However, it remains to be clarified whether DCs may participate in the pathogenesis of other autoimmune diseases. Previously we have demonstrated that, in primary SS, blood immature myeloid DCs are decreased and mature myeloid DCs are accumulated in salivary glands, suggesting the recruitment of myeloid DCs from blood to inflamed salivary glands. In addition, we demonstrated that numerous IFN-γ-producing CD4+ T cells are also infiltrated into the salivary glands from primary SS patients [2]. Based upon these findings, we proposed a hypothesis that myeloid DCs play a role in pathogenesis of primary SS by initiating Th1 immune response. In this study, we report

that the decrease PD-0332991 chemical structure of blood myeloid DCs and accumulation of salivary gland-infiltrating DCs is universal in the early phase of not only primary SS but also secondary SS, and this alteration was restored spontaneously during the natural clinical course. As shown in Table 1, patients enrolled into this study comprised 24 patients with secondary SS (two men and 22 women, mean age 55·5 years), 29 with primary SS (two men and 27 women, mean age 58·6 years), 11 with SLE (two men and nine women, mean age 25·3 years),

14 with SSc (one man and 13 women, mean age 54·9 years) and 12 with RA (three men and nine women, mean age 55·9 years). In addition, 32 healthy volunteers (12 men and 20 women, mean age 48·0 years) were also enrolled into this study as normal this website controls. All patients presented to our hospital between May 1999 and June 2003 and were diagnosed freshly as having autoimmune diseases. No patients or volunteers had evidence of infections at the time of this study. All patients underwent routine laboratory examinations and

were also examined for a variety of autoantibodies. Informed consent was obtained for this study in accordance Phospholipase D1 with the provisions of the Declaration of Helsinki. All SS patients met the criteria of the Research Committee on SS of the Ministry of Health and Welfare of Japan [12], as well as the European Community criteria [13]. Patients with SLE or SLE-merged secondary SS fulfilled the diagnostic criteria for SLE of the American College of Rheumatology (ACR) [14,15]. Patients with RA or RA-merged secondary SS fulfilled the diagnostic criteria for RA of the ACR [16]. Patients with SSc or SSc-merged secondary SS fulfilled the diagnostic criteria for SSc of the ACR [17]. We determined the onset of SS by a patient complaint about Sicca syndrome in a medical interview (Table 1). In order to assess whether the number of peripheral blood DCs (PBDCs) changes during the natural course of primary SS, six primary SS patients with long-term follow-up were examined sequentially. All the six primary SS patients’ PBDCs were examined in the chronic phase of the disease, 24 months or after the onset of Sicca syndrome [all women, mean age 56·5 years (range 51–71 years)].