Monday, September 30, 2013

A New Diagnostic Test for Sero-Negative Sjoggies?

Immundot image found here. 

It's a story that I've heard over and over from frustrated readers: "I have all of the symptoms on Sjogren's syndrome, but the doctor told me that my blood doesn't have the anti-SSA/SSB antibodies. I wish that I knew what was making me feel so sick."

For these patients, an invasive and uncomfortable lip biopsy could be next in the diagnostic process, which may or may NOT prove the presence of Sjogren's syndrome.

It appears that another test may be available in the future which would offer patients and their health care teams another clue to their illness' identity. Thanks to the Sjogrens Soc. Canada's tweet that alerted me to this recently published study, found here:

Anti-SSA Ro52/Ro60 antibodies testing by immunodot could help the diagnosis of Sjogren's syndrome in the absence of anti-SSA/SSB antibodies by ELISA.
Mekinian A, Nicaise-Roland P, Chollet-Martin S, Fain O, Crestani B.
Rheumatology (Oxford). 2013 Sep 11. [Epub ahead of print]
Objective. The objective of this study was to assess the diagnostic value of anti-Ro52/60 antibodies by immunodot in patients with suspected SS..........Conclusion. In patients with dry eye/mouth syndrome without anti-SSA/SSB antibodies by ELISA, the detection of anti-Ro52/Ro60 antibodies by dot could help in the diagnosis of SS.

It will be interesting to see if this type of diagnostic test will be made available on a large scale any time soon. Let's keep our eyes peeled.


Katherine Lovett said...

This was me. I had to have a lip biopsy for confirmation. Blech!

Kelly said...

Yup, sero-negative, symptom positive. In wait-and-see mode for several years. This is interesting, definitely. Thanks for posting.

Melissa - 710.9 said...

Hooray! Like other autoimmune conditions, SS is best handled with early treatment. The key to early treatment? Early diagnosis! Let's hope this decreases diagnostic time.

Anonymous said...

The Nicox Immco early SJogren's test was only tested on mice - no human subjects have ever been evaluated in a research study with it. The Immco staff refuse to discuss the test with Dr. Birnbaum at Johns Hopkins and Dr. Vivino at Penn Sjogren's despite their formal requests to discuss the test. The Immco research has never been duplicated by any other lab - their results remain unreplicated, primarily because they won't share their their research so that anyone else can try to replicate it.

The Nicox Immco test can only be regarded as being a scam. Save your money and everyone's time by skipping this test. It is worthless.

Anonymous said...

Continued from above comment....

Moving on...the anti SSA Ro52 early Sjogren's test that is the subject of this blog post is pretty shaky right now, but at least some people doing some research into Sjogren's.

This article: suggests that anti-Ro52 antibodies are not at all specific for Sjogren's, but may also be positive in many other illnesses.

For the 155 out of 247 human subjects that were positive for anti-Ro52 and negative for the standard (Sjogren's=type) anti-Ro60:

"Clinical data from the 155 patients showed high prevalence in autoimmune diseases (73%) including myositis or dermatomyositis (n=30), lupus (n=23); Sjögren and/or sicca syndrome (n=27); CREST or Systemic sclerosis (n=11) and autoimmune hepatitis (n=11). We found that pulmonary manifestations were often associated with the presence of anti-Ro52 antibodies (n=34, 22%)"

So, it would appear that according to one group in 2011, that alone, anti-Ro52 in the absence of anti-Ro60 indicated not only Sjogren's, but all of the other diseases listed.

Still, as was said in the original Blog post, hopefully this will lead to some useful, practical progress in the early diagnosis and management of Sjogren's, and it is a good blog post. Also, Melissa's comment is right on!

(I mentioned the Immco early Sjogren's detection test first, because a lot of people are confused about that test, and the truth about the unscientific scammy basis of that test needs to be known.)

Anonymous said...

A day later I realize that the study I referenced in the two anonymous posts above, and the one Julia originally posted about, are written by many of the same authors and with the same inconclusive and unconvincing results.

This group is obviously flogging a failed technology - it was a good start with a theory of Ro52 but it turned out to be nonspecific in the first study, and remained equally nonspecific in the second study.

I would encourage this research group to keep trying, except that the second paper was not needed years after the first one, so I don't trust them now and suspect they are approaching a dangerous place where they become of more con-men than scientist.

On the other hand, publication of failed results can be as useful as publication of successful ones. It can stop other scientists from repeating the same mistakes, or may contain a germ of some idea that eventually turns out to be successful.

I thank Julia for posting this - it is interesting, even now in 2015.