Male patients with primary Sjögren's syndrome have unique clinical manifestations and circulating lymphocyte profiles

Abstract

Objectives: We aimed to explore the relationship between clinical characteristics and circulating lymphocyte profiles in Chinese male patients with primary Sjögren's syndrome (pSS).

Method: Data from 397 patients with pSS were analyzed retrospectively. 37 were male, which is a prevalence of 9.3%. The clinical, laboratory, and immunophenotypic profiles of peripheral blood lymphocyte subsets were compared between male and female pSS patients.

Results: Male patients with primary Sjögren's syndrome have unique clinical manifestations and circulating lymphocyte profiles. Male patients complained more about xerophthalmia and presented with more extra-glandular manifestations as compared with female patients. The CD4⁺/CD8⁺ ratio (P = 0.030), the prevalence of CD4^-CD8^- T cells in lymphocytes (P = 0.020), the absolute number of CD4^-CD8^- T cells (P = 0.035), the prevalence of CD4⁺ T cells in lymphocytes (P < 0.001), and the absolute number of CD4⁺ T cells (P = 0.023) were significantly lower in male patients compared to female patients. On the other hand, the prevalence of CD8⁺CD28⁺ T cells (P = 0.030) and CD4⁺CD25^high T cells (P = 0.040) in lymphocytes was significantly higher in male patients than in female patients. Moreover, compared to females with pSS, an elevated serum IgG level, low C3 and C4 levels, anti-SSB positivity, and ANA titers of ≥ 1:160 positivity were more frequent in male with pSS.

Conclusions: Male patients with pSS have distinctive peripheral blood lymphocyte subpopulations, present with more severe clinical symptoms and immunological features, and have an unfavorable prognosis. Key Points • Male patients with pSS have more severe clinical symptoms and specific characteristics of peripheral blood lymphocyte subsets. • Male pSS patients exhibit a higher intensity of the disease (as evaluated by ESSDAI). • Male patients with pSS require individualized treatment regimens and closer follow-up.

Keywords: Clinical characteristics; Lymphocyte profile; Male; Primary Sjögren's syndrome.