{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T20:28:21Z","timestamp":1792787301944,"version":"4.5.0"},"reference-count":49,"publisher":"BMJ","issue":"3","license":[{"start":{"date-parts":[[2024,8,13]],"date-time":"2024-08-13T00:00:00Z","timestamp":1723507200000},"content-version":"unspecified","delay-in-days":12,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"ASAP-II","award":["09150162010166"],"award-info":[{"award-number":["09150162010166"]}]},{"DOI":"10.13039\/501100003246","name":"Dutch Research Council","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100003246","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/100002491","name":"Bristol-Myers Squibb","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100002491","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["RMD Open"],"accepted":{"date-parts":[[2024,7,22]]},"published-print":{"date-parts":[[2024,8]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>The aim of this study was to assess the histopathological features of the parotid glands in patients with paediatric-onset Sj\u00f6gren\u2019s disease (pedSjD) in comparison to patients with adult-onset Sj\u00f6gren\u2019s disease (adSjD).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This study was performed in Groningen, the Netherlands. Patients with pedSjD from a diagnostic paediatric cohort (n=19), patients with adSjD from a diagnostic adult cohort (n=32) and patients with adSjD who participated in a clinical trial (n=42) with a baseline parotid gland biopsy were included. Parotid gland biopsies were analysed after (immuno)histological staining for SjD-related histopathological markers and compared between groups.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      All characteristic histopathological features of adSjD were also observed in pedSjD. There were no significant differences in lymphoepithelial lesions or immunoglobulin A (IgA)\/IgG plasma cell shift between the pedSjD and the adSjD cohorts. However, compared with the diagnostic adSjD cohort (with comparable total EULAR Sj\u00f6gren\u2019s Syndrome Disease Activity Index (ESSDAI) scores), pedSjD showed more severe lymphocytic infiltration as reflected by a higher focus score (p=0.003), a higher relative surface area of CD45+ infiltrate (p=0.041), higher numbers of B and T lymphocytes\/mm\n                      <jats:sup>2<\/jats:sup>\n                      (p=0.004 and p=0.029, respectively), a higher B\/T lymphocyte ratio (p=0.013), higher numbers of CD21+ follicular dendritic cell networks\/mm\n                      <jats:sup>2<\/jats:sup>\n                      (p=0.029) and germinal centres (GC)\/mm\n                      <jats:sup>2<\/jats:sup>\n                      (p=0.002). Compared with the trial adSjD cohort, with significant higher total ESSDAI scores (p=0.001), only the B\/T lymphocyte ratio and numbers of GC\/mm\n                      <jats:sup>2<\/jats:sup>\n                      were significantly higher in the pedSjD cohort (p=0.023 and p=0.018, respectively).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Patients with pedSjD exhibit more pronounced histopathological features compared with patients with adSjD at diagnosis. Notably, the histopathology of patients with pedSjD aligns more closely with that observed in an adSjD clinical trial cohort, with even stronger B lymphocyte involvement.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/rmdopen-2024-004201","type":"journal-article","created":{"date-parts":[[2024,8,14]],"date-time":"2024-08-14T01:25:11Z","timestamp":1723598711000},"page":"e004201","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":4,"title":["More severe parotid gland histopathology in paediatric-onset than in adult-onset Sj\u00f6gren\u2019s disease"],"prefix":"10.1136","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9576-0904","authenticated-orcid":false,"given":"Geertje Elizabeth","family":"Legger","sequence":"first","affiliation":[{"name":"Pediatric Rheumatology, University Medical Center Groningen, University of Groningen, Groningen, The 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L","family":"Spijkervet","sequence":"additional","affiliation":[{"name":"Oral and Maxillofacial Surgery, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arjan","family":"Vissink","sequence":"additional","affiliation":[{"name":"Oral and Maxillofacial Surgery, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4422-7640","authenticated-orcid":false,"given":"Suzanne","family":"Arends","sequence":"additional","affiliation":[{"name":"Rheumatology and Clinical Immunology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hendrika","family":"Bootsma","sequence":"additional","affiliation":[{"name":"Rheumatology and Clinical Immunology, University Medical 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