compared with the SSA− SjD and non-SjD groups (spontaneous pain: 2.61 ± 2.83 vs. 3.39 ± 3.01 vs. 3.52 ± 3.09, P < 0.001), but more frequently having ocular signs (low tear production: 57% vs. 52% vs. 28%, P < 0.001; ocular surface staining [OSS]: 83% vs. 69% vs. 35%, P < 0.001). Immunoglobulin levels showed a similar pattern, with the high IgG level group reporting less severe ocular symptoms in the SjD (spontaneous pain: 2.41 ± 2.82 vs. 3.10 ± 2.91 vs. 3.40 ± 2.96; P < 0.001 and P < 0.05) and non-SjD (spontaneous pain: 2.09 ± 2.35 vs. 3.58 ± 3.11 vs. 3.85 ± 3.11; P < 0.001) groups but more severe signs (SjD group: low tear production: 60% vs. 53% vs. 49%; OSS: 88% vs. 72% vs. 70%; P < 0.001) compared with the normal and low-level groups. A similar pattern was noted for IgA levels. Most associations remained significant when considered concomitantly. Conclusions: Ocular manifestations of DE are influenced by serological factors. Specifically, SSA+ and high IgG and IgA status align with a disease picture of clinical signs of DE disease out of proportion to pain symptoms, while SSA− and low and normal IgG and IgA status align with a DE disease picture of symptoms that outweigh signs. Financial Disclosure(s): Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article. |
| format | Article |
| id | doaj-art-eebaa2a1e7724711adbb43944671f53b |
| institution | DOAJ |
| issn | 2666-9145 |
| language | English |
| publishDate | 2025-11-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Ophthalmology Science |
| spelling | doaj-art-eebaa2a1e7724711adbb43944671f53b2025-08-20T03:17:36ZengElsevierOphthalmology Science2666-91452025-11-015610084310.1016/j.xops.2025.100843Serological Influences on Dry Eye: Insights from the Sjögren's International Collaborative Clinical AllianceChloe Shields, BS0Pragnya Rao Donthineni, MD1Rohit Muralidhar, BS2Shreya Bhatt, MS3Ema V. Karakoleva, BS4Alan Baer, MD5Robert Fox, MD6Sara S. McCoy, MD, PhD7Anat Galor, MD, MSPH8University of Miami Miller School of Medicine, Miami, Florida; Department of Ophthalmology, Miami Veterans Affairs Medical Center, Miami, Florida; Bascom Palmer Eye Institute, University of Miami, Miami, FloridaBascom Palmer Eye Institute, University of Miami, Miami, Florida; Shantilal Shanghvi Cornea Institute, L.V. Prasad Eye Institute, Hyderabad, IndiaNova Southeastern University College of Osteopathic Medicine, Davie, FloridaDepartment of Ophthalmology, Miami Veterans Affairs Medical Center, Miami, Florida; Bascom Palmer Eye Institute, University of Miami, Miami, Florida; Nova Southeastern University College of Osteopathic Medicine, Davie, FloridaDepartment of Ophthalmology, Miami Veterans Affairs Medical Center, Miami, Florida; Penn State University College of Medicine, Hershey, PennsylvaniaDivision of Rheumatology, Johns Hopkins University School of Medicine, Baltimore, MarylandDivision of Rheumatology, Scripps Memorial Hospital and Research Foundation, San Diego, CaliforniaUniversity of Wisconsin School of Medicine and Public Health, Madison, WisconsinDepartment of Ophthalmology, Miami Veterans Affairs Medical Center, Miami, Florida; Bascom Palmer Eye Institute, University of Miami, Miami, Florida; Correspondence: Anat Galor, MD, MSPH, Bascom Palmer Eye Institute, 1201 NW 16th St, Miami, Florida 33125.Purpose: To define associations between serologies, specifically Sjögren syndrome–related antigen A (SSA) antibody and immunoglobulin (Ig) levels, on ocular profiles in patients enrolled in the Sjögren's International Collaborative Clinical Alliance (SICCA) cohort. Design: A retrospective cohort study. Subjects: Individuals from the SICCA cohort (n = 3514). Methods: A retrospective analysis to examine relationships between dry eye (DE) symptoms and signs and serologic status, including SSA (SSA+ Sjögren disease [SjD], SSA− SjD, non-SjD) and Ig (G, A, M) levels (low, normal, and high). Main Outcome Measures: Univariate analyses using analysis of variance and chi-square tests examined differences in ocular profiles by serologies. Multivariable analyses were then performed to account for potential confounding variables, including other serological measures. Results: The mean age of the SICCA cohort was 53 ± 13 years, with the majority identifying as female (91%, n = 3185) and White (54%, n = 1894). The presence of SSA impacted ocular profiles, with the SSA+ SjD group reporting less severe symptoms compared with the SSA− SjD and non-SjD groups (spontaneous pain: 2.61 ± 2.83 vs. 3.39 ± 3.01 vs. 3.52 ± 3.09, P < 0.001), but more frequently having ocular signs (low tear production: 57% vs. 52% vs. 28%, P < 0.001; ocular surface staining [OSS]: 83% vs. 69% vs. 35%, P < 0.001). Immunoglobulin levels showed a similar pattern, with the high IgG level group reporting less severe ocular symptoms in the SjD (spontaneous pain: 2.41 ± 2.82 vs. 3.10 ± 2.91 vs. 3.40 ± 2.96; P < 0.001 and P < 0.05) and non-SjD (spontaneous pain: 2.09 ± 2.35 vs. 3.58 ± 3.11 vs. 3.85 ± 3.11; P < 0.001) groups but more severe signs (SjD group: low tear production: 60% vs. 53% vs. 49%; OSS: 88% vs. 72% vs. 70%; P < 0.001) compared with the normal and low-level groups. A similar pattern was noted for IgA levels. Most associations remained significant when considered concomitantly. Conclusions: Ocular manifestations of DE are influenced by serological factors. Specifically, SSA+ and high IgG and IgA status align with a disease picture of clinical signs of DE disease out of proportion to pain symptoms, while SSA− and low and normal IgG and IgA status align with a DE disease picture of symptoms that outweigh signs. Financial Disclosure(s): Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.http://www.sciencedirect.com/science/article/pii/S2666914525001411Dry eyeSerologySjögren disease |
| spellingShingle | Chloe Shields, BS Pragnya Rao Donthineni, MD Rohit Muralidhar, BS Shreya Bhatt, MS Ema V. Karakoleva, BS Alan Baer, MD Robert Fox, MD Sara S. McCoy, MD, PhD Anat Galor, MD, MSPH Serological Influences on Dry Eye: Insights from the Sjögren's International Collaborative Clinical Alliance Ophthalmology Science Dry eye Serology Sjögren disease |
| title | Serological Influences on Dry Eye: Insights from the Sjögren's International Collaborative Clinical Alliance |
| title_full | Serological Influences on Dry Eye: Insights from the Sjögren's International Collaborative Clinical Alliance |
| title_fullStr | Serological Influences on Dry Eye: Insights from the Sjögren's International Collaborative Clinical Alliance |
| title_full_unstemmed | Serological Influences on Dry Eye: Insights from the Sjögren's International Collaborative Clinical Alliance |
| title_short | Serological Influences on Dry Eye: Insights from the Sjögren's International Collaborative Clinical Alliance |
| title_sort | serological influences on dry eye insights from the sjogren s international collaborative clinical alliance |
| topic | Dry eye Serology Sjögren disease |
| url | http://www.sciencedirect.com/science/article/pii/S2666914525001411 |
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