Toggle Main Menu Toggle Search

Open Access padlockePrints

Systemic interferon type I and type II signatures in primary Sjögren’s syndrome reveal differences in biological disease activity

Lookup NU author(s): Shereen Al-Ali, Dr Jessica Tarn, Dr Dennis LendremORCiD, Dr Bridget Griffiths, Professor Fai NgORCiD



This is the authors' accepted manuscript of an article that has been published in its final definitive form by Oxford University Press, 2018.

For re-use rights please refer to the publisher's terms and conditions.


ObjectiveTo assess the relationships between systemic IFN type I (IFN-I) and II (IFN-II) activity and disease manifestations in primary SS (pSS). MethodsRT-PCR of multiple IFN-induced genes followed by principal component analysis of whole blood RNA of 50 pSS patients was used to identify indicator genes of systemic IFN-I and IFN-II activities. Systemic IFN activation levels were analysed in two independent European cohorts (n = 86 and 55, respectively) and their relationships with clinical features were analysed.ResultsThree groups could be stratified according to systemic IFN activity: IFN inactive (19–47%), IFN-I (53–81%) and IFN-I + II (35–55%). No patient had isolated IFN-II activation. IgG levels were highest in patients with IFN-I + II, followed by IFN-I and IFN inactive patients. The prevalence of anti-SSA and anti-SSB was higher among those with IFN activation. There was no difference in total-EULAR SS Disease Activity Index (ESSDAI) or ClinESSDAI between the three subject groups. For individual ESSDAI domains, only the biological domain scores differed between the three groups (higher among the IFN active groups). For patient reported outcomes, there were no differences in EULAR Sjögren’s syndrome patient reported index (ESSPRI), fatigue or dryness between groups, but pain scores were lower in the IFN active groups. Systemic IFN-I but not IFN-I + II activity appeared to be relatively stable over time.ConclusionsSystemic IFN activation is associated with higher activity only in the ESSDAI biological domain but not in other domains or the total score. Our data raise the possibility that the ESSDAI biological domain score may be a more sensitive endpoint for trials targeting either IFN pathway.

Publication metadata

Author(s): Bodewes ILA, Al-Ali S, vanHelden-Seeuwsen CG, Maria NI, Tarn JR, Lendrem DW, Schreurs MWJ, Steenwijk EC, vanDaele PLA, Both T, Bowman SJ, Griffiths B, Ng WF, Versnel MA

Publication type: Article

Publication status: Published

Journal: Rheumatology

Year: 2018

Volume: 57

Issue: 5

Pages: 921-930

Print publication date: 01/05/2018

Online publication date: 20/02/2018

Acceptance date: 20/11/2017

Date deposited: 29/07/2019

ISSN (print): 1462-0324

ISSN (electronic): 1462-0332

Publisher: Oxford University Press


DOI: 10.1093/rheumatology/kex490


Altmetrics provided by Altmetric


Funder referenceFunder name
British Sjogren's Syndrome